Ophthalmic Examination

Question 1

Systemic conditions of the eye usually present…..

Answer 1

bilaterally

Question 2

What is important to take note of in a Hands off Ophthalmic Examination? (5)

Answer 2

Behaviour- Vision, blink rate
Size and position of globe
Asymmetry
Ocular Discharge
Eyelid conformation

Question 3

What are the three main reflexes tested in a hands on examination?

Answer 3

Palpebral reflex
Menace response
Vestibulo-ocular reflex

Question 4

What does the Schirmer test do?

Answer 4

measuring aqueous portion of precorneal tear film- dry eye

Question 5

What is classed as a normal reading in a Schirmer test?
What is abnormal?

Answer 5

15mm/min and above are normal
10mm/min and less is abnormal

Question 6

What is tested during a focal light examination? (3)

Answer 6

Dazzle Reflex
PLR (pupillary light reflex)
Swinging Light Test

Question 7

What structure does Retroillumination illuminate (lol)?

Answer 7

Tapetum Lucidium causes a green illumination behind the eye (like a mirror)

Question 8

What does Retroillumination aim to examine?

Answer 8

1. Pupil Shape
2. Pupil Size & Symmetry
3. Presence of Opacity

Question 9

What is dyscoria?

Answer 9

abnormal pupil shape- can be due to trauma, masses etc.

Question 10

What is aniscoria?

Answer 10

asymmetry in pupil size

Question 11

What is the difference between Mydriasis and Miosis?

Answer 11

Mydriasis- large pupil
Miosis- small pupil

Question 12

In the dark, with an abnormally large pupil…

Answer 12

the aniscoria becomes less obvious

Question 13

In the dark, with an abnormally small pupil…

Answer 13

the aniscoria becomes more obvious

Question 14

How does Retroillumination help detect opacities?

Answer 14

any opacity will obstruct the passage of light towards the tapetum lucidum and will obscure the tapetal reflex- we can use this to help us locate the opacity

Question 15

What is Hyphaema?

Answer 15

blood in the anterior chamber

Question 16

An opacity in the posterior segment of the eye….

Answer 16

moves in the same direction as the examiner

Question 17

What is the difference between cataracts and nuclear sclerosis?

Answer 17

Nuclear Sclerosis- normal aging change where the lens nucleus becomes compacted with time to cause a blue/grey appearance on the lens- does not cause visual impairement
Cataracts is a true opacity in the lens that is potentially blinding

Question 18

What is the Tyndall effect?

Answer 18

Aqueous fluid in the anterior chamber is usually clear- when there are proteins present inside the fluid, the light may reflect in multiple directions, leading to the scattering of light. This is called the Tyndall effect and shows the presence of inflammatory cells in the fluid.

Question 19

What is Tonometry?

Answer 19

estimation of intraocular pressure

Question 20

What are the three different methods of Tonometry?

Answer 20

1. Indentation
2. Applanation
3. Rebound

Question 21

What is the normal IOP of an animal?

Answer 21

10-25mmHg (varies between individuals and between eyes but shouldn’t have more than 20% difference)

Question 22

What is Tropicamide?

Answer 22

eye drops to dilate the pupil

Question 23

What is the difference in the views of Direct and Indirect Ophthalmoscopy?

Answer 23

Direct- upright (but limited) field of view of the fundus
Indirect- virtual, inverted and magnified (bigger field of view)

Question 24

What is needed to be done before performing Indirect ophthalmoscopy?

Answer 24

pupils need to be dilated

Question 25

How does monocular and binocular indirect ophthalmoscopy differ?
Include advantages/ disadvantages.

Answer 25

Monocular- lens is held by examiner- no depth perception but has a low cost
Binocular- lens is positioned on a headband , larger depth perception but equipment can be very expensive to purchase

Question 26

What is Fluorescein stain used for?

Answer 26

To examine corneal ulcers
Jones Test- blockages in the lacrimal system
Seidal Test- uses cobalt blue light to monitor for aqueous humour leaks

Question 27

When would you perform corneal/ conjunctival cytology?

Answer 27

Purulent Conjunctivitis
Melting Ulcers
Inflammatory infiltrates in the cornea