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Ophthalmology > Module 1 - Basic Eye Exam > Flashcards

Module 1 - Basic Eye Exam Flashcards

1
Q

What do you mean by oculus?

A

Eye

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2
Q

What do you mean by dextro?

A

Right

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3
Q

What do you mean by sinister?

A

Left

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4
Q

What is oculus dexter?

A

Right eye

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5
Q

What is oculus sinister?

A

Left eye

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6
Q

What is oculus uterque?

A

Both eyes

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7
Q

What step in the eye examination is the measurement of the smallest object a person can identify at a given distance?

A

Visual acuity

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8
Q

What is the unit of measurement used in the Philippines in measuring the visual acuity?

A

Metric system (meters)

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9
Q

What is the unit of measurement used in the Other countries in measuring the visual acuity?

A

English system (feet)

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10
Q

What is measured as a fraction?

A

Distance visual acuity

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11
Q

What does the first and second number of the visual acuity mean?

A 
First number (numerator): distance of patient from the eye chart
Second number (denominator): distance at which the letter can be read by a person with normal vision
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12
Q

What are the 5 charts used in testing visual acuity?

A 
Number acuity
Snellen chart
HOTV chart
Picture chart
Illiterate E chart
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13
Q

What are the procedures in testing distance visual acuity?

A

Position patient at 6 meters
Use a well lit chart
Start with right eye first (occlude the other eye)
Ask patient to read smallest line he can distinguish
If VA is 6/12 or worse, repeat test using a pinhole
Test the left eye similarly
Record VA for each eye

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14
Q

What should be used if VA is 6/12 or worse?

A

Pinhole

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15
Q

If the patient cannot see the largest letter, what should be done?

A

Bring patient closer (record new distance as the numerator eg. 3/60 for a patient at 3 mm from chart)

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16
Q

In testing distance VA, if patient still unable to see largest letter at 1 meter what should be done?

A

Do counting fingers (eg CF at 1 ft)

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17
Q

In testing distance VA, if patient unable to count fingers, what should be done?

A

Determine if he can detect movement of your hand (eg HM 2 ft)

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18
Q

In testing distance VA, if patient cannot detect movement what should be done?

A

Detect presence and direction of light

  • LP - light perception
  • LP with direction - light direction with localization of light
  • NLP - no light perception (totally blind)
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19
Q

What is a quick method to assess best corrected vision?

A

Pinhole vision

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20
Q

What is expected by looking through a pinhole?

A

The refractive errors of the peripheral cornea and crystalline lens of the eyes are significantly reduced or eliminated

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21
Q

In pinhole test, visual acuity simulates that with proper eyeglasses in place. True or false?

A

True

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22
Q

Pinhole test is not done as part of the visual acuity test. True or false?

A

False

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23
Q

What are the 2 indications of doing near vision testing?

A

Near vision complaints

Difficulty testing for distance (ex. Bedridden patients)

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24
Q

What are the 8 steps in performing an eye examination?

A 
Measure and record visual acuity
Examine the external eye
Examine the cornea
Assess the pupillary reflexes
Evaluate ocular motility
Measure ocular pressure
Evaluate visual fields by confrontation
Examine the fundus using a direct ophthalmoscope
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25
Q

What chart is used for near vision testing?

A

Rosenbaum pocket vision chart

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26
Q

What is the usual distance of near vision testing?

A

13-15 inches in front of the patient

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27
Q

What do you call the measurement recorded in near vision testing?

A

Jaeger equivalent

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28
Q

What are the 6 structures that needs to be inspected in the external eye?

A 
Lids 
Eyelashes
Surrounding tissues
Cornea
Anterior chamber
Iris
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29
Q

What is used for the upper eyelid when everting the lids?

A

Cotton bud

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30
Q

What tests elicit the corneal light reflex?

A

Hirschberg test

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31
Q

What is the indication of Hirschberg test?

A

Strabismus testing

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32
Q

For uncooperative child, the Hirschberg test tests what?

A

Only test of alignment

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33
Q

What are the 3 techniques for Hirschberg test?

A

Hold penlight or light source in front of patient
Ask patient to fixate at something in the distance
Note position of corneal light reflex on each eye

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34
Q

How would you interpret normal corneal light reflex?

A

Reflex slightly nasal to the center of cornea

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35
Q

How would you interpret esodeviation corneal light reflex?

A

On deviated eye, reflex displaced temporally

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36
Q

How would you interpret exodeviation corneal light reflex?

A

On deviated eye, reflex displaced medially

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37
Q

What are the procedures in testing pupillary reaction?

A

Use a penlight
Dimly lit room; subject looking at the distance
Inspect pupil size and shape
Test for direct pupillary reaction and consensual pupillary reaction

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38
Q

What is expected in direct pupillary reaction?

A

Constriction of pupil when tested eye is exposed to bright light

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39
Q

What is expected with consensual pupillary reaction?

A

Constriction of pupil of the opposite eye when tested eye is exposed to bright light

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40
Q

What is the indication of swinging penlight test?

A

Anisocoria (unequal pupils)

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41
Q

What is anisocoria?

A

Unequal pupils

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42
Q

What are the techniques for checking right eye response in swinging penlight test?

A

Shine light on right eye and check right pupil reflex

Shine light on left eye and check right pupil reflex

43
Q

What are the techniques for checking left eye response in swinging penlight test?

A

Shine light on left eye and check left pupil reflex

Shine light on right eye and check left pupil reflex

44
Q

What are the 2 normal response for swinging penlight test?

A

Direct light reflex

Consensual light reflex

45
Q

What normal response of the swinging penlight test does the pupil constricts to direct light?

A

Direct light reflex

46
Q

What normal response of the swinging penlight test does the pupil constricts to light shining on opposite pupil?

A

Consensual light reflex

47
Q

What 2 structures are affected in afferent lesion when eliciting swinging penlight test?

A

Retina

Optic nerve

48
Q

What 2 structures are affected in efferent lesion when eliciting swinging penlight test?

A

CN III

Pupillary muscle

49
Q

Afferent lesion in swinging penlight test is known?

A

Marcus Gunn Pupil

50
Q

What happens when there is efferent lesion when eliciting swinging penlight test?

A

Affected eye loses consensual and direct light reflex

Unaffected eye maintains consensual and direct reflex

51
Q

What happens when there is afferent lesion when eliciting swinging penlight test?

A

Intact consensual light reflex

Paradoxical pupil dilation to direct light

52
Q

What condition occurs on moving light from opposite to affected eye?

A

Marcus Gunn Pupil

53
Q

What innervates the lateral rectus?

A

CN VI

54
Q

What innervates the superior oblique?

A

CN IV

55
Q

What innervates other eye muscles?

A

CN III

56
Q

What is the action of superior muscles (SO, SR)?

A

Elevates the eye

57
Q

What is the action of the inferior muscles (IO, IR)?

A

Depress the eye

58
Q

What is the action of oblique eye muscle?

A

Abduct the eye

59
Q

What is the action of the lateral rectus?

A

Abducts the eye

60
Q

What is the action of all other recti muscles?

A

Adducts the eye

61
Q

What eye muscle intorts?

A

Superior muscles

62
Q

What extorts the eye muscles?

A

Inferior muscles

63
Q

What are the cardinal fields of gaze?

A 
Right and up
Right
Right and down
Left and up
Left
Left and down
64
Q

What is the pressure of the eyeball in mmHg?

A

Intraocular pressure

65
Q

Intraocular pressure is determined by

A

Outflow of aqueous humor from eye

66
Q

What is the normal IOP range?

A

10-20 mmHg

67
Q

What tool is the gold standard of IOP?

A

Goldmann Applanation Tonometer

68
Q

What are the 3 other means of measuring IOP?

A

Palpation tonometry - using the index finger
Schiotz tonometer
Electronic tonometers

69
Q

What is the entire area seem when your gaze is fixed in one direction (central visual and the side [peripheral] visual fields)?

A

Visual field

70
Q

What tests help detect eye diseases or nervous system problem that limit your ability to see objects clearly in the entire visual field or a part of it?

A

Confrontation field tests - visual field test

71
Q

What test is a simple screening method that allows estimation of a patient’s visual field?

A

Confrontation test

72
Q

What will you do if there are variations in the confrontation test?

A

Count how many fingers

Identify if fingers are moving or not

73
Q

What are the procedure for confrontation test?

A

Patient faces MD
Eye is tested one eye at a time (usually right first)
MD also closes his/her eye that is directly opposite the patient’s closed eye
Patient focuses on the MD’s nose
ME moves his/her finger from periphery towards the center
Patient indicates when he/she sees MD’s finger
Testing done on all quadrants

74
Q

What ancillary test tests central vision?

A

Amsler Grid test

75
Q

What type of diseases does the Amsler Grid test detects?

A

Macular diseases

76
Q

What are the procedures in using the Amsler Grid test?

A

Tested one eye at a time

Patient indicates area that is not seen or is distorted

77
Q

What staining is used to detect dendritic ulcer (HSV)?

A

Fluorescein dye staining

78
Q

What ancillary test checks the patient’s ability to distinguish color?

A

Color vision test

79
Q

Is color vision test not part of a routine eye examination?

A

It is part of the routine eye examination

80
Q

What are the indications of color vision test?

A

Color blindness

Screen applicants for job in fields where color perception is essential, such as the military pr electronics

81
Q

What is done in ophthalmoscopy as this aids in examining the fundus?

A

Dilation

82
Q

Is dilation in ophthalmoscopy routinely done?

A

It is not routinely done

83
Q

What is the usual dilating drops?

A

Tropicamide

Phenylephrine

84
Q

Dilation in ophthalmoscopy is not achieved in what 3 conditions?

A

Shallow anterior chamber
Patients undergoing neurologic observation
Patients who underwent cataract surgery

85
Q

What are the 5 landmarks in direct ophthalmoscopy?

A 
Red reflex
Optic disc
Retinal blood vessels
Retinal background
Macula
86
Q

Describe the red reflex

A

Reflected light from the fundus
Red to red orange
Evenly colored
Dull color or absent

87
Q

The dullness or absence of red reflex are due to what 2 conditions?

A 
Media opacities (including vitreous)
Retinal disease
88
Q

What is the shape of the optic disc?

A

Slightly oval in vertical meridian

89
Q

What is the approximated diameter of the optic disc?

A

1 mm

90
Q

What condition can be assumed if the optic disc is tilted?

A

Myopia

91
Q

What is the color of the optic disc?

A

Pink in color

92
Q

What is the color of the optic disc if there is optic atrophy?

A

Pallor

93
Q

What is the physiologic cup?

A

Central depression

94
Q

Central depression measures how many?

A

0.2 to 0.4

95
Q

What condition can be assumed of there are large cups?

A

Glaucoma

96
Q

What is the normal cup-disc ratio?

A

0.2 to 0.4

97
Q

What condition can be assumed if there is large cup-disc ratio?

A

Glaucoma

98
Q

Where does the central retinal artery starts?

A

Optic disc

99
Q

Central retinal artery branches into what 4 divisions which supplies the 4 quadrants?

A

Superotemporal branch
Inferotemporal branch
Superonasal branch
Inferonasal branch

100
Q

True or false. Similar arrangement of retinal vein that collects at the optic disc

A

True

101
Q

What is the normal artery-vein (AV) ratio?

A

2:3

102
Q

What should be taken note of in retinal circulation?

A

Arteriovenous crossings

103
Q

What are the 3 factors contributing to red orange color?

A

Retinal pigment
Choroidal pigment
Blood

104
Q

What are the 3 lesions to watch out of in retinal background?

A

Exudates
Hemorrhages
Scars

Ophthalmology (3 decks)

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