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Theory and Methods Fall 2015 > Theory and methods quizlet exam 1 - Sheet1 > Flashcards

Theory and methods quizlet exam 1 - Sheet1 Flashcards

1
Q

Tan-

A

Antimicrobials

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2
Q

Vitreous Cortex

A

Shell of condenses vitreous that surrounds gel; Anterior hyaloid face starts 1.5mm anterior to ora serrata; Posterior hyaloid face adheres to internal limiting membrane of retina. Made mostly of intensely packed collagen fibrils

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3
Q

Paremyd

A

0.25% tropicamide and 1% hydroxyamphetamine which is a Sympathomimetic, good for dilation with minimal accommodative effect. More expensive. Mydriasis and weak cycloplegia

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4
Q

Tropicamide Hydrochloride

A

Muscarinic Antagonist. Causes Mydriasis and cycloplegia. Used in clinic for: Routine dilation, Cycloplegic “damp” refraction, Pre and Post Operative Surgery. Side effects: Photophobia, blurry vision, lasts 6 hours, unknown effect in pregnancy

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5
Q

Phenylephrine Hydrochloride

A

Direct-acting sympathomimetic. Contracts radial muscle of iris for dilation. Causes mydriasis, no cycloplegia. Used in clinic for: 0.12% solution for allergies OTC; 2.5% solution for routine eye exam dilation. Pre and Post operative surgery exams: 10% solution to break posterior synechia. Adverse effects: stinging, headache, tears, photophobia, possible sympathetic reactions, blanching in eyes, lasts 6 hours, unknown effect in pregnancy. Caution for cardiac disease, severe HTN, aneurysms. Very expensive

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6
Q

Reticular/ Bullous Retinschisis

A

Splitting of nerve fiber layer; 0.95% prevalence of population; taut ballooning of tissue as blister, reticular pattern due to sclerosed scleral vessels; outer layer shows honeycomb pattern and reduced choroidal detail; 1/3 associated with retinal detachment; 3/4 have snowflake bodies; Blister thought to be filled with hyaluronic acid

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7
Q

Fluramene.

A

Combo of Lissamine and fluorescein sodium. Allows tear film and corneal assessment in one drop, Viscosity designed to not break up tear film

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8
Q

Diffuser SL Filter

A

Used for general, non focal illumination, for anterior segment. Low magnification, used for gross examination of lids and skin, max width and height

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9
Q

Green-

A

Miotics

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10
Q

How much of an eye drop is typically absorbed in the eye?

A

5%

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11
Q

Cobalt Blue BIO filter

A

Autofluorescence of optic disk; drusen

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12
Q

Best place to introduce an ophthalmic preparation.

A

Lower eyelid cul-de-sac

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13
Q

Rose Bengal Vital Dye

A

Surface integrity evaluation for damaged or dead cells; 1% 1.3 mg paper strip; Stains vivid magenta for about 5 minutes, stings significantly; Used for dry eye and herpes keratitis evaluations; May be hard to differentiate red dye and inflammation;

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14
Q

CHRPE

A

Solitary pigmented lesion w/ or w/o a hypopigmented halo; Bear tracks; Atypical pigmented lesions; Hyperplasia of the RPE; “freckle of the eye”

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15
Q

Ophthalmic Suspension

A

Solid particles in a liquid; Must be shaken before dispersed for homogeneity

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16
Q

Sclerotic Scatter

A

Light is directed to limbus and indirect illumination highlights subtle findings of cornea

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17
Q

Haag Streit illumination

A

Vertical illumination with bulb at top of tower

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18
Q

Vogt (Kohler) Illumination

A

Homogeneous beam

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19
Q

Corona ciliaris

A

Anterior portion of ciliary body; 2mm wide; probably won’t see this on BIO; Contains 60-70 ciliary processes

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20
Q

Pars Plana

A

Broad, flat, pigmented band about 4-5mm wide of ciliary body

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21
Q

At risk for angle closure

A

Less than grade 2 van Herick; Half or less of trabecular meshwork seen in all four quadrants

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22
Q

Why do we dilate?

A

Look at retinal periphery: retinal tears and detachments, infection, inflammation, neoplasm; Look at lens for cataracts

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23
Q

Pink

A

Anti-Inflammatories

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24
Q

Ora Serrata

A

Junction of neural retina and ciliary body, Has ciliary processes and corrugated appearance nasally

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25
Q

Ophthalmic Ointments

A

Non-aqueous; Base is oily chemical like petroleum, paraffin oil, or lanolin; Sterile preparations must be prescribed that way for eye use, OTC versions are not sterile

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26
Q

Sodium Fluorescein Dye

A

2% solution, Comes in 1 mg filter paper strip or single dose sterile pipettes. Used with cobalt blue filter to assess integrity of cornea and conjunctiva. Conjunctiva will stain orange, cornea and anterior chamber will be green. Marks damaged areas. Fluorescence affected by pH, concentration, other things in solution. Other uses: TBUT, Goldmann tonometry, detecting foreign bodies or wounds, Jones test 1 or 2. May sting or cause yellowed vision

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27
Q

Vitreous base

A

Area at ora serrata where the vitreous adheres firmly to retina; Vitreous fibrils originate here; May be hyperpigmented; There is almost never a detachment here

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28
Q

Lissamine Green Vital Dye.

A

Bluish-green alternative to Rose Bengal with much less discomfort. Same instillment and uses as Rose Bengal

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29
Q

Zeiss illumination

A

Round housing unit at middle of instrument with bulb encased

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30
Q

Aqueous Ophthalmic Solutions

A

Saline and salts to maintain pH 5.0-8.0, 2 year shelf life

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31
Q

Interpupillary Distance of BIO

A

15mm, created by prisms

32
Q

Red

A

Mydriatics & Cycloplegics

33
Q

Weiss’ Ring

A

Ringed floater from where the vitreous used to attach to the optic nerve. Shape changes over a long period of time because of gravity

34
Q

Slit Lamp Magnification Systems

A

Grenough/Flip-type, Galilean rotating barrel, Zoom

35
Q

What can you do to decrease systemic absorption of an ophthalmic drop?

A

Hold punctum for 1-3 min

36
Q

3 Things You Should Check Before Instilling a Drop

A

Brand Name, Concentration, Expiration Date

37
Q

Ocular Melanosis or Perilimbal Pigment

A

Common in people with darker skin, extra pigment in conjunctiva, Increases with age, Cannot be removed, Benign

38
Q

Who are considered “at risk” patients for BIO exams?

A

Patients w/ diabetes or HTN; Family History of disease; Occupation with high visual demand or hazardous; Taking medicine with ocular side effects; Wearing contact lenses; Those who had eye surgery;

39
Q

Retinal Equator

A

Imaginary circle that runs along the retina to intersect all of the vortex veins. Separates the anterior and posterior poles

40
Q

Long Posterior Ciliary Nerves

A

Yellow projections seen at the midline 3 & 9 o’clock, separate the retina into superior and inferior

41
Q

1 Cause for Malpractice in Optometry.

A

Misdiagnosis of intraocular disease: Open Angle Glaucoma, Retinal Detachment, Tumors. Because doctors did not use diagnostic dilation drops

42
Q

Properties of +20D BIO Condensing Lens

A

50mm diameter; 3x image magnification; 46 degree field of view; 43cm working distance;

43
Q

Drugs used to break posterior synechia

A

Scopolamine, Phenylephrine

44
Q

White without Pressure (Ww/oP)

A

White/gray area between equator and ora serrata; Vitreous adheres strongly to retina and retina appears thickened; 2.3% Caucasians, 23% Blacks, increases with age-common at 40-50; May be associated with tractional retinal tears; No visual field defect

45
Q

What is the longest you should look at one area with the BIO at a time?

A

40 seconds

46
Q

Yellow Wratten Filter

A

Enhances fluorescein color. Not attached to slit lamp, is hand-held

47
Q

Orange-

A

CAIs

48
Q

Cyclopentolate

A

Antimuscarinic. Used for: Cycloplegic Refraction; Pupil Dilation; Uveitis-prevent posterior synechia, immobilize iris, and stop pain. Could take up to 45 minutes to go into effect and could last a full day. Adverse effects: blurred vision, photophobia, stinging, clumsiness, nausea, antimuscarinic side effects, unknown effect in pregnancy

49
Q

Fluress/Fluorox/Flucaine

A

P-aminobenzoic acid ester. 0.4% benzoxinate, 0.25% fluorescein sodium. Adverse effects: stinging, bruning, red eye, rare blurry vision. Shelf life 18 months. Used for tonometry and assessing integrity of cornea and conjunctiva

50
Q

Proparacaine Hydrochloride

A

M-aminobenzoic acid ester,0.5% ophthalmic solution. Fast-acting topic anesthetic, decreases blink reflex and touch sensation. Lasts 10-20 min. Blocks sodium ion permeability to inhibit action potential Uses: Tonometry, Gonioscopy, Corneal and conjunctival procedures, Punctal plug insertion/removal, Cataract extraction, NOT necessary for dilation. Adverse Effect: Stinging, Possible Hypersensitivity, Overdose can cause corneal opacification and vision loss. Can kill epithelium and cause to slough off; Category C: unknown affect on pregnancy

51
Q

Purple-

A

Adrenergic agonists

52
Q

Vitreoretinal symphysis

A

Area of vitreous base that straddles the ora serrata

53
Q

Short Posterior Ciliary Nerves

A

Perpendicular to ora serrata; At 6 and 12 positions; 10-20 nerves per eye in other areas; Surrounded by choroidal pigment

54
Q

4 Things for Documenting Drug Instillation

A

Drug Name; Concentration; # drops instilled; Time of Instillation

55
Q

Vitreous Body

A

2/3 of globe, mostly collagen type 2, 98% water, contains hyaluronic acid

56
Q

White with Pressure (Ww/P)

A

Optical phenomenon of retina causes by use of scleral depressor by physician; Histologically similar to Ww/oP; Thought to have less potential to cause retinal breaks

57
Q

Tests to do BEFORE dilation

A

Visual Acuities, Pupils, Intraocular Pressure, Angles -Gonioscopy(van Herick or Shadow test)

58
Q

Slit Lamp Illumination Systems

A

Vogt (Kohler), Haag Streit , Zeiss

59
Q

Ophthalmic Color Codes

A

Red- Mydriatics & Cycloplegics. Pink- Anti-Inflammatories. Tan- Antimicrobials. Gray- NSAIDs. Green- Miotics. Turquoise- Prostaglandin analogs. Purple- Adrenergic agonists. Orange- CAIs. Blue/Yellow- Beta Blockers

60
Q

Case History Flags for No Dilation

A

History of angle closure attack: -reported seeing halos, -intermittent eye pain when changing lighting, -intermittent blur, redness, nausea

61
Q

Ophthalmic Gels

A

Highly viscous solution with aqueous saline and special polymer; Increases contact time on ocular surface

62
Q

Vortex Veins

A

4-15 choroidal tributaries that drain into the ophthalmic veins

63
Q

Gray-

A

NSAIDs

64
Q

Single-Dose Unit

A

Should be discarded after one use; No preservatives to stop bacterial growth

65
Q

Pavingstone Degeneration

A

Primary chorioretinal atrophy, cobblestone degeneration; Choriocapillaris occlusion with RPE and retinal tissue death, but neural sensory retina is still good; 0.1-1.5mm nonpigmented areas between equator and ora serrata, for 5-7 o’clock area; Some have RPE hyperplasia around them; 30-70% become bilateral with age

66
Q

Blue/Yellow-

A

Beta Blockers

67
Q

Tractional Retinal Holes

A

From abnormal vitreoretinal adhesion; Round red hole with overlying floating fragment of tissue; Between equator and ora serrata; May have localized retinal detachment; Can occur near or away from vitreous base

68
Q

Mutliple-Dose Unit

A

Intended for repeat use; Contains preservatives to limit microbial growth or kill microbes

69
Q

If you decrease the BIO condensing lens’ power, what will happen?

A

Magnification increases; Field of view decreases; Working distance increases

70
Q

Strong mydriatics and cycloplegics.

A

Homatropine: 1-3 days. Scopolamine: 3-7 days -also for breaking synechia. Atropine: 7 days. Unknown safety in pregnancy, all good for uveitis treatment. Same side effects as Cyclopentolate

71
Q

Firmest attachments of Vitreous Cortex

A

Vitreous base; Optic disk; Macula; Retinal Blood Vessels

72
Q

Retinal Tuft

A

Granular retinal tissue; Gray/White lesions in periphery, usually between equator and ora serrata; Typically bilateral, cause floaters, in 15% of population

73
Q

What children are considered “at risk” for BIO exams?

A

Prematurity, complications at birth; Family History of retinoblastoma, congenital cataracts, or metabolic/genetic diseases; Infection of the mother during pregnancy; Difficult labor associated with fetal distress of low APGAR; High refractive error; Strabismus; Anisometropia; Known or suspected central nervous system defect

74
Q

Atrophic Retinal Holes

A

Retinal break without vitreoretinal traction; 2-3% of population; Usually between equtor and ora;

75
Q

Typical/ Flat Retinoschisis

A

Splitting of neurosensory retina at outer plexiform layer; 0.7% of population, 38-82% bilateral, increases with age; Usually asymptomatic but shows as scotoma on visual fields test;

76
Q

Turquoise-

A

Prostaglandin analogs

77
Q

Benign Choroidal Melanoma

A

Choroidal Nevus; Hyperpigmentation of choroid; Flat, gray lesion, 1.5mm thick and 6mm wide; Isolated retinal detachment may occur; May spread or become malignant with pregnancy

Theory and Methods Fall 2015 (4 decks)

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