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6th MELEAH Sam 2 test 2 > Opthalmic 1 > Flashcards

Opthalmic 1 Flashcards

1
Q

OD means? OS means? OU means?

A

OD = right eye, OS = left eye, OU = both eyes

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2
Q

________: movement of the iris. This finding is usually supportive of lens instability

A

Iridodonesis

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3
Q

_______: in a well-lit environment

A

Photopic

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4
Q

_______: in a dark environment

A

• Scotopic

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5
Q

__________: using light that is shone into the eye to reflect against internal structures and highlight normal/abnormal features during the ophthalmic exam

A

Retroillumination

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6
Q

_________: inflammation of the cornea. Most commonly evident by the presence of corneal ulceration, corneal infiltrate, or blood vessels

A

Keratitis

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7
Q

________ _______: inflammation of the cornea (keratitis) that is caused by lack of sensory innervation (ophthalmic branch of CN V)

A

Neurotrophic keratitis

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8
Q

_________: applying light pressure to both eyes (through the eyelids) simultaneously with your index finger to detect for asymmetry. This is a useful test for detecting disease of the orbit or space occupying disease behind the globe

A

Retropulsion

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9
Q

__________: disruption of the corneal epithelium and exposure of the corneal stroma

A

Corneal ulceration

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10
Q

________: application of fluorescein dye to the ocular surface which then appears at the nares. This is a test of nasolacrimal patency

A

Positive Jones Test

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11
Q

__________: application of fluorescein dye to the ocular surface and subsequent appearance of aqueous humor leaking through dense fluorescein stain. This test confirms corneal perforation

A

Positive Seidel test

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12
Q

______: defined as a breakdown of the blood ocular barrier.

A

Uveitis

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13
Q

___________: vision loss that occurs from optic nerve damage as a result of high intraocular pressure

A

Glaucoma

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14
Q

A well designed ______ ______ will promote a thorough exam and clear communication

A

examination form

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15
Q

What are your 5 required tools?

A

• Strong light source in a dark environment • Schirmer Tear Test • Fluorescein • Tonometry (proparacaine) • Ophthalmoscope (tropicamide)

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16
Q

Which tool are appropriate and not appropriate for a strong light source?

A

Halogen = appropriate (Finoff transilluminator, Otoscope) Incandescent = too dim (pen light) LED=too bright (need a piece of white tape)

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17
Q

True or False: A magnifier is not helpful

A

False!!!!! extremely helpful

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18
Q

ID

A

Distichia

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19
Q

Describe the benefits? What is it?

A

• Macrolens attachments benefits:

– Inexpensive

– Good images of the anterior segment

– Ability to save and share images!

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20
Q

What do we do in the initial patient assessment? (4)

A

– Distance examination

– Vision tests

– Tests of orbital symmetry

– Retroillumination

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21
Q

In addition to initial patient assessment we also do these 3 procedures?

A
  • Cranial nerve assessment
  • Minimum database
  • Ophthalmoscopy
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22
Q

What is the first thing you do in the initial patient assessment

A
  • Assessment of entire body
  • Assessment of head and eyes at a distance
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23
Q

What can we do to assess vision in our animals?

A

• Cotton Ball Test

– Most visual animals follow cotton balls

• No sound or scent

– Cats may choose not to participate!

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24
Q

When we are assessing vision we place objects in a random order and this is doing what?

A

• Maze Testing

– Place objects in random order

– Conduct in both bright and dim light settings

– Look for speed of navigation and object avoidance

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25
Q

How do we assess orbital symmetry?

A
  • Orbital palpation
  • Dorsal view assessment
  • Retropulsion
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26
Q

What are we testing in these pics?

A

Retroilllumination

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27
Q

What cranial nerves/assessements do we like to assess?

A

– Palpebral reflex

– Menace response

– Pupillary light reflex

– Dazzle reflex

– Oculocephalic reflex

– Corneal reflex

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28
Q

What nerves do we test in the palpebral?

A

– CN V (afferent)

– CN VII (efferent)

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29
Q

What nerves do we assess in the menace response? What does it require?

A

– CN II (afferent)

– CN VII (efferent)

– Learned (~12 weeks old)

– Requires visual acuity of only 20/20,000!

NOT THAT GREAT

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30
Q

The pupillary light reflex asesses what nerves?

A

– CN II (afferent)

– CN III (efferent) oculomotor

(shine bright light in eye assess indirect and direct crossover at chiasm)

31
Q

What nerves do the dazzle reflex?

A

– CN II (afferent)

– CN VII (efferent)

(subcortical and often have it if pathways intact)

32
Q

What is significant about the pupillary light reflex and the dazzle reflex?

A

**These tests do not reflect vision**

33
Q

What nerves does the oculocephalic reflex?

A

– CN II* (afferent)

– Peripheral and central vestibular components

– CNs III, IV, and VI (efferent)

she likes it to test mobility

34
Q

The corneal reflex assesses these nerves?

A

– CN V (afferent)

– CN VI and VII (efferent)

35
Q

What is being shown here?

A

• Corneal reflex – abnormal example

Neurotrophic keratitis OD

= Loss of the ophthalmic branch of CN V

36
Q

WHAT DO you do for the minimum database? (3)

A

– Schirmer Tear Test I

– Fluorescein Stain

– Tonometry

37
Q

Guildeline for Schirmer tear test 1

  • ____________
  • ____________
  • ____________

NORMAL

  • Dogs= __________
    • ​______
  • Cats= ________
A
  • Guidelines
    • Performed before any other drops or ointments
    • Performed before sedation or anesthesia
    • Performed for 60 seconds
  • Normal
    • Dogs = >15mm wetting/minute
      • Basal and reflex tearing
    • Cats = unpredictable!
38
Q

This is an example of?

39
Q

After performing the schirmer tear test for our minimum database we next do?

A

Fluorescein Stain

40
Q

Describe the dye for Fluorescein stain? What structures will and won’t stain?

A

Aqueous stain

  • (Hydrophilic (stroma) dye that fluoresces green under cobalt blue light)
  • Epithelium – hydrophobic – will not stain
  • Stroma – hydrophilic – will stain bright green
  • Descemet’s membrane – hydrophobic – will not stain
41
Q

What are the 3 common uses for Fluorescein stain?

A
  1. Diagnosis and characterization of corneal ulceration
  2. Demonstration of nasolacrimal patency (Jones Test)
  3. Demonstration of corneal perforation (Seidel Test)
42
Q

Decribe the pattern of stain and what is being exhibited in the pic?

43
Q

Decribe the pattern of stain and what is being exhibited in the pic

44
Q

Decribe the pattern of stain and what is being exhibited in the pic

A

Descemetocele

45
Q

What does the Jones test assess?

A

• Assesses nasolacrimal patency

46
Q

What are the system components for the nasolacrimal components? (6)

A
  • – Medial canthus
    • Upper punctum (circled)
    • Lower punctum (circled)
  • – Lacrimal sac
  • – Nasolacrimal duct
  • – Nasal and pharyngeal openings
47
Q

When performing the jones test and you note a blckage what negative affect could this cause?

A

Blockage could cause epiphora (tearing)

48
Q

A positive Jones Test demonstrates _______ ________

A

nasolacrimal patency

49
Q

A negative Jones Test does or does not prove this?

A

does not necessarily prove nasolacrimal obstruction

50
Q

What is being tested here?

A

Seidel Test

51
Q

A positive Seidel test confirms _____ _______

– What does it demonstrate?

A
  • corneal perforation
  • Demonstrates aqueous leaking through fluorescein stain
52
Q

________:

Measures intraocular pressure in mmHg

53
Q

Guidelines for tonometry:

-Do not perform in ____ eyes

Performed (BEFORE OR AFTER?) pupil dilation?

54
Q
  • fragile
  • Peformed BEFORE pupil dilation (tropicamide)
55
Q

Tonometry

  • Which reading is your most accurate?
  • ____-____ mmHG is normal and should be below < _____mmHG at ALL TIMES
  • Pressures over >______with vision loss indicate ______
  • Low intraocular pressures are consisitent with ______
A
  • The lowest reading is your most accurate reading!
  • 10-20 mmHg is normal. Should be <25mmHg at all times.
  • Pressures >25mmHg with vision loss = Glaucoma

• Low intraocular pressures are consistent with Uveitis

56
Q

This pic is depicting what type of tonometry?

A

Tonometry (Tonopen: applanation)

57
Q

Applanation tonometry correlates force used to this? What do we use when peforming this?

A

Correlates force used to flatten cornea with IOP

Use topical anesthetic

58
Q

Unfortunately applanation tonometry is easy todo this to? What do we do daily or prior to use?

A

• Easy to artificially elevate IOP

– Brachycephalics

  • Calibrate
59
Q

What factors do we consider with Ophthalmoscopy? (5)

A
  1. Magnification
  2. Field of view
  3. Depth perception (stereopsis)
  4. Initial ease of use
  5. Safety
60
Q

A large field of view allows for a more rapid and thorough _____ examination, making the _____technique more valuable for veterinary ophthalmology

A

fundus; indirect

61
Q

The pointer is indicating

A

Lens diopter number

62
Q

WIth applanation tonometry what 4 coefficient of variance are considered?

A

– Reliability of result

– Should be 5% (TonoPen)

– Should be 95% (TonoPen Avia)

– Measures variability between 3-6 readings

63
Q

What are some easy mistakes with applanantion tonometry?

A

– Tip cover too tight

– Tip cover too loose

64
Q

What instrument is being shown

A

Tonometry (Tonovet: rebound)

66
Q

______:

– Lightweight probe “bounces” off cornea

Is topical anesthetic required?

A

TonoVet

No topical anesthetic required!

67
Q

The tonovet is calibrated by manufacturer and can be species dependent for horse, dogs, and other. It records _____ measurements

A

Records 6 measurements

– Averages final result (excludes highest and lowest)

– Line indicates standard deviation

  • No line (<1)
  • Low line (1-2.5)
  • Mid line (2.5-3.5)
  • High line (>3.5)
68
Q

What is really important for the opthoexam especially when measuring IOP? What 4 things should we do?

A

Proper restraint

  • No pressure on neck
  • Hand under chin and behind head
  • Head in neutral position
  • Patient standing, sitting or sternal
69
Q

Which is the correct IOP?

• 25mmHg, 13mmHg, 17mmHg

A

13 mmHG

– Lowest IOP most accurate

70
Q

What are some easy mistakes that affect the IOP?

A

– Pressure on neck

– Head position

– Squinting dog

– Pressure on globe from improper lid retraction

71
Q

True or False

– Lissamine Green ( both corneal stains)

– Rose Bengal( both corneal stains)

ARE commonly used tests

A

False

Less commonly utilized tests

72
Q

______ is required for complete exam? (what is it and what structures can we assess after it?

A

Tropicamide

This medication is used to widen (dilate) the pupil of the eye in preparation for certain eye examinations. It belongs to a class of drugs known as anticholinergics. Tropicamide works by relaxing certain eye muscles.

– Retina

  • Neurosensory retina
  • Retinal pigmented epithelium

– Tapetum

– Choroid

– Sclera

– Optic nerve

73
Q

Each image is demonstrating what for ophthalmoscopy?

74
Q

Label the parts

6th MELEAH Sam 2 test 2 (18 decks)

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