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Neuromsk 2 > Non-BPPV Eye Exam > Flashcards

Non-BPPV Eye Exam Flashcards

1
Q

What is the flow of the eye tests?

A

Oculomotor tests first:

Gaze evoked nystagmus
vergence
Smooth pursuit
Saccades

After that, VOR tests:
Head shake
Head impulse
DVA
VOR 1
VOR 2

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2
Q

What are the 4 occulomotor tests

A

gaze evoked nystagmus

Vergence

smooth pursuit

Saccades

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3
Q

What are the 5 VOR tests?

A

Head shake nystagmus test

Head impulse test

Dynamic visual acuity

VOR 1

VOR 2

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4
Q

What should you do before the visual and vestibular tests

A

Record the patients baseline symptoms

Observe for presence of nystagmus

Ask pt if they can see clearly

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5
Q

After each test, what should we do?

A

Record patients symptoms on a scale of 0-5

Allow symptoms to return to baseline before continuing

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6
Q

What tests must you do first:

Oculomotor or VOR

A

Oculomotor

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7
Q

How to perform gaze evoked nystagmus test?

A

Pt will fixate on target 12-18” away infront of head then gaze left and R

Then without fixation, pt will do the same (gaze L and R again with frenzels)

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8
Q

How far away is the target during the gaze evoked nystagmus test

A

12-18”

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9
Q

Which occulomotor test do you need frenzel goggles for

A

Gaze evoked nystagmus

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10
Q

If nystagmus is beating L during the gaze evoked nystagmus test this means that

A

The L side is the healthy side

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11
Q

What are the 3 degrees of nystagmus

A

1st degree: only nystagmus while looking toward healthy eating ear

2nd degree: nystagmus present in center and while looking toward healthy ear

3rd degree: nystagmus present in all 3 directions

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12
Q

How to conduct the vergence test?

A

Slowly bring target toward center of patients eyes and ask when they see double vision

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13
Q

How close should the target be able to get before a patient sees double vision in the vergence test

A

At least 6cm

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14
Q

What is considered an abnormal vergence test

A

Diplopia before 6cm or disconjugate eye movement

Or adverse reaction

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15
Q

How far away is the target for smooth pursuit and Saccades testing?

How far should the eyes move in each direction?

A

12-18”

About 30 degrees each way

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16
Q

How to perform saccadic testing

A

Have pt look back and forth between your nose and a target both held at 12-18” in front of patients about 30 degrees from center

17
Q

What directions must you test smooth pursuit and Saccades

A

In all 4 directions

18
Q

What frequency do you need to use to test VOR?

A

120 or 240

19
Q

How do you test VOR: headshake nystagmus

A

FRENZELS ON

Ask pt to close eyes

Pitch head down 30 degrees

Shake head to 120/240 for 20 seconds

Have them look back to center and gauge for nystagmus

20
Q

Which VOR test needs frenzels?

A

Headshake nystagmus test

21
Q

If nystagmus is present w/ VOR headshake nystagmus test what should the patient do

A

Look L and R to gauge which side the nystagmus is coming from

22
Q

Acute nystagmus is ____

After 2-3 days it is ____

Chronic within one week is ____

A

3rd degree nystagmus (worse when acute)

2nd degree

1st degree

23
Q

How to perform the HIT test or head impulse test

A

Sit infront of patients at 11-18 inches, pitch head 30 degrees down then have pt look at your nose while you slowly turn their head each direction.

While slowly turning head apply quick rotational thrusts

Abnormal: pt has corrective saccade

24
Q

If while performing the head impulse thrust the Pt has a corrective saccade going to the left, what does this mean?

A

Hypofunction on the left

25
Q

How far away should the pt be for the VOR DVA test

A

10 feet

26
Q

How to perform VOR DVA

A

Pt flexes head 30 degrees and reads from eye chart

Then you rotate pts head to 240hz passively while they attempt to read eye chart again

They should get within 3 lines of before

27
Q

VOR 1 vs VOR 2

A

VOR 1- Pt actively move head at 2 hz, should be able to go for a minute before target held infront of them gets blurry

VOR 2- Pt actively moved both target and head in opposite directions. No metronome. Positive test is if they get dizzy or have the target get blurry or jumping

Neuromsk 2 (9 decks)

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