Adult - Eyes

Question 1

How close should the ophthalmascope be

to the patient’s eye?

Answer 1

start 12 inches away

and then move to within 1 - 2 inches

Question 2

At what setting should the wheel of the ophthalmascope be to begin with?

Answer 2

zero

Question 3

What is the sequence for fundoscopic examination?

Answer 3

1. obtain red reflex
2. proceed from optic disc
3. end with fovea centralis in the macula

(moving laterally/temporally)

Question 4

donut-like with orange-pink neuro-retinal rim and central white depression (physiologic cup)

Answer 4

optic disc

from whence the arteries enter the retina

Question 5

what is the expected cup to disc ratio?

Answer 5

Cup should be not more than

1/2 the size of the disc diameter

differential if it is greater?

glaucoma

Question 6

Which are larger in the retina - the arteries or the veins?

Answer 6

The veins are larger than the arteries

A:V ratio is 2:3 to 4:5

Question 7

Where is the macula located in comparison to the optic disc?

Answer 7

2 to 2.5 disc diameters temporally

Question 8

What is AV nicking?

significance?

Answer 8

a raised area at the intersection between and artery and vein on the retina

indicative of hypertension

Question 9

2.5 mm-diameter reflective area, which is slightly darker

and lies in the center of the macular region

Answer 9

fovea centralis

area of most acute vision

Question 10

Where should the patient be directed to look if the macula is difficult to visualize?

Answer 10

Directly into the light of the ophthalmascope

Question 11

How is the snellen chart interpreted?

Answer 11

numerator is the patient

denominator is normal person

20/30 = the patient can see at 20 feet what the normal person can see at 30 feet

Question 12

Based on Snellen assessment, at what point should the adult patient be referred?

Answer 12

20/30

Question 13

define hyperopia

Answer 13

farsighted

Question 14

define **myopia **

Answer 14

nearsighted

Question 15

define presbyopia

Answer 15

difficulty maintaining clear focus at near distance

typical age? often begins near age 40

**physiology? **

lens less flexible

ciliary muscles weaker

Question 16

Is arcus senilis permanent?

Answer 16

yes

it will not resolve even when lipid profile is improved

Question 17

define pterygium

Answer 17

raised, wedge shaped growth on the conjuctiva

often in dry climates

Question 18

define blepharitis

Answer 18

staph or seborrhea of lid edge

Question 19

typical description of blepharitis

Answer 19

red, scaly, greasy flakes at lid margin

Question 20

treatment for blepharitis

Answer 20

scrub lids and lashes

Question 21

What is the most common eye disorder?

Answer 21

conjunctivitis

Question 22

Antibiotic treatment for bacterial conjuctivitis in the adult

Answer 22

• fluoroquinolone → -floxicin
  
  • levofloxicin
  • ofloxicin
  • ciprofloxicin
• macrolide → -mycin
  
  • tobramycin
  • gentamycin

Question 23

Treatment for gonococcal conjunctivitis in the adult

Answer 23

ceftriaxone IM

(same as for genital)

Question 24

Treatment for chlamydial conjunctivitis

Answer 24

macrolide → -mycin

Question 25

Which type of glacoma is acute?

Answer 25

closed angle

Question 26

which type of glaucoma is chronic?

Answer 26

open angle

Question 27

open-angle glaucoma may be asymptomatic

what are two signs and symptoms that may be present when symptomatic

Answer 27

cupping of the disc

constriction of visual fields

Question 28

Closed angle glaucoma (acute)

4 signs and symptoms

Answer 28

extreme pain

blurred vision

halos around lights

pupils dilated or fixed

Question 29

Diagnotic test for glaucoma

Answer 29

tonometry

Question 30

Open angle glaucoma -

acute or chronic

treatment

Answer 30

chronic

Treatment:

• alpha 2 agonists
• **beta blockers **
• **miotic agents **

Question 31

Closed angle glaucoma

acute or chronic?

treatment?

Answer 31

Acute

• carbonic anhydrase inibitor
• osmotic diuretic
• surgery

Question 32

What is the most common cause of treatable blindness?

Answer 32

cataracts

Question 33

What effect do cataracts often have on colors?

Answer 33

yellowing

Question 34

Do cataracts tend to produce halos around lights?

Answer 34

Yes

what other eye condition does also?

closed angle (acute) glaucoma but cataracts are not painful and closed angle glaucoma is quite painful

Question 35

Does a patient with cataracts have a red reflex?

Answer 35

no

Question 36

Can diplopia occur due to cataracts?

Answer 36

yes - diplopia in one eye can occur with cataracts

and so can sensitivity to light

Question 37

What is the leading risk factor for cataracts?

Answer 37

aging

Question 38

What eye condition has flashes of light (photopsia) as a unique feature?

Answer 38

retinal detachment

Question 39

In addition to flashes of light, what three other symptoms does retinal detachment feature?

Answer 39

floaters

blurred vision

shadow or blindness in field of vision in one eye