optoprep quiz Flashcards
when to prescribe myopic prescription?
isometropia
upto 1 year old: -5.00
1-2 yo: -4.00
2-3yo: -3.00
anisometropia:
up to 1 year: -2.50
1-2 year: -2.50
2-3 year: -2.00
when to prescribe hyperopia no esotropia?
isometropia
up to 1 year old: +6.00
1-2yo: +5.00
2-3yo: +4.50
anisometropia:
up to 1 year: +2.50
1-2 year: +2.00
2-3 year: +1.50
when to prescribe for hyperopia with esotropia?
isometropia
up to 1 year old: +3.00
1-2yo: +2.00
2-3yo: +1.50
anisometropia:
up to 1 year: +2.50
1-2 year: +2.00
2-3 year: +1.50
when to prescribe astigmatism?
isometropia
up to 1 year old: 3.00
1-2yo: 2.50
2-3yo: 2.00
anisometropia:
up to 1 year: +2.50
1-2 year: +2.00
2-3 year: +2.oo
when do kids see 20/20?
20/20 - by 3-5 year old - Snellen
with preferential viewing -
VEP - 6-7 months
when do kids develop contrast sensitivity?
Reaches adult-like levels for low frequency attenuation at about 2-4 months
and is completely developed by 3-5 years
Blink response to visual threats age develops
This begins at 2 months of age
color vision development:
- Newborns have the ability to notice color but cannot distinguish red, green, or
yellow - 2 months infants are able to distinguish red-green
- 3 months they can recognize similar hues within color groups;
- adult-like levels by 3 years of age
Pupil responses development
- pupils are sluggish in newborns
- well-developed by 1 month
Accommodation development
- A newborn’s accommodation is accurate for about 30cm
- a lag of accommodation of
about +0.75 D occurs by about 4 months of age
- a lag of accommodation of
- well-developed and accurate for further distances by 6 months
Stereopsis development
- Newborns do not have any stereopsis ability
- emerges at 4 months
- well-developed by 6 months
NPC development
Newborns can converge up to 10 cm; this improves to the ability to converge to the nose by 6 months
Fixation/follow a moving target development
response begins to emerge at 4 months of age
Binocular alignment development
Alignment typically occurs by 1 month of age and reaches adult-like levels of angle lambda at 18 months
Acuity (using visual evoked potential VEP)
Newborn: 20/400
1 month: 20/200
2-4 months: 20/80
6-12 months: 20/20
Acuity (using preferential looking)
Newborn: 20/400 to 20/1200
1 month: 20/300 to 20/1200
2-4 months 20/150 to 20/600
6-12 months:20/50 to 20/200
18 months: 20/40 to 20/100
24 months: 20/30 to 20/80
3 years: 20/20
Optokinetic response development
This will be asymmetric (T-N and N-T response) for the first 4 months and becomes a symmetric response at 6 months of age
pursuits development
Emerge at about 2-4 months of age
saccades development
Horizontal saccades are present in newborns; vertical saccades begin at 2 months
Fixation development
newborn is able to fixate on a person’s face
AOA when should kids be examined?
asymptomatic children be examined at 6 months of age
3 years
before entering 1st grade
every 2 years thereafter.
how to properly cyclo kids?
1 gtt 0.50% cyclopentolate OU instilled - for 1 year old or under
1% for older
when is cyclo contraindicated
Cyclopentolate may also be avoided in children with Down syndrome, cerebral palsy, trisomy 13 and 18, and other central nervous system disorders because of a possible increased reaction
psychosocial stages
- . Age: infancy (birth to 18 months):
tust vs mistrust
oral-sensory - Age: early childhood (2-3 years)
muscular-anal
Autonomy vs. Shame - Age: pre-school (3-5 years)
Initiative vs. Guilt (Purpose)
locomotor-genital - school age (6-11 years)
Industry vs. Inferiority
latency - adolescence (12-18 years)
Identity vs. Role Confusion (Fidelity)
fidelity
lower motor neuron defect vs central lesion
- Facial paralysis due to an upper motor neuron (central lesion) will cause weakness or paralysis of the contra lower facial musculature only
May be due to space occupying lesion or CVA - Bell’s palsy is due to a lower motor neuron (peripheral) lesion, in which both ipsi upper and lower facial weakness occurs.
what is the primary complication in a patient diagnosed with Bell’s palsy or any 7th nerve palsy?
corneal exposure
treatment of Bell’s palsy
- monitor
- but steroids none to help if started within 72 hours
what is Ramsay-hunt syndrome?
HZV lesions on face , neck + (peripheral facial palsy/Bell’s palsy)
what is this ?
Actinic keratosis is a precursor to squamous cell carcinoma; it appears as scaly, dry skin that does not heal.
Which of the following signs is considered essentially pathognomonic for psoriasis?
oil drop sign - involvement of the nail bed
onycholysis - separation of the nail bed from the nail plate
Auspitz’s sign - scale is removed in psoriasis from the skin and pinpoint
Babinski reflex
Stroking of the underside of the foot causes the toes to fan out with dorsiflexion of he big toe.
- should be gone by age to or means cortical spinal damage
belpharitis medication contraindicated in those with sulfur allergy?
Blephamide® is a combination of sulfacetamide and prednisolone.
what type of astigmatism increases the progression of myopia?
ATR
normal myopia progression rate
- 0.3 to 0.5 diopters per year in childhood
- decreases/stops in teen years
amiodarone used for? SE and tx of SE
use: anti-arthymia
SE: bilateral yellow/brown/ powdery epithelial deposits
- Inf central
- swirl out, but do not affect limbus
- do not affect VA
- if stop drug will go away
= corneal verticillata
what meds cause corneal verticillata ?
chloroquine
hydroxycholorqine
indomethacin
amiodarone
atovaquone
chlorpromazine
tamoxifen
what is fabry’s disease signs?
corneal verticillata
lens opacities
conj anurysm
edema of ON, macula, retina
optic atrophy
corneal verticillata
what are other names for Cornea verticillata ?
vortex keratopathy
whorl keratopathy,
Fleischer vortex
primary congenital glaucoma triad + signs + prognosis + who
males
bi> uni
triad:
photophobia
epiphora
blepharospasm
other signs:
cloudy cornea.
large - globes and corneas , myopia, higher IOP, cupping, hypoplasia of iris stroma
if progresses and not treated -> IOP stretching eye -> buphthalmos
treatment - glaucoma surgery-> post sx c/d should return to normal 0.3 or less
megalocornea
bilateral
diameter > 13
everything else is normal , cornea clear
what layer does forceps injury affect?
descemets
Haab’s straie
in descemets
in glaucoma
Apgar score
appearance - color
pulse - Heart rate
grimace - reflex
activity - muscle tone
respiration
scale is 0-2 for each section, then add together
10 - baby is in best possible condition
8-9 good
4-7 fair
0-3 poor
retinoschisis
- usually bilateral
- absolute VF defect
Berlin’s edema
commotio retinae at macula
comottio retinae
WsP
WsP location
IT
WsP complication
increases chances of RD
valsalva
terson’s retinopathy
hemmorhaging because of high ICP -> increased IOP-> compression of the CRV
valsalva
ssri
inhibit reuptake of serotonin
what age do you get lebers? inheritance?
teen- 20s
mitochondrial
to calculate power of bioptic do can/want
can/want * 1/ wd(in m) = power of stand lamp
converting m to snellen
snellen / 50
ex. 20/100 -> 100/50 = 2 M
m-> snellen
m * 50
converting 10/200 to 20/x
what makes 10 -> 20
multiply denominator by same
what is it? who?
epiblepharon
individuals of asian decent or fat people because no LL crease. -> lashes are vertical and can scratch cornea
- seen in graves
JND, what are starting trial lenses
JND: just move snellen acuity 2 decimals
trial lenses: dived JND by 2
Just find JND
when do you treat for ERM?
VA 20/40 or worse
+ symptomatic
tx - membrane peel + vitrectomy
may not get back to normal VA
flomax
treats benign prostatic hyperplasia
A-antagonist
floppy iris syndrome
miosis/ poor dilation
stopping med will not fix SE, recommend to do cataract surgery before stating med
if 1 eye + OR and other eye is -OR
lenses switched
diagnosing DM
fasting blood sugar 126 or more
A1c 6.5 or higher
2 hour post prandial glucose 200 or more
in amblyopia how should yo show the patient the letters?
5-6 snellen letters in a line
or
isolated letter with crowded bars
Dacryocystitis treatment
- if not sick systemically:
Oral keflex, augmentin, warm compress - sick - hospitalize + iv antibiotics
-chronic : dacryocystorhinostomy
preseptal cellulitis treatment
- Augmentin if not sick
- sick/difficulty with compliance - hospital
When do you follow up for hordeolum?
F/u not needed unless lesion doesn’t heal
Kenalog injection SE
Pain
Temp skin atrophy
Subcutaneous white deposit
De pigmentation of injection site
Retinal and choroidal occlusion
Increased IOP
Photocoagulation complications
Choroidal detachment -> angle closure glaucoma
RRD
CME
Macular pucker
Exudative RD
Cryotherapy complications
Eyelid edema - 100%
Chemosis - 100%
Transient diplopia if accidentally do the eom
Vitrits
