Opthalmoscopy

Question 1

What is a technique using a handheld instrument to look inside the eye?

Answer 1

Opthalmoscopy

Question 2

How does Direct and indirect ophthalmoscopy differ?

Answer 2

Direct is using magnified monocular view inside the eye, limited field of view
Indirect can be monocular (MIO) or binocular (BIO) very wide field of view

Question 3

What technique uses the slit lamp to view the fundus.

Answer 3

Fundus Biomicroscopy

Question 4

What is the back part of your eye called?

Answer 4

Fundus

Question 5

What are 3 different lenses used with fundus biomicroscopy?

Answer 5

Hruby lens
fundus contact lenses
non-contact condensing lenses

Question 6

What is something that helps us see better in the eye?

Answer 6

Dilation

Question 7

What is a pharmacological enlargement of pupil via eye drops? what does it allow?

Answer 7

Dilation

Allows much better view of the eye

Question 8

What is an integral part of truly “comprehensive” eye care?

Answer 8

Dilation

Question 9

What are some perceived disadvantages?

Answer 9

blurred vision (not usually true)
light sensitivity (uncomfortable)
long-duration

Question 10

Is VA affected by dilation?

Answer 10

Generally doesn’t affect VA… Really??? (I think my eyes were blurry when I was dilated?)

Question 11

What are the advantages of direct ophthalmoscopy?

Answer 11

Easier than indirect
Provides good magnification
Ability to adjust focus (cornea to retina)

Question 12

What are the disadvantages of direct ophthalmoscopy?

Answer 12

Limited field of view
No stereoscopic view (no depth perception)
Dimmer image which limits resolution

Question 13

True/False: Direct Ophthalmoscopy is done in well lit room.

Answer 13

False, lights are dimmed

Question 14

What are the CLED’s of Ophthalmoscopy?

Answer 14

Correction: no, (unless highly myopic)
Lighting: dimmed
Eyes: monocularly
Distance: start at 40 cm and move in

Question 15

What are you looking for with direct ophthalmoscopy?

Answer 15

Observe the retinal reflex and fundus looking for media opacities

Question 16

How big is the optic nerve?

Answer 16

Optic nerve is about 1.5 mm.

Question 17

How limited is the direct ophthalmoscope?

What is the magnification of it?

Answer 17

Only about 10% of field of view.

15x magnification

Question 18

What do you do with ophthalmoscopy?

Answer 18

locate optic nerve head
check CUP, COLOR, CONTOUR
examine disc noting appearance
examine area adjacent to disc
examine area further out into quadrants checking blood vessels
lastly, move into line of sight to examine macula
switch hands and pt eye and repeat

Question 19

Why do you check macula last?

Answer 19

because it is bright for the patient

Question 20

What do you record?

Answer 20

Optic nerve:
-cup to disc ratio (C/D)
-color of rim
-contour and margins
-spontaneous venous pulsation (SVP)
Blood Vessels:
-arteriovenous (AV) ratio and any AV crossing changes
Macula:
-homognous color?
-foveal reflex?
Really anything that is ABNORMAL!!

Question 21

What do you do if you find something abnormal?

Answer 21

identify
record
do something

Question 22

Where is the cup in relation to the disc?

Answer 22

in the center of the disc

Question 23

True/False: cups can be oval, or oblong, so you record the horizontal and vertical portions of the ratio.

Answer 23

True, C/D ratio: 0.3/0.2 (H/V)

A little longer horizontally…

Question 24

True/False: In glaucoma if you lose ganglion cells you lose them at the cup first… so cup is larger.. (not important to remember right now)

Answer 24

True

Question 25

What is the optic nerve margins?

Answer 25

the outside of the optic nerve, nice distinct margins. where end of nerve ends and where retina begins.

Question 26

What is the name of the heart beat you can see by the optic nerve?

Answer 26

Spontaneous venous pulsation (SVP)

Question 27

With blood vessels how can you tell the difference between arteries and veins?

Answer 27

Veins are darker, and generally arteries go over top off veins.