Opthalm Flashcards

1
Q

4 essential components of the ophthalmoscope

A

on off switch
lenses
light
diaphragm

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2
Q

how should an ophthalmoscope be held

A

as a microphone
no wrist flexation
always keep index finger on lens dial

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3
Q

ophthalmoscopes provide a high magnification of approx 15x but have a small field of view which between x and y degrees

A

6.5-10

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4
Q

why will you not be able to see a sterioscopic/ 3d vision

A

using one eye

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5
Q

will you be able to see the macula?

A

no

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6
Q

what will take up the whole field of view

A

optic disc !!

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7
Q

what should you ask patients before doing the examination

A

pain
glasses

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8
Q

you must set the ophthalmoscope according to the patients refractive error, what should it be set to if the patient wears contact lenses

A

0

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9
Q

if patients do wear glasses but only for reading what should you set then refractive error to

A

0

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10
Q

if a patient wears glasses for distance such as driving or tv what should then ask them

A

long or short sighted

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11
Q

how can you work out for a patient if they are long or short sighted

A

look through glasses if things appear smaller they are short sighted if things appear bigger they are long sighted

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12
Q

if a patient is short sighted/ myopic should you set the dial to what colour numbers

A

red

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13
Q

if a patient is long sighted/ hypermetropic what colour should you set the dial to (can also be yellow/green/white)

A

black

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14
Q

if things appear a lot smaller or larger in a patients glasses that means that their lenses are thick and relatively strong. What would this prompt you to do in relation to dials

A

set to a high number

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15
Q

how can you make carrying out the examination easier for yourself

A

bright scope - halogen bulb, new batteries
dark room
comfortable patient
dilate pupils

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16
Q

after hand hygiene and introducing yourself to the patient you should give the patient clear instructions and explain what you are going to do. What would you instruct them to do at this stage

A

remove glasses
fixate on distant object
blink and breathe as normal

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17
Q

If YOU wear glasses, what should you do during exam? to make it easier

A

keep them on… else can take off and add error to dial

18
Q

when carrying out the examination where is an appropriate place to place your hands on the patient

A

shoulder

19
Q

you use the red reflex to detect any opacities in the media such those caused by…. 2

A

cataract
retinoblastoma

20
Q

how do you test the red reflex

A

set lens to 0
shine light at pupil from arms length
observe red reflex
compare in each eye

should be both eyes red

21
Q

what would you observe in a patient with cataract when you look at the red reflex

A

absent

22
Q

what colour glow do you expect in the eyes when you do a red reflex test

A

yellow or orange glow

23
Q

when doing direct ophthalmoscopy should you start with your dominant or non dominant eye

A

dominant and close non dom

24
Q

you use your

right eye
right hand
and right index finger on dial to check the patients

left or right eye

A

right

25
Q

what is the angle of approach temporal to the patient in degrees

A

15 NOT 45

26
Q

why is angle of approach 15 degrees

A

its where the blind spot or optic disc is

27
Q

what should you use as your aiming beam ie keep visualised as you get nearer to the patient

A

red reflex

28
Q

why is it important to get close to the patient

A

increases field of view

29
Q

what 3 parts of the optical media are you trying to assess

A

cornea
lens
vitreous

30
Q

what 2 parts of the fundus are you trying to see

A

optic disc
retina

31
Q

what 2 parts of the retina are able to be viewed

A

macula
blood vessels

32
Q

one key structure to observe is the optic disc, what are the 3 Cs to think about

A

cup disc ratio
colour
contour

33
Q

what would you expect to see when you visualise the eyes of a diabetic patient potentially

A

new vessels

34
Q

what changes to the cup disc ratio would you expect to see in glaucoma

A

bigger vertical CDR

35
Q

what would you expect to see in optic disc pallor/ optic atrophy

A

disc margins appear sharp and disc is pale

36
Q

some symptoms of papilloedema

A

headaches
worse when coughing
transient visual obscurations
elevated disc
blurred disc margins
disc haemorrhages
absence of spontaneous venous pulsation
normal vision in initial stages

37
Q

what else can be seen when checking retinal BV?

A

arterioles and veins
calibre
new vessels, collateral vessels

38
Q

what else can be seen when looking at macula (if pupil dilated)

A

foveal relfex
any other finding in macula = abnormal
- haemorrhages
- microaneurysms
- exudates
- cotton wool spots
- drusen
- atrophy

39
Q

2 types of age related macula degeneration

A

dry and wet: green, red splodges

40
Q

what does diabetic retinophy look like?

A

lots of BV and light spots