Clinical Sciences Ophthalmoscopy

Front 1

The examination of the interior of the eye uses an:

Back 1

Ophthalmoscope

Front 2

Consists of a light source, mirror or prism, and auxiliary lenses:

Back 2

Ophthalmscope

Front 3

Direct Ophthalmoscope
(-Magnification? -Image? -Field of View?)

Back 3

15x
Upright
6.5 degrees

Front 4

Monocular Indirect Ophthalmoscope
(-Magnification? - Image? - Field of View?)

Back 4

5x
18-25 degrees
Corrected image by inverting lens system

Front 5

Binocular Indirect Ophthalmscope
(Magnification? - Image? - Field of View?)

Back 5

1.9x (uses +20 D lens)
25 degrees
Inverted/Perverted

Front 6

Small aperture (used for...)

Back 6

small/undilated pupils

Front 7

Large aperture (used for...)

Back 7

dilated pupils

Front 8

Fixation aperture (cross hairs) (used for observation of...)

Back 8

Macula and estimate of size

Front 9

Slit aperture (used for...)

Back 9

detecting height or depth of findings by bending or deflection the streak

Front 10

Cobalt filter (used for...)

Back 10

evaluating cornea (uses +20 D lens and fluorescein)

Front 11

Red-Free filter (used for...)

Back 11

Observing vessels and hemorrhages and estimation of their depth

Front 12

Polarized Filter (used for...)

Back 12

Reducing glare

Front 13

Yellow Filter (used for...)

Back 13

Reducing hazardous UV during prolonged retinal examination

Front 14

On Ophthalmoscope, plus is indicated by:
Minus is indicated by:

Back 14

green or black numbers
Red numbers

Front 15

Wheel is arranged to rotate from plus to minus in what direction?

Back 15

Counterclockwise direction

Front 16

Any opacity between you and the retina will be seen __ ____ (behind lighting) and will appear silhouetted or _____

Back 16

In Retro
Black

Front 17

Most common opacities:

Back 17

Corneal Scars
Lenticular (cataracts)
Vitreous floaters

Front 18

What is Parallax?

Back 18

Depth of opacities in the ocular media can be estimated by rotating your view around a reference point.

Front 19

What thing in the eye is used as a nodal point?

Back 19

Pupil

Front 20

Opacities that move "with" your movement are In Front or Behind the nodal point?

Back 20

Behind
(Posterior lens/vitreous)

Front 21

Opacities that move "against" your movements are In Front or Behind the nodal point?

Back 21

In Front
(Cornea, AC)

Front 22

How far should you be from pt during Ophthalmoscopy?
And at what angle off visual axis?

Back 22

1.5 - 3 cm
15-20 degrees

Front 23

ONH Evaluation, 6 things to look for:

Back 23

1. Shape of cup & size of ONH
2. CD
3. Depth of Cup
4. Color of rim tissue
5. Margins (flat/elevated)
6. Venous Pulsation

Front 24

ONH H to V ratio:
(has slightly oval form)

Back 24

70 - 90%

Front 25

CD ratios with a larger V or H ratio are more suspect for Dz.

Back 25

Vertical

Front 26

Average CD's for Caucasions:
And for African Americans:

Back 26

.3 +/- .2
.5 +/- .15

Front 27

Donut Rule-If the hole in the middle (cup) equals the donut sides (the rim) the CD is:

Back 27

~.35 (1/3)

Front 28

Depth of Cup - the distance the focus changes in the eye as you focus back is:

Back 28

~ 1/3 mm per Diopter

Front 29

Very deep cups will show a grey dot pattern at the base. This is the:

Back 29

Lamina Cribosa

Front 30

ONH-colors of rim tissue:
(what do these different colors mean?)

Back 30

Salmon (normal)
White (Optic atrophy)

Front 31

An observed pulsation of the venous arcades as they pass over the rim of the cup or at the central bifurcation is called:

Back 31

Venous Pulsation

Front 32

If margins on ONH are elevated, this is called:

Back 32

Papilledema

Front 33

Eye Pathology made easy: These colored things (white, red, black) mean:

Back 33

White: Atrophy, infarcs
Red: Blood
Black: Pigment (congenital, Inflammation/Scarring)

Front 34

Temporal Scleral Crescent
(where would you see this? what color is this?)

Back 34

Margins, white stuff

Front 35

Myelinated nerve fibers
(where would you find these? what color is this)

Back 35

Superior, Inferior or "nasal"
White stuff

Front 36

Temporal Pigment Crescent
(where do you see this? what color?)

Back 36

At edge of disc
Black

Front 37

About how many feeder vessel are there on a healthy nerve?

Back 37

~12

Front 38

Myopic Crescents
(seen where? What color)

Back 38

Temporal
White (kind of shiny/sparkly)

Front 39

Cup Type I

Back 39

-Flat
-Small Cup
-Central Bifurcation
-Small, flat feeder vessels
without deflection
-CD: 0 - .15
-Depth <1 D

Front 40

Cup Type II

Back 40

Cylinder
-Temporal Rim
-Central Bifurcation
-Feeder Vessels bend/follow rim
-CD: .2 -.8
-Depth: 4 D

Front 41

Cup Type III

Back 41

Slope
-NO temporal rim
-Central Bifurcation
-Feeder vessels DO NOT bend/jog
-CD: .1 - .7
-Depth: 1-3 D

Front 42

Cup Type IV

Back 42

Hook
-NO temporal rim
-NO central Bifurcation
-Vessel climb over rim
-CD: .15 - .6
-Depth: 1-2 D

Front 43

Cup Type V

Back 43

Pot
-Thin temporal rim
-Central Bifurcation?
-Vessels climb over rim
-Rim rolled 360
-Lamina Dots seen
-CD: >.8
-Depth: 3-5 D

Front 44

Estimate the CD by:

Back 44

Color AND feeder vessels

Front 45

Fundus Colors

Back 45

Albino (No RPE layer)
Blonde (light orange, fades to near albino)
Brunette (med orange to brown tint)
Dark (dark w/ slight green tint)
Tigroid (blotchy, orange-striped pattern)

Front 46

Method for giving size and distance:

Back 46

Disk Diameters (DD)

Front 47

A/V ratio for healthy? Abnormal? (indicates what?)

Back 47

2/3 or 45
1/2 indicates HTN

Front 48

What is the only place in the body that the vascular bed can be directly seen?

Back 48

Retina

Front 49

Ratio of the reflective light off the vessel to the blood column is called:
Normal is:
Abnormal is: (this indicates what?)

Back 49

Arterial Light Reflex (ALR)
1/4
1/2 (HTN & Arteriosclerosis)

Front 50

When vein changes direction as it crosses artery at 90 degrees is called:

Back 50

Banking

Front 51

An apparent tapering of a vein as it crosses under an arteriole: (is a sign of...)

Back 51

Nicking
HTN and Arteriosclerosis

Front 52

What should you ask yourself if you see tortuous vessels?

Back 52

Is this normal? Or is it HTN? (look for other signs such as tapering, nicking etc)

Front 53

White stuff WITHIN a vessel
(plaque that's been thrown off of heart or carotid)

Back 53

Emboli

Front 54

White stuff AROUND a vessel
(soft or hard, "cotton wool")

Back 54

Exudates

Front 55

White stuff AWAY from vessels (small deposits of retinal waste)

Back 55

Drusen

Front 56

White stuff:
-Infarcations
-"cotton wool" fuzzy
-single

Back 56

Soft Exudates

Front 57

White stuff:
-Stasis secondary infiltrates
-small, discrete, distinct
-numerous

Back 57

Hard exudates

Front 58

4 basic types of hemorrhages (red stuff)

Back 58

1. Pre-retinal
2. Dot & Blot
3. Flame
4. Sub Retinal

Front 59

Under Red-Free filter, retina appears:
Blood appears:

Back 59

Green
Black

Front 60

RPE blocks out _____ light
So if this color is used, what happens?

Back 60

Green
Any finding BELOW the RPE will disappear

Front 61

D-shape hemorrhage found:
Size?
Indication of:

Back 61

Pre-retinal
Large
Blood dyscrasias & DM

Front 62

Flame hemorrhage found:
Indication of:

Back 62

Nerve Fiber Layer
HTN

Front 63

Dot and Blot hemorrhage found:
Size?
Indication of:

Back 63

Inter Retinal
Small
DM

Front 64

Sub Retinal hemorrhage found:
Size?
Indication of:

Back 64

Choroid
Large
Chorioretinitis, ARMD

Front 65

Macula
a) Pigmentation:
b) FLR:
c) White Stuff:
d) Red stuff
e) Black stuff

Back 65

a) Darker, even pigmentation
b) Foveal Light Reflex
c) Atrophy, Dry degeneration, Drusen
d) Blood
e) Pigmented lesions

Front 66

Where is the Macula found in relation to the Disc?

Back 66

2 DD Temporally

Front 67

If you find black stuff around Macula:
a) nerve untouched
b) Papillary choroiditis

Back 67

a) Toxoplasmosis
b) Histoplasmosis