MIDTERM Flashcards
What is another name for a Wide beam?
Diffuse Beam
What is another name for a rectangular beam?
Parallelpiped
When a pt. comes in with a red eye, you must observe the _________ of the redness
Laterality
When observing the red eye, you must document the __________ of the injection.
Symmetry
On a red eye evaluation, when you have pt. look left, right, up and down, you are observing the ________ __ _______.
Pattern of Injection
What is the name of the injection when there is redness all over?
Diffuse Injection
What is the name of the injection when there is redness in a localized area?
Sectoral Injection
What is the name of the injection when there are vessels coming out from the limbus?
Ciliary Injection
What are the most superficial vessels in the eye?
Conjunctival Vessels
What are the 2nd most superficial vessels in the eye?
Episcleral
Note: They have no movement
What is the grading scale on the Efron scale for Conjunctival and Limbal redness.
0 - Normal, 1 - Trace, 2 - Mild, 3 - Moderate, 4 - Severe
What is the first type of inspection of injection?
Gross Inspection
What is the grading scale of a ptosis?
> 0.5mm and more would suggest a ptosis or lid droop
The normal upper lid margin rest about __ mm below the upper limbus.
2mm
Note: For the lower lid margin, it would be 1 mm above the lower limbus
What light source of choice is used to confirm an APD?
BIO
Note: The transilluminator has a high level intensity
How is Lymphadenopathy and Red eye connected?
Viral Infection
Note: Preauricular lymph nodes are usually swollen and the inferior lids drain into the preauricular lymph nodes.
What is the feel of of infected lymph nodes?
Firm, Tender, Enlarged and sometimes Warm
Note: If you find a non-tender node, that is usually a sign of malignancy
You have measured your patients palpebral fissures and notice a difference of 0.6mm. What could this indicate?
Ptosis (lid droop)
How is a sinus problem issue associated with an Eye problem?
An Eye infection can be present
What type of sinusitis is concurrent with Red eye?
Acute Sinusitis
What type of drug would you recommend to a pt. with , when trying to decrease the inflammation from sinusitis and an eye infection?
Psuedophedrine
What sinuses are we only able to evaluate?
Frontal and Maxillary
Note: Ethmoid cannot, as its an area we cannot access physically
What device is commonly used when assessing if a sinus is blocked or not?
Transilluminator
Note: If a glow is present, a sinus is open. If there is a glow missing, then there is a blockage
What are 4 MAJOR evaluation tests that can be conducted for a red eye?
Gross and External observation
Lymphadenopathy
Palpebral Fissure Measurement
Sinuses
Why is it important to measure pupil size in Light and Dark?
Measure Annisocoria (para and symp).
Note: This will allow you to determine whether its physiological or abnormal
What is the clinicial significance of an APD?
Check for a lesion of the optic nerve or severe retinal disease
What is the pupillary pathway for the sympathetic system?
Signal goes to PN (Pretectal Nucleus), Dilation of pupil and is part of the Afferent response
What is the pupillary pathway for the parasympathetic system?
Signal goes to EW (Edinger Westpahl), Constricts pupil and is part of the Efferent response
What does it mean if one pupil constricts more on direct that the other?
First warning of APD
What is anisocoria?
Pupil sizes are both different from one another
When EVALUATING pupils, what type of light is the best to be used?
Brightest
Note: Increases the response to light, thus enhancing the ability to detect an abnormal reaction
When you find an +APD, what will the affected eye see?
Dimmer light
Note: Normal eye will NOT constrict to the same amount as the normal eye’s direct response
What is pupillary escape?
Pupil will constrict, then re-dilate and stays dilated
What light source of choice is to confirm a APD?
BIO > Direct Opt > Transilluminator > Penlight
Note: Must be the brightest portable light source
Slit Lamp is NOT portable
What is a physiological Anisocoria?
Present if the pupil are not the same size, the difference is small (1mm).
NOTE: The size difference in both dim and light conditions and the difference between the palpebral fissure
If you have a pt. with a difference in the size of pupils in DIM conditions, what system would be have this type of problem?
Sympathetic
If you have a pt. with a difference in the size of pupils in BRIGHT conditions, what system would be have this type of problem?
Parasympathetic
What is a quick and gross assessment to find the depth of the Anterior Chamber?
Shadow Technique
What are two possible grading system for the shadow technique?
Graded as either DEEP or SHADOW
When preforming the shadow technique, what is the grading scale?
No Shadow/Grade 4 = "Wide" open angle Grade 3 = >25% of nasal iris in shadow Grade 2 = >30% Grade 1 = >40% Grade 0 = >50%
What is a proptosis?
Forward displacement of an organ
What is Exopthalmos?
Forward displacement of the eye, due to endocrinological dysfunction
Ex. Hyperthroidism
What is the most common cause of unilateral and bilateral exopthalmos?
Thyroid Eye Disease
What is usually the measurement for a ptosis?
3 mm of the upper lid covers the cornea
Note: 3 mm is the major difference between a ptosis vs. proptosis
You ask your pt. to downgaze and notice the Munson’s V sign, what does this mean?
Pt. has Keratoconus
A pt. comes in with abnormally widened palpebral fissures, what is the names of this ocular problem?
Dalrymple’s Sign
What is Von Graefe’s sign?
Upper lid lag on downgaze
What is the Stellwag’s sign?
Incomplete blinking
What is Gifford’s sign?
Difficulty in everting the upper eyelid
What is Viguroux sign?
Eyelid fullness
What is Mobius Sign?
Poor convergence
What is Boston’s sign?
Jerky lid lag
What is the avg. and normal findings for a Caucausian using hertel’s exopthalmometer?
AVG- 21mm
NR - 11 to 21mm
Note: A difference of 3mm and more is an abnormal finding
What is the avg. and normal findings for an Asian individual using the hertel’s exopthalmometer?
AVG - 16 mm
NR - 11 to 21mm
Note: A difference of 3mm and more is an abnormal finding
What is the avg. and normal findings for an African-American individual using the hertel’s exopthalmometer?
AVG - 23 mm
NR - 11 to 23 mm
Note: A difference of 3mm and more is an abnormal finding
Why would an Optometrist record the base of the hertel’s exopthalmometer?
A reference point, so a repeat of the exam can occur
What type of beam is used for the detection of MGD and Blepharitis?
Diffuse/Wide beam
What type of beam is used for Chalazion or a Hordeolum?
Diffuse/Wide beam
Evaluation of contact lenses, what type of beam is used?
Diffuse/Wide beam
What type of beam would you use for tear film assessment?
Diffuse/Wide beam
What are the three types of Direct illumination?
Parallelpiped, Optic Section, and Conical Beam