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Clinical Skills 3 > More Refraction > Flashcards

More Refraction Flashcards

1
Q

What are the 2 types of hyperopia?

A

Manifest and Latent

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2
Q

When is a manifest hyperopia uncovered? Can plus lenses relax it?

A

during subjective refraction, Yes

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3
Q

When is a latent hyperopia uncovered? Can plus lenses relax it?

A

Uncovered during cycloplegia, no

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4
Q

What eye disorders can cycloplegia help?

A

Esotropia, Pseudomyopia, Latent Hyperopia and Amblyopia

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5
Q

What are the signs a symptoms of Latent Hyperopia?

A
  1. near point complaints (headaches at near, difficulty with sustained reading)
  2. esophoric at distance
  3. miotic pupils
  4. high FCC
  5. decreased accommodative amplitude for age
  6. static ret has more plus than subjective
  7. NRA > +2.50
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6
Q

What are 6 signs and symptoms of pseudomyopia?

A
  1. low myopia on subjective
  2. near point symptoms
  3. fluctuating VA
  4. accommodative spasm after near work
  5. NRA > PRA
  6. low amplitude
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7
Q

Why would you use cycloplegics during anterior segment inflammation?

A
  1. stabilize the blood aqueous barrier
  2. helps reduce the permeability of blood vessels
  3. stabilizes the iris
  4. decreases possibility of posterior synechiae
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8
Q

Cycloplegics are parasympathetic drops that are ______/______. They block the action of acetylcholine.

A

anticholinergic/antimuscarinic

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9
Q

What are the 2 eye muscles that cycloplegics paralyze?

A

Ciliary Muscle and Iris Sphincter

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10
Q

Are cycloplegics sympathomimetic or parasympatholytic?

A

Parasympatholytic

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11
Q

Cycloplegics are _________ alkaloid

A

belladonna alkaloid

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12
Q

What are examples of synthetic cycloplegics?

A

tropicamide/mydriacyl

cyclopentolate/cyclogyl

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13
Q

What are examples of semi-synthetic cycloplegics?

A

homatropine

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14
Q

What are examples of natural cycloplegics?

A

scopolamine

atropine

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15
Q

What type of cycloplegic is usually used for a cycloplegic exam?

A

cyclopentolate

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16
Q

Which cycloplegic is used for uveitis?

A

Scopolamine, atropine and homatropine

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17
Q

What are common side effects of cycloplegics?

A 
toxicity
hypersensitivity
allergic
angle closure
systemic reactions
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18
Q

What demographic of patients is more likely to have a hypersensitivity reaction to cycloplegics?

A

Pts with down syndrome

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19
Q

Which is the strongest and longest acting cycloplegic eye drop?

A

Atropine

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20
Q

What is the max cyclo and max mydriasis of atropine?

A

max cyclo = 1-3 hrs

max mydriasis = 30-40 min

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21
Q

How long do the cyclo and mydriasis last from atropine?

A 
cyclo = 7-12 days
mydriasis = 7-10 days
22
Q

What are 3 reasons to use atropine in patients?

A
  1. esotropia in young patients
  2. amblyopia therapy (like patching)
  3. aid in acceptance of new lenses
23
Q

When do you get max cyclo with cyclopentolate?

A

Can be 30-60 min or up to 2 hrs

24
Q

T or F. Cyclopentolate has longer cyclo effect in light irises

A

False! Shorter

25
Q

What is the total cyclo and mydriasis duration with cyclopentolate?

A 
cyclo = 1 day
mydriasis = 1+ day
26
Q

When do you get max cyclo and max mydriasis with tropicamide?

A

max cyclo = 30-45 min

max mydriasis = 20-35 min

27
Q

What is the duration of cyclo and mydriasis for tropicamide?

A 
cyclo = 15 min (0.5%), 40 min (1%)
mydriasis = 4-6 hrs
28
Q

With a cyclopleged retinoscopy, should you expect more plus or more minus?

A

More Plus.

Pt no longer has the ciliary muscle there to give extra plus, so they will NEED more plus from us

29
Q

If pt needs a very high amount of plus, the pt could have what eye disorders?

A

latent hyperope pseudomyope
Accommodative ET
accommodative spasm

30
Q

What is an average amount of latent hyperopia to expect?

A

+0.50

31
Q

How can you calculate latent hyperopia?

A

wet - dry = latent hyperopia

32
Q

What are allergic reactions associated with proparacaine?

A

contact dermatitis

Stevene-Johnson syndrome

33
Q

What percentages of phenylephrine are commonly used?

A

0.125%
2.5%
10%

34
Q

What drug type is phenylephrine?

A

sympathomimetic

alpha adrenergic agonist

35
Q

Is phenylephrine a vasodilator or a vasoconstrictor?

A

Vasoconstrictor.

Blanches the conj.

36
Q

T or F. Phenylephrine has no cycloplegic effects

A

True

37
Q

When do you get max dilation from phenylephrine? What’s the duration?

A

40-60 mins, 4-6 hours

38
Q

Early, may or may not need rx. What type of Presbyopia?

A

Incipient

39
Q

Reduced accommodation becomes problematic – requires correction

A

Functional

40
Q

Virtually no accommodative ability

65-70 yo, pts who are pseudo?, need +2.25,2.50

A

Absolute

41
Q

Accommodative ability becomes insufficient earlier than expected based on the patient’s age (accommodative insuffiency)

A

Premature

42
Q

Near vision decreases at night in dim lighting conditions due to Increased pupil size and decreased depth of field

A

Nocturnal

43
Q

This machine measures the potential acuity of the retina/optic nerve, is able to get through media opacities and is useful when sending pts for cataract surgery.

A

Retinometer

44
Q

How does a retinometer test VA?

A

projects diffraction gratings with different spatial frequencies onto the retina
-only need a tiny window through the opacity

45
Q

A retinometer can measure visual acuity within what range?

A

20/300 to 20/25

46
Q

What type of presentation is associated with a retinometer, interferometer, and potential acuity meter?

A

Maxwellian presentation

47
Q

What percent of transmitted light is needed for an interferometer to work?

A

2%

48
Q

Does an interferometer work best on a constricted or dilated pupil?

A

Dilated

49
Q

A potential acuity meter can measure visual acuity within what range?

A

20/400 to 20/20

50
Q

What is a type of device that measures Snellen acuity?

A

Potential acuity meter

Clinical Skills 3 (5 decks)

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