Ophthalmic Exam Flashcards
what is required to discern depth
focused, narrow, bright beam of light
sparates the layers
tools required for a ophthalmic exam
strong light source in a dark environment
Schirmer tear test
flourescein
tonometry
means of viewing fundus (tropicamide)
magnification
means of discerning depth
3 vision tests
cotton ball test
photopic maze
scotopic maze
tests of orbital symmetry
orbital palpation
dorsal view assessment (exophthalmia/endophthalmia)
retropulsion
what can become evident with retroillumination
vitreal opacities
palpebral reflex tests:
CN V (trigeminal) - afferent
CN VII (facial) - efferent
menace response test:
CN II (optic) - afferent
CN VII (facial) - efferent
cover opposite eye, use open fingers
remember young animals will not have a menace response!
pupillary light relex (PLR) tests
CN II (optic) - afferent
CN III (ocularmotor) - efferent
dazzle reflex test:
CN II (optic) - afferent
CN VII (facial) - efferent
oculocephalic reflex
Intact CN II
**does not need to function in order to elicit positive response, but is necessary to initially develop the reflex**
peripheral and central vestibular components
CN III, IV, ans VI
fast phase of nystagmus toward head rotation
corneal reflex tests
CN V (trigeminal) - afferent
CN VI and VII (abducens, facial) - efferent
what tests are part of the minimum data base
Schirmer Tear Test (STT)
Flourescein Stain
Tonometry
what does schirmer tear test assess
aqueous portion of the tear film
tests the tears present and reflexive production
what is a normal STT
> 15 mm wetting/minute
what is flourescein stain
hydrophilic dye that fluoresces green under cobalt blue light
which layers are hydrophilc and will therefore fluoresce under a cobalt blue light whne stained with fluorescein
tear film - needs to be flush
stroma - will stain bright green, ulcer
epithelium and descemet’s membrane will not stain
3 common uses of fluorescein stain
diagnosis and characterization of corneal ulcers
demonstration of nasolacrimal duct (jones test)
demonstration of cornea perforation (seidel test)
corneal ulcer detected or not detected
not detected - normal fluorescein
blockage of nasolacrimal system could cause
epiphora
Excessive tearing
T/F a negative jones test proves nasolacrimal obstruction
False
a positive jones test demonstrates patency, but a negative does not prove obstruction
what does seidel test demonstrate
aqueous leaking through fluorescein stain
positive seidel confirms corneal perforation
what does tonometry measure
intraocular pressure in mmHg
not performed in damaged eyes, before pupil dilation
IOP > 25mmHg with vision loss indicates
glaucoma
normal IOP
10-20mmHg
should be <25mmHg at all times
low IOP are consistent with
uveitis
what is the adnexa
everything that supports the eyeball orbit, periocular skin, eyelids, third eylid, conjunctiva
blepharitis
inflammation of the eyelid
the eyeball should be evaluated for
symmetry, size and shape
corneal evaluation
evaluate epithelium, stroma, descemet’s membrane and endothelium for clarity
important considerations: depth, magnification , quality
specular reflection
assists in lesion localization
disturbance of this reflection indicates irregularity or ocular surface
the anterior segment of the eye consists of
anterior chamber and posterior chamber
T/F tropicamide dilation required for complete exam of the fundus
True
