Ophthalmology Clinical Testing

Front 1

what causes over-estimation of IOP during applanation?

Back 1

too much fluoro, thick K, astigm against the rule >3D

Front 2

what causes under-estimatonof IOP during applanation?

Back 2

too little fluoro, thin K, high myope (floppy sclera), astigm w/ the rule >3D, K edema

Front 3

goldmann visual field

Back 3

stimulus size: diameter doubles (area quadruples) for each higher roman numeral
Filters 1-4=5db each; Filters a-e=1db each

Front 4

what conditions increase pigment in the angle as seen on gonio?

Back 4

PDS, PXF, (lesser degree: iritis, DM, post op, trauma, post laser, melanoma, hyphema, old brown irides)

Front 5

what are the gonio findings of Fuchs iridocyclitis?

Back 5

abn vessels in angle w/out PAS

Front 6

which gonio lens allows for direct visualization of the angle?

Back 6

Koeppe

Front 7

for indirect gonioscopy, what is the angle of the mirrors?

Back 7

62-64 degrees

Front 8

Photostress recovery

Back 8

use on pts w/ VA 20/80 or better; shine light for 10 seconds;
Recovery <60 seconds=Normal
>90-180 seconds=Maculopathy

Front 9

tests to try for mild non-physiologic vision loss

Back 9

fogging refraction, stereo, red-green

Front 10

tests to try for severe non-physiologic vision loss

Back 10

rocking mirror, prism splitting, OKN, fogging refraction

Front 11

VER

Back 11

unrealiable to distinguish ON dx from retinal dx as can be abn in both; 2 crucial parameters= time btwn stimulus presentation & first positive wave (latency) & amplitude of wave; pattern=required for VA in preverbal kids & non-physiologic vision loss (flash not helpful); can have false reading by accommodating to “fog” vision

Front 12

Oculovestibular caloric reflex

Back 12

impairment=infranuclear, end-organ function deficit; intact reflex in pt w/ gaze palsy=supranuclear disturbance; COWS=describes fast phase, but nystagmus is named after slow phase. In comatose pt, tonic to slow phase side

Front 13

Bells phenomenon

Back 13

if up gaze palsy but normal bells phenomenon, infranuclear pathway must be intact, therefore, problem is in supranuclear region

Front 14

MRI
T1 (longitudinal relaxation time)

Back 14

vit dark, fat bright, good for anatomy

Front 15

MRI
T2

Back 15

vit bright, fat dark, good for pathology

Front 16

Maddox rod

Back 16

measures cyclodeviations, horizontal & vertical deviations; image seen is virtual image perpendicular to striations just behind the rod (real image is parallel to rod but requires too much accommodation to see)

Front 17

Double Maddox Rod

Back 17

measure torsion

Front 18

Parks 3 step test

Back 18

1) palsy of which causes hyper;
2) worse gaze 3) worse tilt (RLR=RSO)

SR IO IO SR
IR SO SO IR

Front 19

Krimsky

Back 19

prisms over fixating eye to center deviated light reflex on non-fixating eye

Front 20

Hershberg

Back 20

1mm=15PD=7degrees

Front 21

Bruckner

Back 21

bilateral red reflex test: brighter reflex in deviated eye

Front 22

Bagolini

Back 22

Must first assess fixation behavior; tests for suppression & retinal correspondence
NRC & HARC=sees an X.
Monocular fixation=one solid line + other line of X is missing middle
Exotropia=A
Esotropia=V

Front 23

Lancaster red-green

Back 23

Green lens sees green light & lens sees red light; examiner holds green light & forces left eye focus on examiners light. Esotropia—lights cross (red light on left) as seen by examiner---superimposed as seen by pt; assuming NRC & no suppression (therefore, cannot be used on congenital cases)

Front 24

AC/A

Back 24

Accommodative convergence/accommodation ratio: near >10PD than distance=high

Front 25

calculating AC/A:
gradient method:

Back 25

add lens (ie +1.00) difference in accommodation before & after lens / lens power

Front 26

calculating AC/A:
heterophoria method:

Back 26

difference between near & distance / recipical of reading distance (ie 20cm=5) + pupil distance (cm)

Front 27

calculating AC/A:
heterophona method:

Back 27

difference between near & distance / recipical of reading distance (ie 20cm=5)

Front 28

Cover uncover

Back 28

measures tropias

Front 29

cross cover

Back 29

measures tropias + phoria

Front 30

Versions

Back 30

Conjugate movement (up/down/left/right)

Front 31

Vergance

Back 31

Disconjugate gaze (converge/diverge)

Front 32

Neutral density filters

Back 32

measures APD

Front 33

Uhthoff’s phenomenon

Back 33

optic neuritis; decrease in VA w/ increased temperature

Front 34

Lhermitte’s sign

Back 34

MS; electric shock sensation w/ neck flexion

Front 35

Prosopagnosia

Back 35

cant distinguish faces; bilateral medial occiptotemporal lesion

Front 36

Riddoch phenomenon

Back 36

cortical blindness; ability to perceive objects only when in motion

Front 37

Contrast sensitivity charts

Back 37

Pelli-Robson, Regan chart, Vectorvision

Front 38

Purkinje vascular phenomenon & blue-field entopic test

Back 38

subjective tests to visualize vasculature of the eye w/ light is projected through the lids/sclera

Front 39

Cocaine (for diagnostic testing)

Back 39

inhibits NE reuptakedilation (no dilation in any horners)

Front 40

Hydroxyamphetamine

Back 40

horners; increase NE release-->dilation (1st/2nd=+ dilation; 3rd= -dilation)

Front 41

Dilute pilo

Back 41

Adies vs pharm dilated; constricts pupil if parasympathetic denervation supersensitivity is present (Adies); no effect if pharm dilated

Front 42

OKN:
slow phase

Back 42

same directions as stimulus

Front 43

OKN findings for cong motor nystagmus

Back 43

reversal of OKN

Front 44

OKN:
abnormal slow pursuit

Back 44

parieto-occipital lobe

Front 45

OKN:
abnormal saccadic refixation

Back 45

frontal lobe

Front 46

Dye disappearance test

Back 46

dye placed in fornix & check for clearance after 5 minutes (+=significant retention) (normal=clearing of dye=negative test)

Front 47

Jones 1 (primary dye test)

Back 47

checks if tears pass into nose via natural pumping; (+=dye in nose) (normal= + test); 20-30% of normal pts w/ have negative test (high false -)

Front 48

Jones2

Back 48

irrigation of NLD to check for patency (+=dye in nose) (normal= +)

Front 49

Jones3

Back 49

post DCR checking ostomy patency (+=dye in nose)