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Clin Med 3 > Eyes - Lab > Flashcards

Eyes - Lab Flashcards

1
Q

measurement of the smallest object a person can see at a given distance (tests CNII, measurement of central vision)

A

visual acuity

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2
Q

What test would be used if a patient has complaints regarding near vision?

A

Rosenbaum pocket eye chart

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3
Q

At what distance should a patient hold the Rosenbaum pocket eye chart from?

A

no closer than 14 inches

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4
Q

What test could be used to check patient’s distance vision, central vision, and CNII?

A

Snellen chart

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5
Q

At what distance should a patient stand from the Snellen chart?

A

20 feet

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6
Q

The results of vision test using a Snellen chart is reported in fractions, what does the numerator indicate? Denominator?

A

numerator is the distance between the patient and the eye chart (20)
denominator is the distance at which a person with normal acuity reads

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7
Q

If the result of a Snellen chart is 20/100, what does this mean?

A

the patient can read at 20 feet what the average person reads at 100 feet.

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8
Q

What is the range of a normal adult visual acuity?

A

20/12 to 20/25

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9
Q

What is the near normal range when using a Snellen chart to assess visual acuity?

A

20/30 to 20/70

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10
Q

What is the moderate low range when using a Snellen chart to assess visual acuity?

A

20/80 to 20/160

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11
Q

What is the severe low range when using a Snellen chart to assess visual acuity?

A

20/200 to 20/400

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12
Q

What do you inspect on eyebrows?

A

size, extension and texture

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13
Q

A patient has short eyebrows that do not extend beyond temporal canthus and are coarse, what should you be thinking?

A

hypothyroidism

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14
Q

What do you inspect in the orbital area?

A

ptosis, edema, sagging, drainage, or lesions

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15
Q

Periorbital edema is abnormal, what are some causes?

A

it varies: thyroid disease, allergies, or renal disease

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16
Q

yellow-tinted flat to slightly raised, irregularly shaped lesions

A

xanthelasma

abnormal lipid metabolism

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17
Q

Would you see inflammation or drainage in the eyelids of a newborn?

A

NO, newborn eyelids can be swollen or edematous due to birth trauma, but inflammation or drainage are abnormal

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18
Q

What are some things you would inspect for eyelids and eyelashes?

A

symmetry, color, quantity, blinking patterns, ptosis, tremors, flakiness, lesions, inflammation, and edema

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19
Q

What kind of eyelid movements can be seen in a patient with hyperthyroidism?

A

fasciculations or tremors

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20
Q

What test can be performed if you suspect a patient has foreign object or polyps in the eyelid?

A

eyelid eversion

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21
Q

What test do you use to evaluate a patient’s peripheral visual fields?

A

confrontation test

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22
Q

What tests for hemianopia’s and quadrantanopia’s?

A

confrontation test

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23
Q

Briefly describe how to perform the confrontation test

A

1) stand about one meter away from the patient
2) ask the patient to close their left eye, you close your right eye
3) have the patient look directly at you
4) very slowly move your fingers into the visual field halfway between you and the patient, this is done in four quadrants at 45 degrees
5) ask patient to tell you when they see your finger
6) compare the time your patient see your finger with the time you see your finger
7) repeat in the other eye

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24
Q

Will a normal test result from a confrontation test rule out a visual field deficit?

A

NO, an abnormal result is significant, a normal result is not

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25
Name the eye muscles involved with the following eye movement: right and up
right superior rectus | left inferior oblique
26
Name the eye muscles involved with the following eye movement: right
right lateral rectus | left medial rectus
27
Name the eye muscles involved with the following eye movement: right and down
right inferior rectus | left superior oblique
28
Name the eye muscles involved with the following eye movement: left and up
left superior rectus | right inferior oblique
29
Name the eye muscles involved with the following eye movement: left
left lateral recuts | right medial rectus
30
Name the eye muscles involved with the following eye movement: left and down
left inferior rectus | right superior oblique
31
Briefly describe how to test for convergence. What could difficulty with convergence suggestive of?
ask the patient to follow your finger as you bring it closer to their nose hyperthyroidism
32
What should be inspected regarding the pupils?
shape, size and equality | **Record pupil size in each eye in the SOAP note (for SPAL)
33
What is direct pupil response?
when a light source is held in front of one eye and you watch for ipsilateral constriction (the same eye)
34
What is consensual pupil response?
when a light source is held in front of one eye and you watch for contralateral constriction (the opposite eye)
35
What results would you expect for a normal light reaction reflex?
pupils will constrict equally in both pupils (due to identical signals from the midbrain)
36
What are abnormal results for a light reaction reflex?
constriction of one pupil but not the other | slow or no reaction to light
37
What reflex grading would you use if a patient has brisk, hyperactive, with intermittent or transient clonus response to light reaction reflex?
4+ (hyperresponsive actions are rare)
38
What reflex grading would you use if a patient has sluggish or diminished response to light reaction reflex?
1+
39
What reflex grading would you use if a patient has more brisk than expected, slightly hyperactive response to light reaction reflex?
3+
40
What reflex grading would you use if a patient has no response to light reaction reflex?
0
41
What reflex grading would you use if a patient has active or expected response to light reaction reflex?
2+
42
What cranial nerve is involved with near reaction?
oculomotor nerve (CN III)
43
What are the three phases of a near reaction?
1) constriction of the pupils 2) convergence of the eyes 3) accommodation of the lens (cannot visualize)
44
Briefly describe how to perform a near reaction
the patient shifts gaze from a far object to a near object approximately 10 cm away from their eyes Normal: constriction and convergence are observed
45
What abnormality can be detected using the swinging flashlight test?
relative afferent pupillary defect (Marcus Gunn pupil) | *remember afferent is sensory (CN II)
46
What is indicative of an abnormal result for the swinging flashlight test?
slow dilation without initial constriction, may indicate lesion of the optic nerve or retinal lesion
47
Will dense cataracts affect the results of a swinging flashlight test?
no
48
What do you look for in a visual inspection of the eye?
gross abnormalities, scars, opacities, cloudiness
49
What is the purpose of a lateral penlight test?
to observe anterior chamber depth, tests for glaucoma | **this test MUST be don before instilling mydriatics
50
Briefly describe how to perform a lateral penlight test
stand in front of patient and shine light from temporal side of head across front of the eye parallel to plane of iris
51
What are you looking for once you shine the light into the patient's eye during a lateral penlight test?
you're looking for a shadow in nasal aspect of iris | more than 2/3 of nasal iris in shadow (may indicate shallow chamber)
52
What does the corneal light reflex tests for?
ocular alignment | presence of esotropia, exotropia, hypertropia or hypotropia (uneven gaze between the two eyes)
53
Briefly describe how to perform the corneal light reflex
1) the patient is staring at a distant object (15 feet away) 2) shine penlight directly in front of the patient at a distance of two feet 3) compare where the light is reflecting in both eyes Normal: symmetry is observed
54
esotropia
eye is inward from the light reflection (medially)
55
exotropia
eye is outward from the light reflection (laterally)
56
hypertropia
eye is above from the light reflection
57
hypotropia
eye is below from the light reflection
58
What test is used to detect tropias?
cover test | **patients over age of 6 or 7 months
59
What test is used to test CN V1 & V2 and the CN VII?
corneal reflex to touch
60
What test is used to detect present of phorias?
cover-uncover test
61
Which eye are you observing when performing the cover test?
the uncovered eye
62
Which eye are you observing when performing the cover-uncover test?
the covered eye as it is being uncovered
63
During the cover test the patient's eye moved outward, what type of tropia is this?
esotropic | the eye was originally inward and now it moved outward
64
During the cover test the patient's eye moved inward, what type of tropia is this?
exotropic | the eye was originally outward and now it moved inward
65
During the cover test the patient's eye moved upward, what type of tropia is this?
hypotropic | eye was originally downward and now it moved upward
66
During the cover test the patient's eye moved downward, what type of tropia is this?
hypertropic | eye was originally upward and now it moved downward
67
During the cover-uncover test the patient's eye moved outward, what type of phoria is this?
exophoria
68
During the cover-uncover test the patient's eye moved inward, what type of phoria is this?
esophoria
69
When performing the corneal reflex to touch, you provided a gentle stimulation to one cornea, what should be expected as a normal result?
both eyes will blink
70
When performing the ophthalmoscopic inspection, when should you use the small light source? What about the large light source?
small light source should be used for undilated pupils | large light source should be used for dilated pupils and better illumination
71
What do you use the green light for on the opthalmoscope?
drusen bodies, nerve fiber defects or blood
72
What do you used the grid for on the opthalmoscope?
to identify size of lesions
73
When would you use the slit of the opthalmoscope?
to examine the anterior chamber and to determine elevation of lesions
74
If your patient is myopic (near-sighted), what lens should you use to focus on the retina?
minus (red) lens
75
If your patient is hyperopic (far-sighted), what lens should you use to focus on the retina?
plus (black) lens | - this is also used for those who are lacking a lens
76
What would obscure the red reflex?
opacities such as corneal scars, cataract, and vitreous hemorrhage
77
A-V nicking is seen in what type of patients?
hypertensive
78
When examining a patient's optic disc, you find it to be pale and clearly demarcated, is this normal? If not, what could it be?
No, it is not normal, this is optic atrophy
79
What does pathological cupping indicative of?
glaucoma
80
What is the most common cause for new vessels on the optic disc?
proliferative diabetic retinopathy
81
If the optic disc is observed to have blurred margins with or without hemorrhages, what could it be indicative of?
papilledema-bilateral
82
When observing blood vessels in the eye, what should you be looking for?
look at the mid-periphery for scars (inflammatory, laser), hemorrhages, exudates, pigment (white, black) and pigmented lesions
83
Where will you find the macula in relation to the optic disc?
temporal/ lateral to the disc (about two disc diameters away)
84
The foveal reflex is seen better using which color filter?
green
85
What are some common things you ill see in the macula?
circinate ring of hard exudates, hemorrhage (dot, blot, or flame), or pigment deposition

Clin Med 3 (11 decks)

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