UNIT 4: The Patient History & Preliminary Exam

Question 1

What are the 3 essential questions which must be answered?

Answer 1

1) Does the patient have a problem?
2) What is the specific problem?
3) What is or will be the effect of the problem on the patient’s performance or physical status?

Question 2

What are the 3 rules of thumb when gathering data?

Answer 2

1) The history never ends
2) The history should be complete
3) Listen carefully to the patient

Question 3

What are types of tests performed by a refractionist?

Answer 3

1) Visual Acuity Testing
- R, L, Both CC & SC
2) Tests of Ocular Motility and Binocular Vision
- Cover Tests
- Near Point of Convergence
- Motility
- Test of Pupillary Function
3) Confrontations
- Visual Field Screening

Question 4

What do tests done by refractionists require as part of the examination process?

Answer 4

• an occluder
• penlight
• mm ruler
• a near point acuity chart

Question 5

Prior to beginning tests, specific considerations must be given to the exam room, these considerations include:

Answer 5

1) Standard testing conditions
2) Letter size
3) Testing distance
4) Illumination

Question 6

THE ABC’S OF VISION DIFFICULTY
List the A’s : Appearance of the Eyes

Answer 6

• Crossed = turn in/out at anytime
• Reddened
• Watering
• Encrusted eyelids
• Frequent styes

Question 7

THE ABC’S OF VISION DIFFICULTY
List the B’s: Behavior Indications of Possible Difficulty

Answer 7

• Body rigidity while looking at distant objects
• Thrusting head forward or backward while looking at distant objects.
• Avoiding close work
• Short attention span
• Daydreaming
• turning head to one side
• placing head close to book or desk when reading or writing.
• Frowning or scowling while reading or writing.
• Excessive blinking
• Tending to rub eyes
• Closing or covering one eye.
• Dislike for tasks requiring sustained visual concentration.
• Nervousness, irritability, or restlessness after maintaining visual concentration.
• Unusual fatigue after completing a visual task.
• Losing place while reading.
• Using finger or marker to guide eyes.
• Saying the words aloud or lip reading.
• Moving head rather than eyes while reading.
• Difficulty in remembering what is read.
• Persistent reversals after the second grade.
• Confusion of similar words.
• Poor eye hand coordination.
• Unusual awkwardness.

Question 8

THE ABC’S OF VISION DIFFICULTY
List the C’s: Complaints associated with using the eyes.

Answer 8

• Headaches
• Nausea or dizziness
• Burning or itching of eyes
• Blurring of vision at any time