Peri-Operative Cataract and Visual Fields (M4)

Question 1

What are the visual acuities associated with LOCS III trace-grade 1 nuclear cataract? 1. Grade 1+-2-? 2. Grade 2-2+? 3. Grade 3? 4. Grade 4? 5

Answer 1

1. 20/20 to 20/25
2. 20/30 to 20/40
3. 20/50 to 20/60
4. 20/70 to 20/100
5. 20/100 or worse

Question 2

What are the visual acuities associated with LOCS III trace-grade 1 cortical cataract? 1. Grade 2-2+? 2. Grade 2+-3? 3. Grade 4? 4.

Answer 2

1. 20/20
2. 20/25
3. 20/30 to 20/40
4. 20/60 or worse

Question 3

What are the visual acuities associated with LOCS III grade 1 posterior subcapsular cataract? 1. Grade 2–2? 2. Grade 2+? 3. Grade 3? 4. Grade 4? 5

Answer 3

1. 20/25
2. 20/25 to 20/40
3. 20/30 to 20/60
4. 20/70 to 20/100
5. 20/200 or worse

Question 4

What is the purpose of pre-operative cataract testing?

Answer 4

indicates if surgery will improve overall visual function

Question 5

What is the purpose of the potential acuity meter (PAM)?

Answer 5

assess retinal acuity through mild to moderate media opacification

Question 6

What is the equipment used for PAM?

Answer 6

1. PAM
2. slit lamp
3. possibly mydriatic

Question 7

What does the narrow beam in the PAM result in?

Answer 7

reduced scatter

Question 8

What is the dioptric range of the PAM?

Answer 8

-10D to +13D

Question 9

What is the procedure for potential acuity pinhole (super pinhole)?

Answer 9

1. pinhole one eye and occlude other
2. place near acuity card at 40cm
3. illuminate specific line and identify

Question 10

What does the transilluminator do for super pinhole?

Answer 10

helps compensate for loss of retinal illumination from pinhole

Question 11

What is the problem with the clinical interferometer?

Answer 11

lots of false positives (don’t really have problems)

Question 12

What should be the starting point for the clinical interferometer?

Answer 12

2 lines worse than patients best corrected

Question 13

What is it called when the predicted VA is worse than the final VA? 1. What is it associated with? 2

Answer 13

1. false neagtive

2. dense opacities

Question 14

What is it called when the predicted VA is better than the final VA? 1. What is it associated with? 2

Answer 14

1. false positive

2. maculopathy

Question 15

What do third party insurers need to have to cover cataract surgery coverage?

Answer 15

20/40 or worse on glare testing

Question 16

What is the common glare testing device?

Answer 16

BAT (brightness acuity tester)

Question 17

What is the low illumination level of the BAT similar to environmentally? 1. Medium? 2. High? 3

Answer 17

1. indoor fluorescent lighting
2. indirect sunlight/ cloudy day
3. direct overhead sunlight

Question 18

Should the eye be dilated for BAT testing?

Answer 18

no

Question 19

What can be used instead of the BAT that is probably just as accurate and more repeatable?

Answer 19

low contrast Bailey-Lovie chart

Question 20

What is the purpose of the macular photostress recovery test? 1. What test is this similar to? 2

Answer 20

1. measure the return of visual function of the macula following exposure to a bright stimulus
2. ERG

Question 21

What does the macular photostress recovery test differentiate?

Answer 21

retinal disease from ON disease (conduction deficit not affected)

Question 22

What are normal values for the macular photostress recovery test? 1. Abnormal? 2

Answer 22

1. under 60sec

2. over 90 sec

Question 23

What disease will show a decreased brightness comparison test?

Answer 23

optic nerve disease

Question 24

What is a subjective observation of retinal vascular function tool?

Answer 24

entoptoscope

Question 25

What is the procedures performed peri-opertively cataract surgery?

Answer 25

1. seidel test 2. suture cutting (6 weeks out) 3. wound burping

Question 26

What are the incisions during cataract surgery (purpose of them)?

Answer 26

1. main wound (get materials in/out the eye) | 2. paracentesis (avoid IOP spike)

Question 27

What is the purpose of wound burping?

Answer 27

momentarily open the paracentesis wound and allow aqueous to escape, dramatically decreasing IOP

Question 28

How many minutes each is a full threshold VF?

Answer 28

13+ minutes

Question 29

Are -1 or -2 VF tests along the midline?

Answer 29

-1

Question 30

What is the feedback from a VF that gives the threshold (dB) values for all points tested?

Answer 30

numerical

Question 31

What is the feedback from a VF that gives the sensitivity in tones of grey?

Answer 31

greyscale

Question 32

What is the feedback from a VF that gives the deviation from age matched normals?

Answer 32

total deviation

Question 33

What is the feedback from a VF that gives the deviation from age matched normals and adjusts for general reductions due to lens opacities or miosis?

Answer 33

pattern deviation

Question 34

What is the feedback from a VF that gives the significance of the defect?

Answer 34

probability values

Question 35

What is the feedback from a VF that gives the steadiness of gaze, false positives, or false negatives?

Answer 35

reliability indices

Question 36

What are the different global indices on a VF?

Answer 36

1. mean deviation 2. pattern standard deviation 3. glaucoma hemifield test

Question 37

What are the rules for manually calculating a trial lens for the VF?

Answer 37

1. for pt's with +1.00D or less cyl determine spherical equivalent and add +3.00 2. for pt's with +1.25D or more cyl keep cyl the same and add +3.00D