Ophthalmoscopy Prep

Question 1

Ophthalmoscopy may be performed as part of a ….

Answer 1

Neurological examination

Question 2

What can be viewed with opthalmoscopy?

Answer 2

Vasculature of the eye.

To some degree, the nerve supply.

Question 3

Why is a focus wheel used?

Answer 3

To accomodate for any refractive error.

Question 4

What is the function of the focus wheel?

Answer 4

Can be moved to change the strength of the lens, enabling you to focus on the internal structures.

Question 5

Role of lens indicator?

Answer 5

Number changes as lens wheel is moved.

Should be set on 0 before starting the examination.

Question 6

Hyperopia

Answer 6

Longsightedness.
Distant object image focused behind retina.
Hence objects appear out of focus, may cause headaches, eye strain.

Question 7

Myopia

Answer 7

Condition where image of a distant object becomes focused in front of retina.

Causes distant objects to appear out of focus.

Question 8

Why is it good practice to place your free hand on patients head, with thumb above eye?

Answer 8

If you get too close, forehead will touch your thumb preventing you from bumping into the patient.

Question 9

What may we inspect the external structures of the eye for?

Answer 9

Lesions, scars, trauma, any other abnormalities.

Question 10

State the structures of the eye?

Answer 10

Eyelids, eyelashes
Lateral an medial canthus 
Sclera
Conjunctiva 
Iris 
Cornea 
Pupil

Question 11

Blepharitis

Answer 11

Causes red, swollen and itchy eyelids.
Eyelids sticky and difficult to open in the morning
Non-contagious

Question 12

Stye

Answer 12

Small yellowish spot, most commonly caused by blocking of oil gland at base of eyelid.
Can be painful / tender to touch.

Question 13

Conjunctivitis

Answer 13

Inflammation of conjunctiva caused by viral / bacterial infection.
Highly contagious

Question 14

Pinguecula

Answer 14

Yellow bump on eye.
Non-cancerous growth on conjunctiva.
Does not cross over

Question 15

What is used to make vessels of the eye more prominent?

Answer 15

Fluroescein drops.

Question 16

Corneal limbus

Answer 16

Border of the cornea and the sclera.

Question 17

Pterygium

Answer 17

Non-cancerous, wing shaped growth of tissue across cornea.

Patients sight may not usually be painful however eye may appear red.

Question 18

Conjunctival epithelial inclusion cyst

Answer 18

Symptomless swelling of conjunctiva, which may reduce motility.

May be congenital, primary or secondary, due to trauma

Question 19

Diffuse Iris Nevus

Answer 19

Appear as hyperpigmented regions of the iris with minimal disruption of normal iris architecture.

Question 20

How may the red reflex be performed?

Answer 20

Ask the patient to fix their gaze on a distant object.

Look through ophthalmoscope (with light switched on)

Observe for red reflex and identify any areas where it is reduced or distorted.

Question 21

Why is the red reflex observed?

Answer 21

Light reflecting back from blood rich retina.

Question 22

Strabismus

Answer 22

Both eyes are not looking forward in the same direction

Question 23

What is a common observation of the red reflex?

Answer 23

Reduction of bright red colour due to cataracts in one of the patients eyes.

Question 24

Leukocoria

Answer 24

Loss of red reflex.
Abnormal white reflection from retina.
Can occur if retina lacks a tapetum lucidum.

Question 25

When looking through the ophthalmascope if structures are blurry or indistinct what should you do?

Answer 25

Move focus wheel until image is clearer. | If images become more distorted, move the wheel in the opposite direction.

Question 26

Where do retinal vessels branch from?

Answer 26

Optic disc into quadrants of the eye.

Question 27

What colours are the veins and arteries in the eye?

Answer 27

Veins - burgundy | Arteries - Paler with a central silvery core with 2 outer red lines.

Question 28

When examining the macula , it is important to?

Answer 28

Dim the light of the ophthalmoscope.

Question 29

When examining the fovea it is important to?

Answer 29

Ask patient to look directly into the light.

Question 30

Papilledema

Answer 30

Usually bilateral swelling of optic disc as a result of increased intracranial pressure. Causes: Brain tumour Malignant hypertension Respiratory failure

Question 31

Maculopathy

Answer 31

Damage to macula. | - Macula is the part of the eye which provides us with central vision.

Question 32

Exudates

Answer 32

Composed of lipid and protein. Either hard or soft. Often associated with adjacent fluid accumulation in the retina.

Question 33

Soft exudates

Answer 33

Tend to be swollen nerve axons.

Question 34

Age related macula degeneration

Answer 34

``` Causes vision loss in the centre of the field of vision. Drusen deposits (lipids) under retina (seen as yellow spots) are associated with an increased risk of ARMD. ```

Question 35

2 Types of Age related macula degeneration

Answer 35

1. Dry Macular Degeneration | 2. Wet Macular Degeneration

Question 36

Which is the more common type of ARMD?

Answer 36

Dry Macular degeneration - Deterioriation of macula - seen as series of dark patches - caused by accumulation of drusen. - causes atrophy and scaring to retina

Question 37

Drusen

Answer 37

Deposits of extracellular waste that accumulate under the retina, between a specialized layer of cells called the retinal pigment epithelium.

Question 38

Wet macular degeneration

Answer 38

Blood vessels grow under retina, arising from choroid or choroidal neurovascular membrane in back of eye ,leaking blood of fluid.

Question 39

Describe the characteristic signs of Wet macular degeneration?

Answer 39

Pale patches of exudates. | Large pool of blood or lipids.

Question 40

Retinopathy

Answer 40

Process whereby inflammation and vascular remodelling occurs over a period of time.

Question 41

Types of retinopathy

Answer 41

1. Retinopathy of prematurity ROP 2. Diabetic retinopathy associated with type 1 and type 2 diabetes 3. Hypertensive retinopathy

Question 42

Retinopathy of prematurity ROP

Answer 42

, When retinal blood vessels have not developed completely as a result of prematurity.

Question 43

Non proliferative retinopathy

Answer 43

Blood vessels in retina deteriorate. Can become blocked, leads proteins and lipids etc Fluid can collect in retina, impacting sharp vision

Question 44

Proliferative retinopathy

Answer 44

New structurally unstable vessels grow on surface of retina. Can cause frequent minor bleeding.

Question 45

Hypertensive retinopathy

Answer 45

Results from damage to BV. Abnormalities: - thickening of small arteries - blockage of retinal blood vessels