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Opthalmology > Opthalmic Exam > Flashcards

Opthalmic Exam Flashcards

1
Q

What are the 3 main areas of concern that owners normally present their pets with?

A

Altered appearance of the eye
Loss of vision
Pain

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2
Q

What does protrusion of the globe AND the third eyelid indicate and why?

A

A space occupying lesion behind the eye. Normally the third eyelid comes across as the eye is withdrawn, displacing the fat pad. In health the third eyelid would not normally come across with a protruded eye hence it is likely that something is pushing the eye and the third eyelid out from behind e.g. neoplasia, abscess, fluid etc

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3
Q

Which species can move the third eyelid voluntarily (to a degree)

A

Cats

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4
Q

How should you place a STT strip?

A

Do this before anything that might agitate the eye and cause tear production (e.g. light, eyelid manipulation). Bend the strip in the packet, retract the lateral lower eyelid and place in the lower fornix laterally. It should touch the cornea once hooked but not poke the cornea as you place it.

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5
Q

How long should you wait per eye for STT?

A

1 minute

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6
Q

Why is it important that the tear strip is placed laterally?

A

Tears pool in the medial canthus so may give false reading, interference from the third eyelid would alter the result

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7
Q

What is considered normal and low readings for STT1? (remember to consider in context of other signs e.g. ulcer)

A

Above 15mm/min=normal
Lower than 10mm/min=low
In between is unclear, repeat at another time

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8
Q

What is the menace response?

A

Part fingers quickly in front of eye. (Do not touch the hairs, vibrissae or eyelids, and do not fan hand in front of face.) It is a learned (cortical) response not a reflex. A very crude test for vision

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9
Q

What is the anterior chamber?

A

The area in front of the iris

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10
Q

What is the posterior chamber?

A

The area between the iris and the ciliary body (tiny)

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11
Q

What is the anterior segment?

A

The area in front of the lens

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12
Q

What is the posterior segment?

A

The area behind the lens (vitreous humour etc)

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13
Q

What are the three classes of light examination techniques?

A

1) Transilumination/Slit examination
2) Direct Opthalmoscopy (DDO and CDO)
3) Indirect Opthalmoscopy (IO)

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14
Q

What can be assessed by slit examination/transillumination?

A

Anterior structures of the eye-eyelids, conjunctiva, third eyelid (non-transiluminable)
cornea, iris, anterior lens (transiluminable)
Reflexes-PLR (direct and indirect e.g. L to R)

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15
Q

What is the blue light on an opthalmoscope used for?

A

Fluorescein staining

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16
Q

What beam would you use for looking at surface architecture?

A

Circular, bright beam

Look for overall brightness and moisture, white conjunctiva, sharp and smooth purkinje reflexes

17
Q

Do blinding cataracts effect PLR and dazzle reflex?

A

No!

18
Q

How thick is the cornea?

A

0.5mm

19
Q

What is an indirect PLR?

A

When you shine a light on one eye, the other pupil also contracts (indirect)

20
Q

How well can you assess ulcer depth with a slit beam?

A

Not very well-need a slit lamp referral technique as expensive equipment and difficult to interpret

21
Q

What is flare?

A

Protein/cells in the anterior chamber (aqueous humour)

22
Q

What layers will you see highlighted by the slit beam?

A

Cornea, anterior chamber, iris, anterior belly of the lens, lens, possibly posterior belly of the lens

23
Q

What are the seven changes in the AC visible with light examination? (TKHHPAA)

A 
Tyndall effect (flare)
Keratic precipitates
Hyphema
Hypopion
Posterior synechia
Anterior lens luxation
Anterior presentation of the vitreous
24
Q

Where is the aqueous humour made and where does it drain through?

A

It is produced in the ciliary body and it drains via the iridocorneal angle

25
Q

Why do keratic precipitates settle at the bottom?

A

Gravity

26
Q

What is aqueous flare or the Tyndall effect?

A

Light reflecting of proteins in the aqueous humour. Indicates inflammation in the anterior chamber

27
Q

What are keratic precipitates?

A

Cells deposited on the ventral endothelium of the cornea, occurs as a result of inflammation of the iris or cilliary body

28
Q

What is hyphema?

A

Blood in the anterior chamber

29
Q

What is hypopion?

A

pus (white cells) in the anterior chamber

30
Q

What is synechia? posterior and anterior

A

Posterior synechia is when the iris adheres to the lens, anterior synechia is when the iris adheres to the cornea. May lead to glaucoma

31
Q

What is anterior lens luxation?

A

The lens is infront of the pupil, often in the anterior chamber. Leads to closure of iridocorneal angle and hence glaucoma

32
Q

What is anterior presentation of the vitreous?

A

vitreous humour in the anterior segment

33
Q

How should you do a fluorescein test?

A

Strips better than drops
Adheres to stroma (hydrophilic) repelled by epithelium, wet strip with saline and apply a drop onto dorsal conjunctiva, rinse with saline. look for ulcers. BLUE LIGHT

34
Q

What is a Jones test and how do you do it?

A

Do not rinse out fluorescein, wait up to 4 mins and see if flows to nose via NLD, look with blue light. If doesn’t reach the nose may be blocked-indicates flushing

35
Q

What are the three methods for checking intraocular pressure? (aka tonometry)

A

Indentation-old, cheap, inaccurate
Applanation-tonopen vet, new expensive, accurate
Rebound-Tonovet, new, expensive, accurate

36
Q

what is the normal range for IOP?

A

12-22mmHg

37
Q

What 2 conditions can IOP help you to distinguish from one another?

A

Glaucoma vs uveitis although NB long standing uveitis can lead to secondary glaucoma

38
Q

What is Gonioscopy?

A

Measures the iridocorneal angle through which aqueous humour exits. Narrow or closed ICA doesn’t always correlate to glaucoma

Opthalmology (6 decks)

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