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58 Cards in this Set

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What is the process that measures the anterior projection of the corneal relative to the lateral orbital rim?
Exophthalmometry
What are a ton of causes of exophthalmos?
1- graves disease (unilateral)
2- orbital tumor
3- idiopathic intracranial HTN
4- brain abscess
5- cavernous sinus thrombosis
What are 3 causes of enophthalmos?
1- blown out fracture
2- age-related orbital fat
3- congenital (bilateral)
What might you see with exopthalmus? What is this a sign of?
pulsatile proptosis
a sign of arteriovenus aneurysm of the orbit
What 2 things might trick you into thinking EXO?
lid retraction and ptosis
What are 2 pieces of equip. that can measure EXO/ENDO?
1- Hertel (gold standard)
2- Leudde (what we bought)
What measurment must you keep the same everytime you use the HERTEL?
The Base measurement
How many times should ou perform the Leudde?
3 times, record the average
To what standard are the eye measurements for exopthalmometry compared?
each eye to each other, and against the norms
What are the avgerages for EXO?
Caucasians: 12-20
AA: 12-24
Kids: a little smaller
What is the inner eye comparison?
2-3mm b/t the eyes
A change in more than ___ is signifcant. (in exopthalmometry)
2mm
What are 4 tests that test the Potential VA?
1- standard pinhole (Best correct < 20/40)
2- Super pinhole
3- PAM (potential acuity meter)
4- Laser Interferometer
T or F: The potential VA tests reveal the visual capabilities of the retina.
True
If VA get better with standard pinhole, you can conclude that loss of VA is _______ in nature.
Refractive
What can super pinhole be used to detect?
the post-op VA following cataract surgery
If a patient has a poor response with standard PH and a better response with super PH--what can you deduce?
maybe the patient has mild/moderate maculopathy
How does the Super PH act optically?
It contracts the image cone and enhances the depth of focus
What is special about the eye chart in super PH?
It is transilluminated 1000 times brighter than the snellen chart
How big is the pin hole in super PH?
1.5mm
Is the patient fully dilated during super PH?
YES (bummer)
Does the patient wear correction during PH?
NO!!!!!!!
What is a VERY specific feature of the super PH test?
You must hold the chart 5 feet from the patient.
How do you record for super PH?
SPH: 5/10 OD, 5/20 OS
What special test uses an intense light to project a tiny snellen eye chart directly into the eye?
PAM
What are 2 "catches" when doing the PAM test?
1-You must compensate for refractive error or the patient!
2- you must shine the chart through a window in the opacity
Is the patient dilated during PAM?
Yes!!
T or F: the instrument for PAM is attached to the slit lamp.
True
Post-op acuity is usually ____ or ____ than PAM acuity.
good or better
What are some problems that might give you a low potential VA, when you really should have a higher VA?
1- poor dilation
2- dense cataract
3- poor fixation
4- illiteracy
5- poor comprehension
What is the potential acuity test that uses 2 coherent beams to create a 3-d image on the retina?
Laser Interferometry (LI)
Is LI independent of the eye optics?
yes
What does LI actually test?
the macular and cortical function of the visual system.
Is the patient fully dilated for LI?
yes (just as in SPH and PAM)
What is the end result of LI?
The finest grating that the patient can observe 50% of the time.
What can you perform to test Glare?
BAT Brightness Acuity Test
Define Glare/
A visual perception created when external light becomes scattered within the eye---produces haze over retina
Does glare make vision even worse if you already have a cataract too?
yep
What is the exact definition of the BAT?
an objective measurement of disability secondary to opacity
What test would you do if the patient have 20/20 vision but complains of terrible vision at night?
BAT
What are some patients affected by glare?
1- cataract (PSC)
2-post cortical spoking
3- aphakic and pseudophakic
4- PCO (post capsular opacification)--Elschnigs pearls
What are Elschnigs pearls?
capsular fibrosis
Is the patient fully dilated for BAT?
NO NO NO!!!!
When you do begin testing best VA during the BAT?
after the patient has dark adapted for 20/30 seconds
Do you wear correction during BAT?
yes......you gotta see that eye chart 20 feet away
What are 3 tests for macular Integrity?
1- Amsler Grid
2- MAcular photostress recovery
3- Watzke-Allen
What are 2 clinical findings that might suggest early Macular disease?
1- mildly decreased VA
2- opthalmic findings
What is the purpose of the Amsler grid?
to detect and monitor defects in the central visual field
Who are 5 patients that might need the amsler grid?
1- unexplained decrease in vision
2- macular disruption
3- any visual disturbances
4- diabetic patient
5- taking Plaquenil or Chloroquine
On the Amsler grid each square is _____ when held at _____.
1 degree at 30 cm
What is the field size for the amsler grid?
10 degrees on either side of fixation (20 degress total)
Is the patient fully dilated for the amsler grid? Do they wear correction?
no, yes--wear NEAR correction
If the patient reports wavy lines--what is this called?
metamorphopsia
If a part of the grid is missing--this is a _____.
scotoma
If part of the grid is simply blurry or hazy--this is a _________.
relative scotoma
What are some common reasons to see wavy lines on the amsler grid?
1- coalesced drusen
2- ERM
3- macular edema
4- CNVM
5- macular detachment
If that patient reports a monocular central scotoma with no opthalmic findings, look for ______?
mass lesion in anterior visual pathway (before chiasm)
Quandrantic hemianopic defects are located _____.
post- chiasm