Logical Examination Sequencing

Question 1

Goals of comprehensive exam

Answer 1

• evaluate the functional status of the eye
• assess ocular health
• establish a dx
• treatment/management plan
• counsel and educate the patient

Question 2

History

Answer 2

• Vitally important in guiding the exam

- aids in what you are looking for during ophthalmoscopy

Question 3

Entrance test

Answer 3

• help define the status of each of the primary problem areas (health, refraction, functional vision)
• sequence is usually comprised of procedures that have a low cost/benefit ratio, can be performed quickly, do not depend on technologically sophisticated equipment

Question 4

The entrance tests are intended to be _________

Answer 4

Efficient

Question 5

A practitioner may have more than one sequence depending on __________

Answer 5

The type of exam

• annual comprehensive exam
• spec vs contact lens
• age
• pt signs and symptoms

Question 6

Factors that affect the sequencing of entrance tests

Answer 6

• equipment needed
• whether the test is done with or without the patients correction
• whether or not the patients eyes will be dilated

Question 7

What are considered part of the minimum defined database?

Answer 7

Entrance tests

Question 8

Data found in entrance tests

Answer 8

Also provides baseline diagnostic information for future comparison

Question 9

Entrance tests provide valuable information for what

Answer 9

By screening for the presence of ocular anomalies in the absence of patient symptoms such as neurological defects and muscle imbalance

Question 10

Counting fingers

Answer 10

At a distance of 1 ft, expose a selected number of fingers. Aske the patient to tell you how many fingers you are holding up. Increase the distance from the patient until his responses are no longer accurate. Move back toward the patient until he can reliably report the number of fingers presented

Question 11

Hand motion

Answer 11

Using a moving hand as the target, ask the patient if he can see the hand moving. Being at about 1 ft and increase the distance until the patient reports he no longer detects the motion. Then move back toward the patient until he detects the motion once again

Question 12

Light projection

Answer 12

Holding a penlight at a distance about 20in from patient, position the light in different areas of the patients VF. Each time ask the patient to point at the light and note the areas of the field in which the patient has vision
-rarely used

Question 13

Light perception

Answer 13

Direct a penlight at the patient and ask if he can see the light

Question 14

Direct response

Answer 14

Constriction of the illuminated pupil

Question 15

Consensual response

Answer 15

Meaning constriction of the opposite pupil

Question 16

In an afferent pupillary defect there is a _____________ caused by decreased visual function in one eye

Answer 16

Decreased direct

Question 17

The afferent pupillary defect becomes obvious when the flashlight is moved from the normal to the affected eye and _____________________________

Answer 17

Affected pupil dilates in response

Question 18

What test is used to detect APD

Answer 18

Swinging flashlight test