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66 Cards in this Set
- Front
- Back
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What are typical refractive changes encountered in older pts?
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ATR astigmatism, refraction towards hyperopia
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For smaller pupils, what can you do as far as retinoscopy?
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Move closer - but remember working dist
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For media opacities, what can you do as far as retinoscopy?
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Use a spot retinoscope
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Why do pts see diplopia in the phoroptor after subjective refraction?
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Loss of peripheral fusion - most important factor in keeping img single
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T/F - SRx tends to be stable in older pts, unless there is pathology, so keep SRx near habitual.
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True
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What is the best test to know if the pt has a constant or intermittent eye turn?
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Randot stereo (constant strab cannot do randot)
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What vergence component can be treated in older pts?
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Fusional - the ONLY component that can be Tx'd in older pts (test w/ Von Graefe)
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You should expect >__ cm break and >__ cm recovery in NPC.
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9, 7
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You should expect high (XP/EP) at near with older pts.
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XP
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You should expect what kind of tropia with older pts?
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intermittent XT at near
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You should expect low (BI/BO) vergence ranges.
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BO
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T/F - You should expect various levels of suppression in older pts.
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True
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T/F - You should expect CI due to decompensated phoria.
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True
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T/F - Intermittent diplopia should not be expected in older pts.
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False - intermittent diplopia is a common complaint
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T/F - VT is not recommended for older pts w/ CI.
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False - very successful esp for CI
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T/F - You can use fixation disparity for Rxing prism.
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True
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What apparatus used outside the phoroptor is used for Rxing prism?
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Maddox rod (in free space)
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What does the total deviation on VFs measure?
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Compares VF to normals
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What does the pattern deviation on VFs measure?
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Filter out generalized depression from total deviation
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What is the difference between a limbal girdle vs arcus?
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The girdle "hugs" the limbus, while arcus has an area of clearing
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What is the proper course of action to take if you cannot get a good view of the post seg during the DFE?
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B scan or refer to specialist
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What vitamins are recommended for dry eye?
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Vitamins A, C, E - "ACE"
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What is the significance of a CPAP machine and dry eye?
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Used for sleep apnea - if not a tight seal, will blow air into eyes and cause dry eye
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What color does cataracts affect?
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Blue
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Which of the following will a healthy old person get normal results with?
- D-15 - HRR - Ishihara |
HRR and Ishihara (D-15 will show minor problems bu not absolute problems like a true tritanope)
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What is a PHP? What is it used for? How long does it last, and how many degrees?
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Preferential Hyperacuity Perimeter. Detects/monitors ARMD (conversion to wet). 5 minutes, 14 degrees.
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PHP is a (subjective/objective) measure of what type of acuity?
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subjective, hyperacuity (vernier acuity)
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What does RAM stand for? What is it used for?
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Retinal Acuity Meter - for eval potential VA after cat surg
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The "high" setting on the BAT simulates...
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direct overhead sunlight
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The "medium" setting on the BAT simulates...
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partially cloudy day
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The "low" setting on the BAT simulates...
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bright ovehead commercial lighting
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No improvement on the BAT indicates...
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no opacity
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Decr VA on the BAT indicates...
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opacity
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Incr VA on the BAT indicates...
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pinhole effect
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T/F - Elderly are more visually impaired than hearing impaired.
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False - more hearing impaired
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(Lower/Higher) pitched sounds are worse for the elderly?
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higher
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T/F - Use of the stethoscope for hearing impaired elderly is not recommended.
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True
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T/F - Address the caregiver first, then the patient.
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False - patient first, then caregiver
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While doing BVAs, you find that even pinhole won't improve your elderly patient's 20/80 VAs OD, OS. What should you do next?
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Slit lamp
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What is the JND? What is the "rule of thumb" in relation to this?
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Just Noticeable Difference. Take denominator of BVA and divide by two to see how many diopters to change, i.e. 20/100, go in 0.50D steps.
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According to the lecture, what are the three more common cataracts in the elderly?
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Cortical spoking
Nuclear sclerosis Posterior subcapsular |
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Which is age-related, pigment dispersion or pseudoexfoliation?
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Pseudoexfoliation
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Where does cortical spoking usually begin?
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Inferior-nasal quadrant
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Cortical spoking is due to...
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UV light
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T/F - Cortical spoking is possible in both the anterior and posterior cortex.
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True
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Cortical spoking is a (fast/slow) progressing type cataract - f/u usually in ___ months.
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slow, 6-12
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Cortical spoking affects VAs until about __% opacity.
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93
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Grade 1 cortical spoking is characterized by __ to __% opacification.
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0-25
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Grade 2 cortical spoking is characterized by __ to __% opacification.
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25-50
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Grade 3 cortical spoking is characterized by __ to __% opacification.
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50-75
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Grade 4 cortical spoking is characterized by __ to __% opacification.
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75-100
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T/F - Cortical spoking can be graded by both the area opacified and the degree/density of the opacification.
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True
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T/F - NSCs are always symmetric.
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False - can be asymmetric
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T/F - NSCs can be white in color.
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True - rapidly progressing or traumatic NSCs
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Trace NSC characterized by 20/__ VAs and what color?
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~20/20, slight yellowing
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1+ NSC characterized by what VAs and what color?
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20/25-20/30, yellow
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2+ NSC characterized by what VAs and what color?
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20/30-20/40, yellow-orange
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3+ NSC characterized by what VAs and what color?
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20/50-20/60, orange
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4+ NSC characterized by what VAs and what color?
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>20/80, brown
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PSCs are usually what color?
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Whitish, but if present w/NSC will appear brown
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PSCs are due to...
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migration and thickening of lens epithelial cells in the posterior subcapsular area
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T/F - PSCs are associated with vacuoles.
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True
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T/F - PSCs are age-related only.
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False - can be secondary to trauma, chronic uveitis, systemic steroid use.
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T/F - PSCs can be caused by acute uveitis.
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False - chronic uveitis
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T/F - It is possible to have good acuity while reading and in bright light, but have poor VA chart acuity with PSCs.
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True
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A __% dense PSC can cause a decrease in VA.
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3
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