Ophthalmoscopic Exam

Question 1

What is a cataract?

Answer 1

Opacification of the lens (visible through the pupil)

Question 2

What is the most rapidly progressive type of cataract?

Answer 2

Subcapsular cataract

Question 3

Which type of cataract causes gradual clouding of central vision?

Answer 3

Nuclear cataract

Question 4

Are nuclear cataracts usually bilateral?

Answer 4

Yes

Question 5

Which type of cataracts have less impact on vision?

Answer 5

Cortical cataracts (spoke-like appearance)

Question 6

What causes foggy or blurred vision changes?

Answer 6

Cataracts (like looking through a dirty window)

Question 7

Increased glare is a sign or symptom that what is worsening?

Answer 7

Cataracts are progressing

Question 8

Who is most likely to come in with cataracts?

Answer 8

Older people
50% of 65-74 y/o
70% of 75+ y/o

Question 9

How can you avoid cataracts?

Answer 9

Don’t smoke
Wear UVB eye protection (sunglasses)
Avoid long-term systemic steroids
Don’t be a diabetic

Question 10

What can be done to treat cataracts?

Answer 10

Replace the lens of the eye (quick, outpatient surgery w/local anesthesia)

Question 11

What is the order of an eye exam?

Answer 11

1) Red reflex
2) Fundoscopic Exam (cup:disc ratio and vessels and retina)
3) Anterior chamber structures (vitreous body and anterior chamber)

Question 12

T/F The room can be well-lit during a fundoscopic exam

Answer 12

False - helps to darken the room so pupils can dilate and help allow evaluation of the fundus (back of the eye)

Question 13

What is the ratio of disc:cup?

Answer 13

2:1

Question 14

What does the optic disc represent?

Answer 14

Head of the optic nerve

Question 15

What does the physiologic cup represent?

Answer 15

Entry point for retinal vessels

Question 16

Describe a normal optic disc

Answer 16

Round shape
Distinct margins
Yellowish-orange to creamy pink colour
Pale central “physiologic cup”

Question 17

T/F Refer out if you see a pigment crescent in the optic disc

Answer 17

False - this is a normal variant

Question 18

T/F: Myelinated nerve fibers coming out at the disc margins are a normal variant?

Answer 18

True

Question 19

Why might the cup become enlarged, changing the cup to disc ratio?

Answer 19

Increased pressure in the eye

Question 20

What is cupping of the disc indicative of?

Answer 20

Atrophy of the optic nerve d/t increased intraocular pressure (IOP)

Question 21

T/F Untreated open angle glaucoma can lead to blindness

Answer 21

TRUE - optic nerve will atrophy and lead to blindness

Question 22

What is the leading cause of preventable blindness?

Answer 22

Open-Angle Glaucoma

Question 23

Who is more at risk for open-angle glaucoma?

Answer 23

African-Americans (3-5x)

Increased prevalence with age

Question 24

Risks for Open Angle Glaucoma

Answer 24

Family History
Severe myopia
Diabetes
CVD
Medication

Question 25

Which type of eye disorder is difficult to detect because it causes gradual loss of peripheral vision without pain?

Answer 25

Open-Angle Glaucoma

Question 26

Long term use of corticosteroids, such as topical drops, can cause what?

Answer 26

Open Angle Glaucoma

Question 27

T/F Open Angle Glaucoma is asymptomatic until end-stages

Answer 27

True

Question 28

Treatment for Open Angle Glaucoma?

Answer 28

Eye drops to decrease IOP

Question 29

Why is it called Open Angle Glaucoma?

Answer 29

The angle between the cornea and the iris meet is wide and open but the drainage is not working properly, such that fluid builds up in the posterior chamber, creating IOP

Question 30

What most commonly causes an abnormal red reflex?

Answer 30

Cataract