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UCL Medical Retina > Unit 2 - Communication and examination skills > Flashcards

Unit 2 - Communication and examination skills Flashcards

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USMLE® Step 1 flashcards
1
Q

Should contrast sensitivity be measured monocularly or binocularly?

A

monocularly, allowing 20 secs per letter

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2
Q

What is the resolution limit of the eye?

A

30 secs - 1 minute or arc

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3
Q

What are the 4 common causes of acquired visual field defects?

A
  • Diabetes
  • MS
  • Chemical exposure
  • Drug toxicity
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4
Q

Which colour vision tests are better for acquired pathology?

A

Farnsworth- Munsell and d15.

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5
Q

What illumination should colour vision testing be undertaken under?

A

Standard illuminant C

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6
Q

Which test can be used to assess integrity of the optic nerve?

A

Red desaturation test

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7
Q

What are the 4 commonest med ret causes of RAPD?

A
  1. AION
  2. Retinal disease
  3. Retinal detachment
  4. CMV retinitis
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8
Q

What are the 3 reasons why we perform visual field testing?

A

To monitor progression

Evaluate treatment of disease eg PRP

To correlate functional and structural changes in the retina

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9
Q

What is microperimetry useful for?

A

Visual rehab, to identify area of best vision Stargadt’s disease where conventional testing may not find defect.

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10
Q

Why do we need to dilate?

A

To improve steroscopic resolution Increase field of view

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11
Q

How much retinal pathology is missed in undilated pupils?

A

40%

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12
Q

What 5 reasons are there not to dilate?

A
  1. History of CAG
  2. VH of grade 1 or less
  3. History of penetrating injury
  4. Iris clip lens
  5. If patient is driving but if pathology is critical dilate anyway
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13
Q

What should be conducted prior to dilation?

A
  1. A/C depth
  2. VH
  3. Normal history and symptoms especially haloes around light or brow ache in low light levels
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14
Q

What does phenylephrine do?

A

Stimulates dilator muscle

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15
Q

What does tropicamide do?

A

Restricts action of sphincter

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16
Q

When should you be careful using phenlephrine?

A
  1. Overactive thyroid
  2. Diabetes
  3. High BP
  4. Coronary artery disease
  5. Enlarged prostate
17
Q

What pressure rise would cause you to refer a patient following dilation?

A

5mmHg

18
Q

What sort of image does a Volk lens give you?

A

A virtual, inverted and reversed image.

19
Q

What sort of image does a headset bio give you?

A

A laterally, inverted real image.

20
Q

What FOV do you get with a 90D?

A

94

21
Q

What magnification do you get with a 90D?

A

0.75X

22
Q

How much more likely is a patient with learning difficulties to have a sight problem?

A

10x

23
Q

How common is Charles Bonnet syndrome?

A

20-35% of patients

24
Q

How can you relieve Charles Bonnet syndrome?

A
  • Eye movements
  • Blinking
  • In extreme cases anti-epileptic meds may help
25
Q

What are the pros and cons of Amsler?

A

Highly specific

Very low sensitivity.

Only 34% with wet AMD will have distortion

26
Q

What other methods are there to monitor wet AMD?

A
  1. Preferential hyperacuity perimeter
  2. Macula mapping test
  3. Visual retinal display system
  4. Real world (door frames, tiles etc.)
27
Q

What percentage of patients will go up 2 lines just by having a refraction?

A

10%

28
Q

What does escoop give you?

A

Yellow tint

Base up prism

Thick lens offeres some magnification

29
Q

What sort of telescopes are IMT and VIP-IOL?

A

Galilean

30
Q

What are the magnifications/FOV available with IMT?

A

2.2 (9degrees) or 3X (2.2 degrees)

31
Q

How is IMT implanted?

A

One piece lens through large incision

32
Q

How much did IMT improve v/a

A

All improved by up to 3 lines but all had cataracts before and intensive training

33
Q

Why is VIP-IOL better than IMT?

A

theoretical 80 degree field

-ve lens in bag and +ve lens in A/C therefore small incision

34
Q

Why is IMT better than VIP-IOP?

A

better magnification, only 1.3X with VIP

35
Q

How is sound on the orcam conducted?

A

Bone conduction

36
Q

How does esight work?

A

Worn just above specs

Increases mag and CS

Excellent for lecture slides But £10k

37
Q

What is Givevision?

A

Virtual reality system, not ready yet but watch this space.

38
Q

Does eccentric fixation training improve QOL?

A

No

UCL Medical Retina (17 decks)

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