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