Ophthalmology and Ocular Examination 

Question 1

Read the lecture briefly.

Answer 1

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Question 2

Define conjunctiva

Answer 2

The conjunctiva lines the inside of the eyelids and covers the sclera (white part of the eye).

Question 3

Define the movements & nerves the 6 extraocular muscles.

Answer 3

• Rectus muscle actions
– Superior—up gaze
– Inferior—down gaze
– Lateral—external gaze (6)
– Medial—internal gaze

• Oblique muscle actions
– Superior—down and in (4)
– Inferior—up and in

Mnemonic: SO4 LR6 Rest = 3

Question 4

Define 20/20 vision. What do the numerator & denominator stand for?

Answer 4

20/20 means pt can read at 20 feet what normal eye reads at 20 feet.

Numerator = 20 feet (normal), where patient is standing 20 feet away

Denominator = your vision, which can change from 20, increase = worse vision, decrease = good vision

Question 5

Define 20/30 vision.

Answer 5

20/30 eye reads at 20 feet what normal eye could read at 30 feet.

Question 6

It is possible to have vision superior to 20/20, which number changes, top or bottom?

Answer 6

Bottom # decreases–20/10 so eye reads at 20 feet what normal eye could read at 10 feet.

Question 7

What is scleral icterus?

Answer 7

Yellowing of the sclera, typical of liver disease or jaundice.

Question 8

What is a cataract?

Answer 8

A cataract is a clouding of the lens inside the eye which leads to a decrease in vision.

Question 9

List mnemonic for cranial nerves.

Answer 9

I - Olfactory nerve
II - Optic nerve
III - Oculomotor nerve
IV - Trochlear nerve
V - Trigeminal nerve
VI - Abducens nerve
VII - Facial nerve
VIII - Vestibulocochlear nerve
IX - Glossopharyngeal nerve
X - Vagus nerve
XI - Accessory nerve
XII - Hypoglossal nerve

Question 10

Recognize and make appropriate decisions re treatment or referrals for

Answer 10

– Conjunctivitis
– Cataract
– Corneal ulcer (Herpetic Corneal ulcer – dendritic & geographic)
– Macular degeneration
– Diabetic retinopathy
– Hypertensive retinopathy
– Glaucoma
– Uncorrected refractive error
– Ocular trauma
– Papilledema
– Hemianopic and bitemporal VF defects
– Acute onset of CN palsies – Acute onset of strabismus – Leukocoria
– Red Eye
• Conjunctivitis
• Hemorrhage
• Abrasion
• Inflammation–uveitis • Infection
• Glaucoma–acute
– Diplopia
• CNpalsy–canbelife
threatening
– Headache
• Sinuses,tumor,aneurysm • papilledema
• Pediatric concerns
– Turn / strabismus
– Risk of amblyopia <10yo – Infections
– Mass lesions of orbit
• Acute Visual loss
– Ischemia, RD, stroke
• Chronic Visual loss
– Cataract, macular degeneration, glaucoma, other