Exam Questions All Solved 100%
Correct .
3 rxns when object viewed at near - Answer 1. Accommodation
2. Convergence of eyes toward object
3. Pupil constricts
(not true reflexes, may occur w/o each other)
APD (AKA Marcus Gunn pupil) - Answer Swinging light reflex
good eye --> OU constrict
bad eye--> OU dilate
Nonreactive pupil - Answer -dilated 5-6 mm
-can result from damage to CN3 (oculomotor)
-distinguish between APD and 3rd nerve palsy:
consensual light reflex - size of pupil in affected eye remains the same when light is shone into
"good eye"
Pupil in acute narrow angle glaucoma - Answer may be dilated and fixed
*characteristically oval*
Bilateral constriction (miosis) - Answer -glaucoma meds (pilo)
-morphine addicts (small, pinpoint pupils)
Unilateral constriction - Answer occurs w/ :
iritis
interruption of sympathetic pathways
irritative lesion of cornea/conj
Addie's syndrome (tonic pupil) - Answer Pupil responds to light stimulation slowly
,-small, irregularly shaped, nonreactive to direct or consensual light, but reactive to near
stimulation
External exam for SCTL - Answer -Evert lid for papillary rxn
-Schirmer's test (adequate tears)
-Measure palpebral fissures
-Careful MR
-Keratometer reading
**Pupil + horizontal visible diameter measure = MOST IMPORTANT FOR SCLs
CTL fitting guidelines - Answer *Normal fit should show 0.5-1.0mm downward lag w blink // if
decenter prolly too small or too flat
Small eyes --> smaller, steeper BC
Large eyes --> larger, less steep BC
SCL material - Answer lower [H2O] --> more durable
thinner --> more permeable to O2, but also more fragile
Hazy va from lack of O2 - Answer too tight or overwear
Retinoscope "on / off" - Answer emmetropic
Retinoscope "against motion" - Answer -myopic
-->add (-) until "on/off"
Retinoscope "with motion" - Answer -hyperopic
-->add (+) until "on/off"
distometer - Answer Measures vertex distance
Halberg and Janeli clip - Answer eliminates need to measure vertex distance bc trial clips onto
,Horizontal prism bar - Answer base in or out
Vertical prism bar - Answer base up or down
Risleys rotary prism - Answer consists of two counterrotating prisms mounted in rings, one in
front of the other.
-when two bases are stacked their effective power is additive
-when apex stacked in line w base effective power = zero
direct vs indirect ophthalmoscope - Answer -direct: greater magnification (x15), easier w
small, undilated pupils and mechanically easier to use.
-indirect: permits binocular va and depth perception, wider field of view, easier to use in OR
(w/o contamination), more intense illumination, hands free
gonio lens - Answer Used to examine the ciliary body, periphery of the retina, and the angle
structures.
-only method for detecting angle closure
-valuable in locating preferential sx site for drainage and evaluating cause of failure of glaucoma
sx
Keratometer - Answer obtain exact radius of the curvature of the cornea
-valuable in cases or irregular astigmatism, asymmetric astigmatism, oblique astigmatism,
keratoconus and nystagmus
dacryocystography & lacrimal scan - Answer imaging technique used to determine the lacrimal
outflow system in patients who report consistent tearing.
-DCG: best anatomic test to determine the actual site of obstruction
, Ametropia - Answer RE is present
-myopia: nearsighted
-hyperopia: farsighted
Anisometropia - Answer A condition in which the two eyes have different refractive errors
(e.g., one eye is farsighted and the other not).
emmetropia - Answer normal vision
Symptoms requiring URGENT attention - Answer -Pain in the eye
-Sudden loss of va
-Transient loss of va
-Diplopia
-Ptosis
-Flashes of light
-Trauma
Symptoms requiring PROMPT attention - Answer -Discharge and matting of eyelids in the AM
-Red eye
-Swelling of lids
-Halos around light
-Blurred va in the elderly
-Persistent tearing in one eye
-Enlarging nodule on lid
-FBS
Symptoms to be seen ASAP - Answer -Gritty feeling
-Headaches
-Blurred Dva in adults
-Spots before eyes