Eye OSCE

Question 1

What should you look for with inspection of the eye?

Answer 1

symmetry

orbits

lids and lid margins

sclera

conjunctiva

pupils

Question 2

Describe the steps that you should use for eyelind eversion

Answer 2

Used in order to look for a foreign body

Patient looks downward, fingers pull the lid down and the cotton swab or finger is placed on the upper tarsal border

The lid is pulled up over the finger and everted

Basically pinch and pull up

Question 3

_______ is when the pupil is exposed to a light source and constricts

Answer 3

Direct

Question 4

This is when one pupil is exposed to light and the other constricts

Answer 4

Consensual

Question 5

This is when the pupils constrict as the object comes closer to the eyes

Answer 5

Convergence

Question 6

______ is unequal size of the pupils

Answer 6

Anisocoria

Question 7

What is the average pupil size?

Answer 7

4 mm

Question 8

How do you test for a red reflex?

Answer 8

Using the ophthalamoscope, the patient should look directly at the light from an arms ligth away

Question 9

________ is another word for the white reflex and can indicate a serious pathology like a congenital cataract, retinal blastoma, retinal detachment, or other serious conditions

Answer 9

Leukocoria

Question 10

_________ is a neuroectodermal malignancy arising from embryonic retinal cells; can cause childhood blindness; leukocoria is present before

Answer 10

retinoblastoma

Question 11

What cranial nerves are being tested with the cardinal signs of gaze?

Answer 11

3, 4, 6

Question 12

What is the purpose of the cover and uncover test?

Answer 12

Used to identify weaknesses of the EOM

eyes should remain syncrhonous

Question 13

_______ is the ocular ataxia or rhythmical oscillation of the eyes tested with horizontal eye motion

Answer 13

nystagmus

Question 14

Describe the eyes in the caloric reflex

Answer 14

If there is cold water inserted into the ear, the eyes move AWAY in the slow phase, which means that nystagmus is TOWARDS in the fast phase

Question 15

How do you test for visual field confrontation

Answer 15

 Ask patient to look directly into your eyes as you stand about an arm’s length away

 Imagine a bowl between you and hold your fingers at arm’s length and wiggle your fingers as you move them along the edges of the bow approaching the patient’s central visual field

 Estimate the extent of the peripheral vision

 If you suspect loss in a visual field, test each eye by patient covering one eye, you cover your own eye opposite, then use one hand to wiggle along the imaginary bowl in that visual field– if you can see the wiggle, so should the patient – then repeat with the other eye

Question 16

True or False: recent studies suggest that the static finger wiggle and the kinetic red tests be used together

Answer 16

True it increases the sensitivity and specificity

Question 17

When would you use a fluorescein stain? Why does it work?

Answer 17

Used to find any epithelial defects and is performed after a complete examination

The dye has a high affinity for the basement membrane and fluresces with a blue or woods lamp

Question 18

Yall know how to do an snellen eye chart exam if you dont well….

Answer 18

learn it then

Question 19

________ is the acute painful inflammation of the eyelid margins or the meibomian glands

Answer 19

Hordeolum

Question 20

_______ _______ is caused by a meibomian gland that is acutely plugged

Answer 20

Internal hordeolum

Question 21

______ ______ is caused by an eyelash follicle or lid margin tear gland that is inflammed

Answer 21

External hordeolum

Question 22

_______ is the painless, rubbery, nodule lesion that is caused when a meibomian gland becomes obstructed

Answer 22

chalazion

*** more common in the upper eyelid

Question 23

_______ are benign soft yellow plaques filled with cholesterol that are found on the eye; usually the medial aspects of the eye

Answer 23

Xanthelasma

Question 25

______ ______ is spread by direct contact and consists of purulent drainage throughout the day; S. aurelus is most common during the day and M. catarrhalis is most common in kids

Answer 25

Bacterial conjunctivitis

Question 26

_____ ______ also spreads by direct contact but is characterized by a gritty feeling in the eyes with clear discharge; typically starts unilateral but spreads to bilateral

Answer 26

viral conjunctivitis

Question 27

_______ is a benign growth of fibroblastic tissue on the eye on the medial side

Answer 27

Pterygium

Question 28

_____ is blood in the anterior chamber of the eye and is typically caused by trauma but can be secondary to clotting disturbances or vascular abnormalities

Answer 28

Hyphema

Question 29

What is pictured here?

Answer 29

subconjunctival hemorrhage: does not affect vision; may result from trauma, bleeding disorders, or increased vascular pressure

Question 30

______ ______ ______ is an ophthalmologic emergency that is caused by trauma leading to retrobulbar hematoma; leads to increased intraocular pressure

Patients will present with progressive pain, diplopia, and diffuse subconjunctival hemorrhage and chemosis

Answer 30

Orbital compartment syndrome