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Flashcards in Exam Techniques Deck (23)
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1
Q

Limitations of Fix, Follow, Maintain?

A

NOT QUANTITATIVE - not accurate for MILD vision loss, may show fixation preference w/o amblyopia

2
Q

Limitations of FPL (forced choice preferential looking?

A

NEAR ACUITY ONLY assessed - won’t ID any pt over -2.00D

  • UNDERestimates acuity loss d/t amblyo, Rf error and macular pathology (gratings large enough to be OUTSIDE macular area)
  • time consuming, expensive
3
Q

Limitations of Lea grating PADDLES?

A

-examiner’s FACE can be distracting; examiner bias

4
Q

Cardiff acuity used for which two populations? Test distance? Main limitation?

A
  • toddlers, individuals w/ disabilities
  • 1m
  • limitation: VERY poor at determining Rf error.
5
Q

Three GOOD tests to use to check VA in peds:

Advantages?

A

Lea, Patti pics, HOTV

-all are WELL standardized, and available in logMAR forms

6
Q

Three LIMITED (not so good) acuity methods? WHY Is each not so good?

A
  • Tumbling E - laterality (R/L) may be an issue - otherwise good
  • Broken Wheel (Landolt C) - 50/50 chance - it’s only two forced choice
  • Allen figures - NOT STANDARDIZED!! - NO consistent, critical detail
7
Q

“____’s Technique” - a NEAR retinoscopy technique - describe it.

**MAIN problem??

A

Mohindra’s technique.

  • Ret @ 50cm, NOT under cyclo, in a completely DARK room, subtract correction factor
  • PROBLEM: UNDERESTIMATES HYPEROPIA!!
8
Q

What is the MOST ACCURATE way to assess a kid’s TRUE refractive error? What’s the main problem with it you must be conscious of?

A

CYCLOPLEGED Ret

-Problem: retting off axis. OK to have kid look directly @ retinoscope

9
Q

Major problem with Autorefractors in peds population (what do they underestimate?)

-MOST accurate for what type of Rf error?

A
  • underestimate HYPEROPIA

- accurate for ASTIGMATISM; esp AXIS.

10
Q

Bruckner can quickly provide all of the following….

A
  • Presence of STRAB (strab eye = brighter)
  • Presence/equality of RF ERROR
  • Presence of MEDIA OPACITY
  • Presence of PUPIL SIZE ASYMMETRY.
  • Insight as to whether amblyopia may be present.
11
Q

Which TYPE of refraction is recommended in peds? Hints?

A

TRIAL FRAME refraction w/ peds frame (phoropter=accommodation/distracting)

  • Use ret as starting point
  • Don’t over-minus
  • make them READ LETTERS - not just “is it clearer”
12
Q

Most appropriate cyclo potency in kids

A

1Y/O: 1.0% cyclo

Premie/LBW = cyclomydril (0.2% cyclo, 1% phenyl)

13
Q

Sensitivity in picking up a strab is just as high when using an accommodative target as using an interesting light.

A

FALSE - only ACCOMM TARGET will p/u strab.

14
Q

Is a dilated eye exam recommended, or required?

A

STANDARD OF CARE - DILATE EVERY PATIENT at least q 2 yrs. In peds, MUST do it on first eye exam (including BIO!)

15
Q

Can OKN be “normal” even when pt is FUNCTIONALLY blind? How about when they have a massive CENTRAL scotoma? How about if it’s a peds pt w/ a nystagmus?

A

YES-YES-hard to interpret if nystagmus present.

–so, it has its limits

16
Q

RP and Usher’s syndrome will cause WHAT changes to the ERG?

A

Reduced SCOTOPIC response

17
Q

Cone-rod dystrophy and achromatopsia will cause what changes to an ERG?

A

No cones/cone pigments - difficulty in light

-Decreased PHOTOPIC response

18
Q

Albinism will cause what change to the ERG?

A

No pigment - odd one - EXCESSIVE SCOTOPIC response

19
Q

Congenital stationary night blindness will completely eliminate WHICH ERG wave?

A

B-wave (Bipolar, Mueller)

20
Q

Leber’s congenital amaurosis will cause what change to the ERG?

A

Honey badger - reduces PHOTOPIC AND SCOTOPIC ERG.

21
Q

What, specifically, does an EOG measure?

A

Health of the RPE - but specifically, the VOLTAGE difference b/w the cornea and the PP.

-Recall: Arden ratio - want high–> anything

22
Q

VEP - a direct measure of which part of the visual pathway?

A

Visual CORTEX - most commonly used to bypass orbit and assess cortical VA potential.

23
Q

One of the WORST targets you can choose for fix and follow?

A

Anything w/ an AUDITORY cue (i.e. Finger puppet w/ bells) - doesn’t isolate vision.