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Refractive Conditions and Automated Refraction > Refraction 1 > Flashcards

Refraction 1 Flashcards

1
Q

Name the chart that measures VA?

A

Snellen chart

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2
Q

Name of the color deficiency test 2

A

Ishihara Test
Farnsworth D-15

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3
Q

What is the purpose of the duochrome chart?

A

Refine the final sphere in the visual assessment

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4
Q

Which equipment is used to check refractive error in young children?

A

Retinoscope

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5
Q

Name the test that requires red lens on od and a green on the os?

A

Worth’s four dot test

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6
Q

What would the chief complaint be of a patient with diplopia?

A

Double vision

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7
Q

Term for myopia resulting from the elongation of the globe of the eye

A

Axial myopia

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8
Q

What is the term for the eye’s ability to change in power in order to focus on objects at different distances?

A

Accommodation

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9
Q

What is the purpose of mydriatic drops in the eye?

A

Dilates the pupil

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10
Q

What is the term when both eyes are directed in the same direction except when one eye is covered?

A

Heterophoria

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11
Q

What are the 4 forms of medication that is instilled into the eye?

A

Solution, suspension, ointment, systematic

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12
Q

What are the four steps of subjective refinement? In order. 4 MARKS QUESTION IN QUIZ

A

Sphere, cylinder axis, cylinder power, sphere

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13
Q

What does cycloplegic agents do? 2

A

act by paralyzing the sphincter muscle of the iris, causing dilation
paralyzes the ciliary muscle, which inactivates accommodation

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14
Q

What do Mydriatic agents do?

A

act on the iris musculature and dilate the pupils

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15
Q

What do miotics do?

A

act by stimulating the sphincter muscle of the iris, which constricts the pupil

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16
Q

What can topically applied steroids do the eye? 4

A
  • raise the pressures
    -activate the growth of virsus
    -activate the growth of bacteria
    -cause delay in wound healing
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17
Q

Explain VA and how it is determined

A

determined by the smallest object that can be clearly seen and distinguished at a distance compared to distance the patient is from the chart letters / distance from the chart at which a normal person can see.

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18
Q

What happens if the patient squints when obtaining the VAs?

A

false/wrong reading, only allows central rays in which makes the vision better

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19
Q

What does ocular motility refer to?

A

the movements of the eye in all directions of gaze and to its relationship in movement with its fellow eye

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20
Q

When assessing the ocular motility, what are we looking for? 3

A

-the vision or fixation of each eye
-alignment of both eyes in all directions of gaze
-the ability of the two eyes to work together binocularly

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21
Q

What are the 9 positions of gaze?

A

-dextroversion (right gaze),
-levoversion (left gaze),
-supraversion (straight-up gaze),
-infraversion (straight-down gaze)
-4 oblique positions
-primary gaze

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22
Q

What is the Hirschberg’s test?

A

a penlight test- shines the light in the child’s eyes and notes the position of the reflex of light.

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23
Q

What 4 conditions could be present if the light reflex in the hirschberg’s test is not in the center of the pupil?

A

i. Esotropia - reflex is temporally placed in one eye and is normal in the other eye
ii. Exotropia – reflex is nasally placed in one eye.
iii. Hypertropia – reflex is inferiorly placed
iv. Hypotropia – reflex is superiorly placed.

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24
Q

What is the Krimsky’s test?

A

Prisms are placed in front of the fixating eye until its forced to move over (note the prism needed, it is the same as the deviation present)

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25
Q

What is the cover test? and what does/could it show?

A

manifest strabismus tropia is revealed by observation by observation of any eye movements of the uncovered eye to take up fixation when the cover is placed before the fellow eye.

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26
Q

What is the near point of convergence?

A

the point at which fusion can no longer be maintained and one eye deviates outward. The px will see double

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27
Q

What is the 4 worth dot testing? 3

A

investigating fusion, suppression, and binocular functions of the eyes ability to work together

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28
Q

4 worth dot test, 2 red lights seen?

A

left eye suppression

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29
Q

4 worth dot test, 3 green lights seen?

A

right eye suppression

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30
Q

4 worth dot test, 3 green on the left and 2 red on the right seen?

A

Esotropia: no suppression

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31
Q

4 worth dot testm 2 red on the left and 3 green on the right seen?

A

Exotropia: no suppression

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32
Q

What is the difference between subjective and objective refraction?

A

subjective = we determine and evaluate the refractive error based on the patient’s input
objective = we determine and evaluate the refractive error based purely on our judgment

33
Q

4 worth dot test, 1 red, 2 green and 1 white seen?

A

normal result

34
Q

You are performing retinoscopy on a patient and you add a minus trial lens frame to bring the reflex to no movement. Was the light against movement or with?

A

the light is against the movement

35
Q

What can irregular movements of the light during retinoscopy indicate? 3

A

keratoconus, corneal scarring, catarcts

36
Q

What test do we do to determine if a patient has uncorrected refractive error or an ocular pathology?

A

pinhole test - cuts out periphery rays of light, pinhole will improve vision if it is a refractive error

37
Q

What is bincoluar balancing?

A

equalize the accommodative effort between the 2 eyes. They do not necessarily accommodate by the same amount under monocular conditions

38
Q

What happens if binocular balancing is not achieved?

A

If the prescriptions are not balanced the eyes accommodate by the least amount possible to produce a clear image in one eye. The other eye may have a slightly blurred image and asthenopia could result.

39
Q

If the patient says the second lens si darker and smaller during refraction, what does this mean and which lens should you use?

A

it means they are overcorrected and we are adding too much minus

choose the minus lens

40
Q

What are 3 techniques used to determine astigmatism axis?

A

jackson cross - cylinder
fan-and-block technique
astigmatic clock

41
Q

What are the 2 methods to measure he amplitude of accommodation and name the technique

A

Technique - Blur technique
method 1 - push-up-to blur
method 2 - push down to clear

42
Q

What does confrontational field test?

A

detects a patient’s field of view in comparable with their own (normal).

43
Q

What is the order of the process of general refraction? 5

A

a. Perform lensometry to get current rx if px has glasses & Medical hx
b. Take autorefractor readings (Objective Ref.)
c. Take aided VA with current glasses
d. Subjective Refraction
e. Compare aided VA with Subj. Refract. Result with current glasses.

44
Q

What is the purpose of the fogging technique?

A

to create a situation where an attempt at accommodating will blur the vision, inducing relaxation of accommodation

45
Q

What are 3 types of myopia?

A

axial (eyeball too long)
curvature (increase in corneal curvature)
index (refractive change in the lens)

46
Q

What are the 2 types of hyperopia/hypermetropia?

A

axial (eyeball too short)
curvature (flattening of the cornea/lens)

47
Q

What is absolute hypermetropis?

A

the portion of the refractive error that is not compensated for by accommodation

48
Q

What is accommodation?

A

adjustment by the eye for seeing different distances

49
Q

What is amplitude of accommodation?

A

the difference between the maximum and minimum powers of a particular eye and therefore gives the total amount of accommodation available

50
Q

What is aniseikonia?

A

a condition in which the ocular image of an object as seen by one eye is different in size and shape to the other and cannot be fused

51
Q

What is anisometropia?

A

a condition in which there is a difference in the refractive error of the two eyes

52
Q

What is aphakia?

A

absence of the lens of the eye

53
Q

What is asthenopia?

A

a wastebasket term denoting a number of sensations that accompany uncorrected
refractive error and problems in ocular motility

54
Q

What is negative accommodation?

A

to focus from near to distance, the eye decreases its D power

55
Q

What is positive accommodation?

A

to focus on a near object, the eye increases its D power

56
Q

What is emmetropia?

A

a normal eye with no refractive error

57
Q

What is far point of accommodation?

A

that point conjugate with the centre of the macula by refraction at the unaccommodated
and uncorrected eye

58
Q

What is the conoid of Sturm?

A

the area between the 2 focal points of a spherocylindric combination assumes a conoid shape

59
Q

What is cycloplegic refraction?

A

An objective refraction being performed with the aid of a pharmaceutical agent designed
to prevent or reduce accommodation during refraction; wet refraction.

60
Q

What is manifest refraction?

A

A refraction done without cycloplegic agents, dry refraction.

61
Q

How many dots of light would a patient see with Worth’s 4 dot if there is Right eye suppression?

A

3 green lights

62
Q

Assuming your working distance when doing retinoscopy is 66cm. What is the dioptric power of your working lens?

A

+1.50

63
Q

Which eyedrop is used to constrict pupils?

A

Miotic

64
Q

How do Antidepressants affect your pupils?

A

dilation

64
Q

Patient prefers the letters on the red side means:

Patient prefers the letters on the green side means:

A

red - more minus power

green - more plus power

65
Q

What does the scissor reflex indicate when performing retinscopy?

A

Corneal Irregularities

65
Q

What is a good near point convergence result?

A

8-10cm

66
Q

Where should corneal reflection be on a normal patient?

A

slightly nasal

67
Q

Which category does a referral to doctor falls under in a patient;s chart?SOAP

A

Plan

68
Q

When assessing the cylinder axis with astigmatic clock, where should you line the cylinder correction?

A

90 degrees away from the blackest line

69
Q

During fogging, how much power are you adding on the fogged eye?

A

+1.00

70
Q

If you cannot get your patient to see the letters on both red+green equally good, which side should you pick?

A

red

71
Q

What is wet refraction?

A

Refraction with cycloplegia

72
Q

If a patient fails Unilateral cover test, what does that indicate?

A

Strabismus tropia

73
Q

How long should you cover one eye before uncovering during Unilateral cover test?

A

1-2 seconds

74
Q

If you see against motion with retinoscopy, you should add minus. T/F

A

TRUE

75
Q

Jackson Cross Cylinder only allows you to refine the patient’s cylinder axis. T/F

A

FALSE - can do power and axis

76
Q

What is the last step in automated refraction?

A

Binocular balancing

77
Q

What is the standard near vision distant?

A

14-16 inches

Refractive Conditions and Automated Refraction (3 decks)

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