Lecture 1: Retinoscopy & Direct Opthalmoscopy

Question 1

Where does the light source fall in the sleeve down/plane mirror position

Answer 1

within the FP

Question 2

Where do rays go when they exit retinoscope in the sleeve down position

Answer 2

they diverge

Question 3

where is the source is in the sleeve down position

Answer 3

behind the retinoscope (dr.)

Question 4

where is the light source in the long concave position/when lens is at the middle point

Answer 4

AT the focal point

Question 5

what do the rays look like when exiting the retinoscope in the long concave position

Answer 5

parallel

Question 6

where is the source in the long concave position

Answer 6

infinitely far behind the retinoscope (infinity)

Question 7

where does the light source fall in the short concave position/when sleeve is all the way up?

Answer 7

light source falls beyond the focal point of the lens

Question 8

what do the rays do when they exit the retinoscope

Answer 8

converge

Question 9

where is the effective source in the short concave position

Answer 9

in front of the retinoscope (usually between dr’s eye and patient’s eye)

Question 10

where are the lights rays that are reflected from the patients eye coming from

Answer 10

the internal limiting membrane of the patient’s retina

Question 11

when using the retinoscope in the process of distance refraction, we want the patient’s accommodation to be at:

Answer 11

zero diopters; this is called static retinoscopy

Question 12

what the doctor sees depends on what?

Answer 12

where the reflex comes to focus relative to the location of the doctor’s eye

Question 13

what is neutral motion

Answer 13

when the reflex is focused at the doctor’s entrance pupil, the far point of the patient’s eye is also focused at the doctor’s entrance pupil. The doctor will see a bright reflex.

Question 14

In neutral motion; when the far point of the patient’s eye is at the doctors entrance pupil the following is true:

Answer 14

1. all rays of light in the reflex enter the doctor’s eye
2. the reflex is bright
3. it is the endpoint of retinoscopy
4. reflex does not move but blinks on and off

Question 15

what is with motion?

Answer 15

comes to focus behind the doctor’s eye. the doctor sees the reflection moving in the same direction as the movement of the stream from right to left; assuming the sleeve is down

Question 16

what is against motion

Answer 16

when the reflex is focused between the doctor’s eye and the patient’s eye, the doctor sees the reflex moving in the opposite direction as the sweep of the streak because the rays CROSS

Question 17

you are doing retinoscopy in the meridian in which the:

Answer 17

streak is moving

Question 18

for a spherical lens, all meridians become ____at the same time

Answer 18

neutral

Question 19

The relationship between streak movement and reflex motion is ____ if the sleeve is UP vs when the sleeve is down

Answer 19

reversed

Question 20

With the WD in place, if you see with motion, the eye is focused where? What are you supposed to do on the schematic eye?

Answer 20

behind your eye; lengthen the eye

Question 21

With the WD in place, if you see against motion, the eye is focused where? What are you supposed to do with the schamatic eye

Answer 21

in front of your eye; shorten the eye.

Question 22

If you see neutraliity with the WD in front of the schematic eye, then your eye is _____if you see neutrality with no lens in front of the schematic eye, then your eye is _____

Answer 22

emmetropic; myopic

Question 23

After making a perfect eye and taking out the WD and adding a -2.00 in front of the schematic eye, what type of ametropia exists?

Answer 23

2 diopters of hyperopia

Question 24

If you place a +2.00 lens in the holder in front of the eye, what type of ammetropia exists?

Answer 24

2 D of myopia

Question 25

the ___ ___ result equals the discrepancy, but with the opposite sign

Answer 25

net ret

Question 26

The lens that gives neutrality is not the patients rx. It is the ___ finding

Answer 26

gross

Question 27

An ___ eye will not have a gross ret finding of plano; the gross finding will be enough plus to compensate for the ___ ____

Answer 27

emmotropic; working distance

Question 28

The only eye that will have neutrality with a plano lens in place is an eye with ____ equal to the working distance

Answer 28

myopia

Question 29

gross - _____ = net

Answer 29

Working distance

Question 30

what are limitations of direct opthalmoscopy

Answer 30

1. monocular view
2. field of view is limited; cant view peripheral retina
3. not the standard of care if the entire retina needs to be evaluated

Question 31

for direct opthalmoscopy, direct your patients gaze higher than the light of sight by ___ and about 20-30 degrees ____

Answer 31

30; temporal

Question 32

you would use the small aperture for small or ____ pupils. (usually older patients)

Answer 32

undilated

Question 33

when do you use the medium aperture

Answer 33

midsize to large pupils; younger patients

Question 34

when do you use the large aperture

Answer 34

for dilated pupils

Question 35

how do you determine between a choroidal nevus vs RPE pigment

Answer 35

if you use your red free filter and the dark lesion disappears, the lesion is located at the level of the choroid

Question 36

If you dial in ____ and the retina is clean then it is a nevus

Answer 36

green;

Question 37

how do you select lens power when viewing the patients eye with the o-scope

Answer 37

start with the external eye. Dial +8 or 10 with the lens wheel. If there are no opacities or abnormalities, you may say the media is clear. As you move towards the patients eye, remove plus power.

Question 38

In myopes, the optic nerve will appear ____, in hyperopes it will appear ____. Optic nerve should be ____ and distinct.

Answer 38

large; small; pink