Eyes

Question 1

How can you assess depth of the anterior chamber?

Answer 1

stand in front of the pt

shine light from temporal side of patient’s eye

look for a crescent shadow (indicates a shallow anterior chamber) which is abnormal

-increases risk of acute angle closure glaucoma

Question 2

myopia

Answer 2

impaired far vision

Question 3

presbyopia

Answer 3

impaired near vision

occurs in middle age and beyond. may see better when card is held further away

Question 4

How can you test vision with a snellen chart

Answer 4

Snellen chart @20 feet

Patient covers 1 eye and reads lowest line available

Question 5

Acute angle closure glaucoma

Answer 5

less common form of glaucoma

results in sudden increase in IOP and eye pain

crescent shadow present

Question 6

open angle glaucoma

Answer 6

common form

IOP is increased but angle is normal

No crescent shadow present

Question 7

Corneal light reflection

Answer 7

test conjugate gaze by shining light 2 feet in front of pt

normal: symmetric reflection

Abnormal: asymmetric (indicates strabismus)

Question 8

Strabismus

Answer 8

deviation from normal conjugate position (crossed eye)

• convergent strabismus (esotropia): eyes move inward
• divergent strabismus (exotropia): eyes move outward

Question 9

If corneal light reflection is abnormal, what should you do?

Answer 9

check cover-uncover test

• to uncover an imbalance of extra ocular eye muscle tone
• cover the normal eye with card
• the abnormal (weak) eye will move to correct position
• uncover the normal eye
• the abnormal eye will deviate
• if you perform the test by covering the abnormal eye, there will be no change

Question 10

miosis

Answer 10

pupil constriction

Question 11

mydriasis

Answer 11

pupil dilation

Question 12

Horner’s Syndrome

Answer 12

• Ptosis
• Anhidrosis
• Miosis

due to dysfunction of the sympathetic nervous system

may be congenital or association with disease

Question 13

anhidrosis

Answer 13

absent sweating on affected side

Question 14

anisocria

Answer 14

unequal pupil size >.5mm

Question 15

Tonic (Adie’s) Pupil

Answer 15

affected pupil is larger

reduced reaction to light

due to dysfunction of parasympathetic nervous system

Most commonly affects young women

Question 16

How can you check Extraocular eye movements

Answer 16

move fingers through large “H”

Pause at upward gaze to detect nystagmus

Question 17

how can you test eye acommodation

Answer 17

ask pt to follow finger as you move it towards bridge of their nose, eyes will converge and pupils will constrict

Question 18

Pupillary light reflex

Answer 18

shine bright light at eyes

Direct pupillary light reflex: pupil on same side constricts

Consensual pupillary light reflex- pupil on opposite side constricts

Question 19

Ophthalmoscopic exam

Answer 19

1st obtain red reflex (red/orange glow in the pupil)

if absent may be due to: opacity of the lens, retinal detachment, retinoblastoma, artificial eye

Question 20

retinoblastoma

Answer 20

childhood cancer of the retina

Question 21

fundus of the eye

Answer 21

interior surface of the eye, opposite the lens, includes: retina, optic disc, macula, fovea, posterior pole

Question 22

cup to disc ration (CDR)

Answer 22

the measurement used to assess the progression on glaucoma. Glaucoma produces pathological cupping of the optic disc. As glaucoma advances the cup enlarges until it occupies most of the disc area.

Question 23

optic disc

Answer 23

“blind spot” where the optic nerve and blood vessels enter the retina. can be flat of have a certain amount of normal cupping

Question 24

papilledema

Answer 24

optic disc swelling associated with increased intracranial pressure

Question 25

Hypertensive retinopathy

Answer 25

“dry” retina

few hemorrhage, few exudates, multiple cotton wool spots

Question 26

diabetic retinopathy

Answer 26

“wet” retina

multiple hemorrhages, multiple exudates, few cotton wool spots

Question 27

central retinal vein occlusion

Answer 27

associated with variable vision loss “blood and thunder”

Question 28

central retinal artery occlusion

Answer 28

painless loss of monocular vision “cherry red spot”