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Ophthalmology > Ocular Diagnostics > Flashcards

Ocular Diagnostics Flashcards

1
Q

Eye Vitals

A

*Visual Acuity
*Pupillary Exam
Visual Fields
Ocular Motility
*Tonometry
Exam

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2
Q

Visual Acuity Tools

A

Distance: Snellen
Near: Rosenbaum card
Tumbling E
3-7 yr olds: HOTV
Good for kids/illiteracy: Allen picture chart
Preverbal/nonverbal: Fixes & follows, central/steady/maintains

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3
Q

Snellen Chart

A

Recorded as ratio
Numerator is distance from chart (feet or m)
Denominator is distance at which letters can be read by person w/ unimpaired vision
(e.g. 20/70 means you can see at 20 feet what “normal” vision sees at 70 feet)

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4
Q

Rosenbaum chart

A

Held 14 inches from face
Recorded as ratio or Jaeger number.
Ratio is easier for patients to understand, you to explain and widely used by ophthalmologists

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5
Q

VA

A

visual acuity

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6
Q

CC

A

w/ glasses (correction)

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7
Q

SC

A

without glasses (w/o correction)

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8
Q

OD

A

right eye (oculus dexter)

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9
Q

OS

A

left eye (oculus sinister)

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10
Q

OU

A

both eyes (oculus uterque

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11
Q

Which eye is conventionally recorded first?

A

RIGHT (OD)

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12
Q

What to do if patient can’t see largest letter on eye chart…

A
  1. REDUCE DISTANCE to chart
  2. No letters @ <3ft? –> COUNT FINGERS (CF)
  3. No fingers? HAND MOTION (HM)
  4. No movement? PRESENCE of LIGHT (LP)
  5. No light? NO LIGHT PERCEPTION (NLP)
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13
Q

Pinhole occluder

A

Pinholes correct for refractive error (dry eyes, cataracts)

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14
Q

PERRLA

A

Pupils equal, round, reactive to light

Direct? Consensual?

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15
Q

Relative afferent pupillary defect

A

Swinging flashlight test
Abnormal response: Dilation rather than constriction
Indicates lesion of nerve on affected side

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16
Q

Eyes follow 6 cardinal directions

A 
Right, up
Right
Right, down
Left, up
Left
Left, down
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17
Q

Right, up muscles

A

Right superior rectus

Left inferior oblique

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18
Q

Right muscles

A

Right lateral rectus

Left medial rectus

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19
Q

Right, down muscles

A

Right inferior rectus

L superior oblique

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20
Q

Left, up muscles

A

Left superior rectus

Right inferior oblique

21
Q

Left muscles

A

Left lower rectus

Right middle rectus

22
Q

Left, down muscles

A

Left inferior oblique

Right superior oblique

23
Q

Strabismus

A

Misaligned Eyes

One eye w/ limited movement, Both eyes limited movement together, Nystagmus

24
Q

Nystagmus

A

Dancing eyes (oxoclonus/myoclonus –> strong correlation w/ neuroblastoma)

25
Q

Esotropia

A

Eye deviated medially

26
Q

Exotropia

A

Eye deviated laterally

27
Q

Hypertropia

A

Eye deviated superiorally

28
Q

Hypotropia

A

Eye deviated inferiorally

29
Q

Confrontation visual fields

A

Tests peripheral vision for gross defects only

30
Q

Tonometry

A

Measures intraocular pressure
Helpful for glaucoma screening
Start w/ drop of proparacaine/tetracaine
TIPS: tell patient to breathe normally & don’t push on globe

31
Q

Normal IOP

A

10-21 mm Hg

32
Q

External Eye Inspection

A

Inspect eyelids and eyelashes (bruising, swelling, mattering)
Tearing
Rashes or skin lesions
Inspect conjunctiva/sclera (penlight or muscle light)
Palpate orbit
Palpate lymph nodes

33
Q

Slit lamp exam

A

Binocular microscope
3D view of eye
Most useful to look at anterior eye (Corneal abrasions, foreign bodies, trauma)
Can use fluorescein

34
Q

Fluorescein staining

A

Looks at defect in corneal epithelium
Use anesthetic drop first
Remove contacts first!! (Can stain)

35
Q

Eyelid inversion

A

Suspected foreign bodies
Vertical defect w/ fluorescein staining
Have patient look down, pull lid inferiorly/anteriorly and rotate superiorly over CTA

36
Q

Ophthalmoscope Evaluates For

A 
Red reflex
Optic disc
Retinal circulation
Retinal background
Macula (if you're impressive)
37
Q

Cotton wool spots

A

Signs of ischemia or infarct in retina

38
Q

Blood & Thunder

A

Vein occlusion & edema in eye

Typically due to HTN

39
Q

Amsler Grid

A

Evaluates visual distortion w/ grid (for macular degeneration or other visual distortion)
Visual field defects
Central field defects

40
Q

Metamorphopsia

A

Visual Distortion

41
Q

Scotoma

A

Blind spot

42
Q

CT for eyes

A

Always in traumas

Infection? Do CT w/ contrast

43
Q

MRI for eyes

A

w/ and w/o contrast
good for neural structures
Make sure to do “fat suppression”
IIH? MRI w/ MRV to look @ venous system

44
Q

Fluorescein angiography for eye

A

Evaluate retinal bloodflow (leakage)

Central serous retinopathy, macular degeneration

45
Q

Ultrasonography for eye

A

Large black circle is vitreous humor

See detached retina (line through vitreous humor)

46
Q

OCT

A

Optical coherence tomography
Infrared light penetrates retina
Can see downt o 10-15 microns
Can distinguish 15 layers of retina

47
Q

When to refer pt. w/ reduced visual acuity?

A

Worse than 20/20 (or documented baseline) w/ visual symptoms in one or both eyes

Worse than 20/40 in both eyes w/out symptoms

Assymetry (difference of 2+ lines on Snellen chart)

Pesbyopia (reduced near vision w/ no change in distance)

48
Q

When to refer abnormal fundus appearance?

A

Wide range of normal
Use discretion & resources
Don’t be afraid to reach out to ophtho

49
Q

When to refer elevated IOP?

A

> 22mm Hg

Ophthalmology (9 decks)

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