Opto 2.0 Flashcards
What are the 7 essentials of an eye exam
What parts are examined at a minimum
DIPLOMA
Depth IOP Pupils Lamp Ophthalmoscopy Motility Acuity
P-DIVE
Pupil Direct ophth IOP VA EOM
Eyelids are AKA, seperated by ? and meet at the ?
What are their two functions
What structures do they contain
Palpebrae, Palpebral fissure, Canthus
Protection
Lacrimal aid- spread new/pump old
Meibomian glands
3 muscles located w/in the eyelid:
Function and innervation of Orbicularis Oculi muscle
Function and innervation of Levator Palpebrae Superioris muscle
Function and innervation of Mueller’s Muscle
Closes eyelid, CN7
Opens upper eyelid, CN 3
Opens upper/lower lid during fear/surprise via sympathetic ANS
What are the 3 spheres (tunics) of the globe
Define Cornea
Define Limbus
Fibrous Vascular Nervous
Front window of eye, 2/3 of eye refractive surface (other 1/3- lens)
Sclera and cornea junction
What are the two muscle of the pupil what innervates each muscle
Define Conjunctiva and the two types
Define the Ciliary Body
Sphincter- Parasympathetic ANS
Dilator- Sympathetic ANS
Clear membrane covering
Palpebral- eyelid
Bulbar- sclera
Produces aqueous humor
Contains ciliary muscles- alter zonular to change lens
What is the main function of the Ciliary Muscles
Define Choroid
What does this structure provide blood to
Near focus- accommodation
Pigmented and vascular layer between retina and sclera, provides blood to retina
Outer retinal layer
Where is the Anterior Chamber located and what does it contain
Where is the Posterior Chamber located and what is it filled with
What shape is the lens and what structures keep is suspended
Between cornea and iris- aqueous humor and drainage
Behind iris, in front of vitreous
Aqueous humor
Biconvex; Zonules
Vitreous Humor is transparent gel made of ?
What function does it perform
Retina is the ? liner and referred to as the ?
Collagen Protein Hyaluronic Water
Maintains structures
Neural lining, fundus
How many layers of the retina are there
What structures are contained here
What are the two types
10 layers, 9 are transparent
Photoreceptors- send signals to brain
Cones- color, visual acuity (6mill/eye)
Rods- black/white, night vision (120M/eye)
Define the Macula and it’s function
What is the name of the central depression in the macula
What is contained here
Posterior pole of retina- fine, central vision
Fovea- 4mm temporal and 0.8mm inferior to optic nerve
Mostly cones, 1/3 of all nerve fibers
Define the Optic Disc
What is the Disc AKA
What are the extra-ocular muscles
Nerve/vessels converge and leave eye
Physiologic/anatomic blind spot x 15* temporal
4 rectus (Superior Lateral Inferior Medial) 2 obliques (Superior Inferior)
What movements are the 6 extra-ocular muscles in charge of
What is the term that describes how these muscles work
IO: extortion, elevation SO: intorsion, depression SR: elevation LR: abduction IR: depression MR: adduction
In tandem, yoked: ipsilateral opposing muscle relaxes
What are the 3 layers of tears from out to in and where is each layer made?
What type of pathway is the optic nerve?
What type is the oculomotor and parasympathetic?
Oil- outer, from meibomian glands
Water- middle, from lacrimal glands
Mucin- inner, Goblet cells
Optic= Afferent
OM+P= Efferent
Define Double Decussation
Where does this chiasm occur in the brain
When conducting an exam, what is the next step if vision is >20/40 and why?
Direct and Consensual response
Pretectal /Edinger-Westphal nuclei
Pinhole- establishes visual potential w/ or w/out glasses
What eye is tested first during VA
What are the next tests done if Pt can’t read chart
If Pt or chart have to be moved, what does 20/20 at 10ft equal to?
Right (OD), w/ correction if applicable
Count Motion Light None
20/20 at 10ft (on 20ft chart)= 20/40
When is Near Visual Acuity testing preferred
What distance is this method conducted at
What do abbreviations cc and sc mean?
Bed-ridden Pt
14-16”
cc- w/ correction
sc- w/out correction
What does this stand for- “DVA cc 20/20 OD, 20/40 OS”
Define Visual Impairment
Define Visual Disability
Distance Visual Acuity w/ correction 20/20 right eye, 20/40 left eye
Condition of the eye
Condition of individual
Visual Impairment to Visual Disability: 20/12 to 20/20= 20/25 to 20/70= 20/80 to 20/160= 20/200 to 20/400 - CF 10ft= CF 8ft to 4ft=
20/12 to 20/20= normal 20/25 to 20/70= near normal 20/80 to 20/160= moderate low 20/200 to 20/400 - CF 10ft= severe low/legally blind CF 8ft to 4ft= profound low
AF and Army flight physicals have ? many cardinal points
What are the 3 things being evaluated for
Why is dilated ophthalmoscopy not done if PT has shallow anterior chamber depth
AF- 6
Army- 8, add up/down
Paralysis Entrapment Weakness
Triggers angle closure glaucoma crisis
Medications used for dilation are called ?
What two effects do they cause
What are examples of each kind and how long they last
Mydriatics
Adrenergic stimulating- stimulate iris dilator
Cholinergic blocking- paralyze iris sphincter
Adrenergic: Phenylephrine- 3hrs
Cholinergic: max 20-30/45/90/45/40 Tropicamide- 2-6hrs Cyclopentolate- 24hrs Homatropine- 2-3 days Scopolamine- 4-7 days Atropine- 1-2wks
When conducting ophthalmoscopy, what are the five structures being assessed
Normal IOP range
What are the two ways to measure IOP
Macula
Red reflex
Optic disc (physiologic cup)
Retinal circulation/background
10-21mmHg
Hand held tono-pen w/ anesthetic (latex allergy check)
Non-contact tonometry (air puff)
How is Anterior Chamber Depth assessed
What finding indicates a shallow chamber is present
This means Pts are at risk for ?
Shine light from temporal side
2/3 or more of iris in shadow= shallow chamber d/t iris bowing forward
Angle-closure glaucoma
Define Emmetropia
Define Hyperopia
Define Myopia
Normal, objects at infinity are seen clearly w/ unaccommodating eye
Far sight, axial length is short, image falls behind retina
Near sight, axial length is long, image falls before retina
Define Astigmatism
Define Presbyopia
What type of laser is used during SMILE eye surgery procedures
Elliptical, refracting power of cornea and lens different across meridians (horizontal, vertical)
Loss of accommodation, progressive lens hardening prevent focus on near objects
Femto