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Ocular Disease Lab > Lab Final > Flashcards

Lab Final Flashcards

1
Q

Small pupils

A

Old, dark eyes, pilocarpine, heroin, allergies, alcoholism

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2
Q

Big Pupils

A

Young, light eyes, antihistamine, steroid, scopalamide

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3
Q

CN III

A
  1. MR-add
  2. SR-eleve
  3. IR-dep
  4. IO-ext
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4
Q

CN IV

A
  1. SO-int
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5
Q

CN VI

A
  1. LR-Abd
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6
Q

Addies Tonic Pupil

A

Efferent pathway. Affected eye is big. POOR direct. Near response is slow but prolonged. will dilate with 0.125% pilocarpine. Veriform movement

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7
Q

Addie’s Syndrome

A

Decreased corneal sensitivity, deep tendon reflex, tonic pupil

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8
Q

Argyll-Robertson

A

Tectum. Pupil normal or small and irregular. NO direct. GOOD near. Can be unilateral–>bilateral

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9
Q

APD

A

Afferent. Normal pupil. Pupil dilates with direct.

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10
Q

Horner’s Syndrome

A

Sympathetic. Anisocornia in dark. Small pupil. POOR direct and near. Hydroxymethamine 1. One eye-post 1. both-pre

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11
Q

CN III palsy

A

Eye is down and out. No direct or near response. An emergency

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12
Q

Normal exophathalmous readings

A

12-21. Up to 24 if black

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13
Q

Diff. in exophathalmous

A

1-2 mm

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14
Q

Pachymetery

A

Measures the corneal thickness

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15
Q

Normal corneal thickness

A

550 nm. Must be within 5 of each other. 570 for white.

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16
Q

Thin cornea

A

Will have decreased pressures. More at risk of glaucoma as abnormally low

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17
Q

IOP and Pachy

A

Must adjust IOP by 4 mm hg for every 80 micrometers off average

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18
Q

Insurance and cataract

A

Must be worse then 20/40

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19
Q

PAM

A

PT. is dilated. On the SLAMP. Dial in ES. NO rxn. Improvement means good candidate. Smallest line is PA.

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20
Q

BAT

A

Pt. NOT dialted. Habitual rxn. Acuity will get worse with light if have cataracts.

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21
Q

Super pinhole

A

Pt. is dilated. Habitual RXN. 5 ft. test distance. Vas should improve.

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22
Q

Interferometer

A

When they get half right this is their PA. No Rxn. Dilated. For amblyopes and dense cataracts

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23
Q

Cataract test where you are NOT dilated

A

BAT

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24
Q

Cataract test where you do not wear glasses

A

PAM, interformeter

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25
Q

Cataract test where you wear glasses

A

pinhole and bat

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26
Q

+ sidel sign

A

If you put fluoroscene on and it leaks out. The cornea has ruptured

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27
Q

Loupe and magnet

A

Superficial FBs

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28
Q

Spud

A

Mini golf club. Good for embedded FBs

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29
Q

Polytome

A

swiss army knife

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30
Q

Needle

A

Sterile cheap

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31
Q

Alger brush

A

Use to clear up metabolic FB. Leave rust deeper than bowman’s.

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32
Q

Line 1 of Rxn

A

Med and amount and form

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33
Q

Line 2 of rxn

A

How many to disp

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34
Q

Line 3

A

Instructions for pt.

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35
Q

When to do stromal puncture

A

Pt. with RCE

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36
Q

Care after FB removal

A

AB, patch, tell them they loose 1/2 field

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37
Q

Patch rule

A

Patch never sees sunset twice.

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38
Q

OCT

A

Ocular Coherence Tomography

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39
Q

AS-OCT useful with…

A

Keratoconus, corneal degenerations, recurrent micro cysts, corneal scars, cornea transplant, angle closure

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40
Q

5-line raster

A

Series of scans. 2D image

41
Q

Cube

A

Horizontal and vertical. Lower resolution but 3D. Good for macula and ON.

42
Q

Time domain

A

Old, low resole, slow

43
Q

Spectral domain

A

Exact change in wavelength between lasers, high res, faster

44
Q

Luminescence

A

Decay in light

45
Q

How does fluoroscene work

A

Light is absorbed by luminescent material that causes the light to lose energy and be re-emmited. Absorbs 490 (blue) and emits 520 (green)

46
Q

Excitation filter

A

Transmits 490 nm which is the peak absorption

47
Q

Barrier filter

A

Transmits 520 which is the emitted peak

48
Q

Fluorescein solution

A

Eliminiated by liver and kidneys for 24 hours. Normally use 5 mL at 10%.

49
Q

If cannot inject dye

A

30 mg/kg of oral fluoroscene taken 30-60 min after ingestion

50
Q

When to avoid angiography

A

Pregnant women. esp in first trimester

51
Q

Moderately severe reactions

A

1%. Urticaria, SOB, vasovagal rxn, skin necrosis

52
Q

Life threatening cond

A

.0001%. Anaphylactic shock, seizure, cardio collapse

53
Q

Predmeds with fluoro.

A

Can use antihistamine or corticosteroids

54
Q

Scalp needle vein

A

Makes sure extravasation of fluorescein doesn’t occur.

55
Q

Set up for procedures

A

Maximal dilation (6 mm or more is best), color and red free photos

56
Q

Transient eye

A

Eye of interest

57
Q

Procedure

A

Establish a venous line. Start time and inject dye rapidly (10 sec). Appear in eyes in 8-12 sec. Take photos every 1.5-2 sec in transient eye for 30 sec. Wait for 3-5 minutes and take more photos.

58
Q

How long to get to eye

A

8-12 sec

59
Q

Choroidal Flush

A

8-12 sec. Choriocapillaris leaks dye freely. Usually little detail as RPE filtures. Will see dye in cilioretinal artery.

60
Q

Arterial phase

A

2s after choroidal. Retinal arteries fill. Fills from lumen out. choroid can get patchy

61
Q

Arteriovenous phase

A

retinal arteries, capilaries and veins contain fluoroscene. Early part of phase is lamellar phase when fluoroscene is visualized in larger veins.

62
Q

Venous phase

A

30 sec after injection. Fluorescein leaves the arteries and veins have increased fluoroscene. Perifoveal capillary network is best visualized here.

63
Q

Normal macula color

A

Macula will by hypo fluorescent (taller more pigment RPE, xanthophyll pigment, absence of retinal capillaries)

64
Q

Mid phase

A

Recirculation occurs 2-4 min. after injections. The arteries and veins are roughly equal brightness

65
Q

Late phase

A

Gradual elimination of dye from retina and choroid. Staining of the optic disc is normal. Late hyper fluorescence is abnormal. Photos normally taken 7-15 min after injection.

66
Q

Retinal circulation

A

Supplies inner 2/3 of retina. Non-fenestrated. Blood-retinal barrier via tight junctions. Autoregulation, perfusion pressure has negligible effect on blood flow

67
Q

Choroidal circulation

A

Supplies the outer 1/3 of the retina. Fenestrated, low resistance. Blood retinal barrier via tight junction. No autoregulation

68
Q

Cause of hypofluorescence

A

Blockage or vascular filling defect

69
Q

Is it blockage or vascular filling defect

A

If size/shape/location is same as funds photo–>blockage.

70
Q

Pre-retinal Hemmorhage

A

Pre-retinal hemmorhage cause blockage of all retinal and choroid. Will be same as funds photo.

71
Q

Intraretinal hemmorhage

A

bleeding stops at 180. Will be blockage. Will see some vasculature.

72
Q

Subretinal hemmorhage

A

Will see retinal vasculature.

73
Q

CHRPE

A

Subretinal hypertrophy of the RPE. Blocked chroidal fluorescence and normal retinal fluorscene. Blockage.

74
Q

Choroidal nevus

A

Blockage at AV stage. Will see vascu.

75
Q

Non-filling of an artery

A

Will eventually see back flow so this is why it is important to see whole picture

76
Q

Retinal capillary nonperfusion

A

choroidal fluorescene blocked by opaque retina.

77
Q

CRAO

A

Blood flow will not get through here quickly. Will tai 30 sec to 1 min instead of 8-12 sec.

78
Q

Preinjection fluorescence

A

Autofluorescence or pseduofluorescence

79
Q

Autofluorescence

A

Occurs with optic disc drusen and astrocytic hamartomas

80
Q

Psuedofluorescence

A

When barrier and excitation filters aren’t well matched.

81
Q

Early hyperfluorescence

A

Vascular. Retinal or choroidal.

82
Q

Microanyeursms

A

Early hyperflur.

83
Q

Neovascularization

A

Will have early hyperfluorecence and late leakage.

84
Q

Window defect

A

Early hyper. Transmission of hyper is seen in the choroid due to damage of RPE. Size is uniform. Borders are well defined. Can also be due to macula hole.

85
Q

Choroid subretinal neovascularization

A

hyper early. Early fine lacy hyperflur in the sub retinal neovascular. Late=leakage.

86
Q

Leakage

A

Dye leaks from an intravascular space into an extravascular space. A and size changes with time.

87
Q

Pooling

A

Dye fills an anatomical space with a defined border.

88
Q

Staining

A

Deposits of dye in tissue. Normal staining (ON and sclera) Pathological (scars)

89
Q

How long until fluorescein empties from eye

A

10-15 min

90
Q

Normal staining

A
  1. hyper of disc margins
  2. fluor of lamina cribs
  3. fluor of the sclera at the disc margin (sclera crescent)
  4. fluor of the scleral in lightly pigment fundus
91
Q

Cystoid macula edema

A

Will have petaloid appearance late. Can also have diffuse leakage (late picture)

92
Q

Central serous retinopathy

A

Choroidal leakage and pooling into sub retinal space. Early phase shows small hyper fluorescent spot. Late phase shows pooling. Will have borders. Can be smoke stack or ink blot

93
Q

Pigment epithelial detachment

A

Pooling of luis between bruch and RPE. Early hyper from area of detached RPE. Late phase showing well demarcated hyperfluo. borders. Will get brighter with time!

94
Q

Drusenoid PED

A

Between RPE and bruch. Drusen stains more in late angio

95
Q

Fibrous scar

A

Most common location is sub retinal. Will pick up stain as angiogram progresses.

96
Q

Tumors

A

early hyperfluor and lake leakage

97
Q

Widefiled FA

A

Difficult as take picture at different time

98
Q

OPTOS

A

See everything happening at once

99
Q

OCT angiography

A

Can perform without fluoroscene

Ocular Disease Lab (2 decks)

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