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Clinical Skills Year 2 > visual fields lec 1: kinetic perimetry > Flashcards

visual fields lec 1: kinetic perimetry Flashcards

1
Q

what is the definition of a visual field

A

all the space that an eye can see at any given time

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2
Q

how far does the visual field extend superiorly

A

60 degrees

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3
Q

how far does the visual field extend inferiorly

A

75 degrees

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4
Q

how far does the visual field extend nasally

A

60 degrees

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5
Q

how far does the visual field extent temporally

A

100 degrees

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6
Q

what is the visual field limited by

A

facial features/anatomy e.g. forehead, eyebrows, nose, cheek bones

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7
Q

what is considered the central visual field

A

30 degrees inside

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8
Q

what is considered the peripheral visual field

A

30 degrees outside of the central visual field

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9
Q

what does every point on the retina correspond to in the visual field

A

a certain direction in the visual field

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10
Q

where does the nasal retina project

A

temporally

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11
Q

where does the temporal retina project

A

nasally

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12
Q

which orientation will the visual field be in relation to the retinal image on the eye

A

upside down and front to back

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13
Q

if theres a problem with the inferior nasal retina, where will the visual field defect be

A

the superior temporal visual field

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14
Q

which part of the fundus has the highest threshold sensitivity and why

A

the fovea, because it contains the highest density of cones

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15
Q

which part of the fundus has no threshold sensitivity

A

the optic disc = blind spot

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16
Q

what happens to threshold sensitivity as you go away from the fovea and why

A

threshold sensitivity reduces, as cone density reduces

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17
Q

at which side of the visual field is the physiological blind spot and why

A

temporal visual field, as the optic disc is always at the nasal retina

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18
Q

how wide is the physiological blind spot

A

5.5 degrees wide

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19
Q

how far from fixation is the physiological blind spot

A

15 degrees

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20
Q

how high in the visual field is the physiological blind spot

A

7.5 degrees

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21
Q

how much below the midline is the physiological blind spot

A

1.5 degrees below

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22
Q

which side will the physiological blind spot be on the right eye

A

right hand side

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23
Q

which side will the physiological blind spot be on the left eye

A

left hand side

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24
Q

which side will a patient’s right fundus be to the clinician

A

always on the clinicians left side

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25
which side will a patient's left fundus be to the clinician
always on the clinicians right side
26
what is the measurement of visual field called
perimetry
27
what are the two types of perimetry
- kinetic and - static
28
what does the inside of the hill of vision represent
what you can see
29
what does the outside of the hill of vision represent
what you can't see
30
what does the height of the hill of vision represent
the threshold
31
what are the two types of manual kinetic perimetry
- gross perimetry | - golmann perimeter
32
list the steps of how you will carry out manual kinetic perimetry
- stimulus moves from where the px can't see it, to where they can see it - plot this onto a map - stimulus is a fixed size and luminance - eccentricity that the stimulus is seen as is then recorded at every 15 degrees, totalling 360 degrees - points of equal sensitivity form together to make an isopter - one isopter is not enough, so different isopters are measured using different stimulus sizes or light intensities - to measure more closer to the centre fov, the procedure is repeated with smaller/lower luminance stimulus - a minimum of 3 isopters is required for a good contour map of the visual field
33
what type of manual kinetic perimetry is gross perimetry
a gross screening test
34
list the steps of how to carry out gross perimetry
- px faces practitioner - occlude one eye - px told to constantly fixate on examiner's nose - target held at 35cm from the patient's eye, outside the fov - px report when they are first aware of the target - carried out in uniform surroundings if possible - target is moved at a constant velocity and in a imaginary arc - once the px notices the target, make a mental note of it and continue moving the target to the centre, to see if they have a scotoma - repeat in the 8 directions of gaze - repeat with the other eye
35
list the 8 directions of gaze which gross perimetry must be carried out in
- superior - superior temporal - temporal - inferior temporal - inferior - inferior nasal - nasal - superior nasal
36
where must the patient constantly fixate when carrying out gross perimetry
examiner's nose
37
at which distance is the target held from the patient with gross perimetry
35cm
38
list 4 advantages of gross perimetry
- quick - cheap - only method possible with young children or elderly with stroke - detects gross field defects
39
list 4 disadvantages of gross perimetry
- useless for small areas of vision loss - no control of stimulus luminance or contrast - no control over background - recognition of defect is dependent on judgement of practitioner
40
where is the goldmann perimeter mainly used
in hospitals for kinetic perimetry
41
list the components of a goldmann perimeter and state how to use it
- projector - head and chin rest - response button (px presses when they see target) - target - luminance and size controls can be specified (better than gross perimetry) - chart to draw isopter plots on - pantoscopic arm (moves stimulus around) - chin rest positioning (can move around to get the red light on the fovea) - occlude one eye - adjust the chin/head rest so the patients eye is in the centre of the telesope's field - instruct the patient (to push the button when they just see the target) - put up correct refractive correction
42
when will you always give a reading correction when carrying out perimetry
when measuring the inside 30 degrees of visual field
43
what makes up the reading correction
distance correction + reading addition
44
when will you not need to use a correction when carrying out perimetry and what is the exception to this
when measuring the outside 30 degrees of visual field | unless the px has a +/- 8.00 DS refractive error
45
for a full goldmann perimetry when and when not can spectacles be used and why
- specs can be used inside 30 degrees - specs not used outside 30 degrees because the rim gets in the way
46
what lens will you give when carrying out perimetry on a 60 year old px whose normal near add is +3.00D and distance rx is plano
+3.00D lens
47
what lens will you give when carrying out perimetry on a 60 year old px whose normal near add is +3.00D and distance rx is -3.00D
give nothing
48
what lens will you give when carrying out perimetry on a 60 year old px whose normal near add is +3.00D and distance rx is +3.00D
+6.00D lens
49
what is the near addition on the goldmanns table of near addition for a 40-44 year old
+1.50DS
50
what is the near addition on the goldmanns table of near addition for a 45-49 year old
+2.00DS
51
what is the near addition on the goldmanns table of near addition for a 50-54 year old
+2.50DS
52
what is the near addition on the goldmanns table of near addition for a 55 or year old or a cyclopeged px
+3.00DS
53
list the 7 steps of how to use the goldmann bowl perimeter
- select a stimulus e.g. v3 - move the stimulus in from the periphery, non-seeing to seeing - record what they can see - continue to move the stimulus to the centre, asking the patient to report if it disappears (to see any scotomas further in) - repeat at 15/30 degrees intervals (30 degrees is adequate) - repeat for atleast two other stimulus size/luminance combinations - repeat these steps for the other eye
54
how does goldmann perimetry with octopus help with which settings should be used for which aged patients
it has aged matched normal values, for immediate judgement of normality i.e. landings tells you what should be used for what age
55
how is goldmann perimetry with octopus good at being a repeatable test
it has automatic repetition and follow up of kinetic examinations i.e. stimulus moves at the same speed. with a follow up button
56
how is the quantification of goldmann perimetry with octopus
measurement of isopters for the quantification of progression
57
which two types of kinetic testing does goldmann perimetry with octopus have
manual or automatic
58
list 3 advantages of kinetic perimetry
- useful for detecting contraction of visual fields e.g. in retinitis pigmentosa - useful for detecting neurological problems e.g. large visual field defects are detected such as a hemianopia - useful in young children when automated versions are not possible
59
list 6 disadvantages of kinetic perimetry
- requires a skilled operator with manual perimetry - results are operator dependent with manual perimetry - difficult to quantify results with manual perimetry - children/adults with a stroke will find manual perimetry easier (gross perimetry) as they move you can pause - poor sensitivity for detecting scotomas with both manual and automated
60
what refractive correction will you use on a patient who has less than 1D of cyl
mean sphere/BVS (sph + 1/2 cyl)
61
when will you insert a cyl when carrying out perimetry
if the patient's cyl is above 1DC

Clinical Skills Year 2 (20 decks)

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