How close should the ophthalmascope be
to the patient's eye?
start 12 inches away
and then move to within 1 - 2 inches
At what setting should the wheel of the ophthalmascope be to begin with?
What is the sequence for fundoscopic examination?
- obtain red reflex
- proceed from optic disc
- end with fovea centralis in the macula
donut-like with orange-pink neuro-retinal rim and central white depression (physiologic cup)
from whence the arteries enter the retina
what is the expected cup to disc ratio?
Cup should be not more than
1/2 the size of the disc diameter
differential if it is greater?
Which are larger in the retina - the arteries or the veins?
The veins are larger than the arteries
A:V ratio is 2:3 to 4:5
Where is the macula located in comparison to the optic disc?
2 to 2.5 disc diameters temporally
What is AV nicking?
a raised area at the intersection between and artery and vein on the retina
indicative of hypertension
2.5 mm-diameter reflective area, which is slightly darker
and lies in the center of the macular region
area of most acute vision
Where should the patient be directed to look if the macula is difficult to visualize?
Directly into the light of the ophthalmascope
How is the snellen chart interpreted?
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
Based on Snellen assessment, at what point should the adult patient be referred?
difficulty maintaining clear focus at near distance
typical age? often begins near age 40
lens less flexible
ciliary muscles weaker
Is arcus senilis permanent?
it will not resolve even when lipid profile is improved
raised, wedge shaped growth on the conjuctiva
often in dry climates
staph or seborrhea of lid edge
typical description of blepharitis
red, scaly, greasy flakes at lid margin
treatment for blepharitis
scrub lids and lashes
What is the most common eye disorder?
Antibiotic treatment for bacterial conjuctivitis in the adult
fluoroquinolone → -floxicin
macrolide → -mycin
Treatment for gonococcal conjunctivitis in the adult
(same as for genital)
Treatment for chlamydial conjunctivitis
macrolide → -mycin
Which type of glacoma is acute?
which type of glaucoma is chronic?
open-angle glaucoma may be asymptomatic
what are two signs and symptoms that may be present when symptomatic
cupping of the disc
constriction of visual fields
Closed angle glaucoma (acute)
4 signs and symptoms
halos around lights
pupils dilated or fixed
Diagnotic test for glaucoma
Open angle glaucoma -
acute or chronic
- alpha 2 agonists
- beta blockers
- miotic agents
Closed angle glaucoma
acute or chronic?
- carbonic anhydrase inibitor
- osmotic diuretic
What is the most common cause of treatable blindness?
What effect do cataracts often have on colors?
Do cataracts tend to produce halos around lights?
what other eye condition does also?
closed angle (acute) glaucoma but cataracts are not painful and closed angle glaucoma is quite painful
Does a patient with cataracts have a red reflex?
Can diplopia occur due to cataracts?
yes - diplopia in one eye can occur with cataracts
and so can sensitivity to light
What is the leading risk factor for cataracts?
What eye condition has flashes of light (photopsia) as a unique feature?
In addition to flashes of light, what three other symptoms does retinal detachment feature?
shadow or blindness in field of vision in one eye