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67 Cards in this Set
- Front
- Back
The examination of the interior of the eye uses an:
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Ophthalmoscope
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Consists of a light source, mirror or prism, and auxiliary lenses:
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Ophthalmscope
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Direct Ophthalmoscope
(-Magnification? -Image? -Field of View?) |
15x
Upright 6.5 degrees |
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Monocular Indirect Ophthalmoscope
(-Magnification? - Image? - Field of View?) |
5x
18-25 degrees Corrected image by inverting lens system |
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Binocular Indirect Ophthalmscope
(Magnification? - Image? - Field of View?) |
1.9x (uses +20 D lens)
25 degrees Inverted/Perverted |
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Small aperture (used for...)
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small/undilated pupils
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Large aperture (used for...)
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dilated pupils
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Fixation aperture (cross hairs) (used for observation of...)
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Macula and estimate of size
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Slit aperture (used for...)
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detecting height or depth of findings by bending or deflection the streak
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Cobalt filter (used for...)
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evaluating cornea (uses +20 D lens and fluorescein)
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Red-Free filter (used for...)
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Observing vessels and hemorrhages and estimation of their depth
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Polarized Filter (used for...)
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Reducing glare
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Yellow Filter (used for...)
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Reducing hazardous UV during prolonged retinal examination
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On Ophthalmoscope, plus is indicated by:
Minus is indicated by: |
green or black numbers
Red numbers |
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Wheel is arranged to rotate from plus to minus in what direction?
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Counterclockwise direction
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Any opacity between you and the retina will be seen __ ____ (behind lighting) and will appear silhouetted or _____
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In Retro
Black |
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Most common opacities:
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Corneal Scars
Lenticular (cataracts) Vitreous floaters |
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What is Parallax?
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Depth of opacities in the ocular media can be estimated by rotating your view around a reference point.
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What thing in the eye is used as a nodal point?
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Pupil
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Opacities that move "with" your movement are In Front or Behind the nodal point?
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Behind
(Posterior lens/vitreous) |
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Opacities that move "against" your movements are In Front or Behind the nodal point?
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In Front
(Cornea, AC) |
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How far should you be from pt during Ophthalmoscopy?
And at what angle off visual axis? |
1.5 - 3 cm
15-20 degrees |
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ONH Evaluation, 6 things to look for:
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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 |
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ONH H to V ratio:
(has slightly oval form) |
70 - 90%
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CD ratios with a larger V or H ratio are more suspect for Dz.
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Vertical
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Average CD's for Caucasions:
And for African Americans: |
.3 +/- .2
.5 +/- .15 |
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Donut Rule-If the hole in the middle (cup) equals the donut sides (the rim) the CD is:
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~.35 (1/3)
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Depth of Cup - the distance the focus changes in the eye as you focus back is:
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~ 1/3 mm per Diopter
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Very deep cups will show a grey dot pattern at the base. This is the:
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Lamina Cribosa
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ONH-colors of rim tissue:
(what do these different colors mean?) |
Salmon (normal)
White (Optic atrophy) |
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An observed pulsation of the venous arcades as they pass over the rim of the cup or at the central bifurcation is called:
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Venous Pulsation
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If margins on ONH are elevated, this is called:
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Papilledema
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Eye Pathology made easy: These colored things (white, red, black) mean:
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White: Atrophy, infarcs
Red: Blood Black: Pigment (congenital, Inflammation/Scarring) |
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Temporal Scleral Crescent
(where would you see this? what color is this?) |
Margins, white stuff
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Myelinated nerve fibers
(where would you find these? what color is this) |
Superior, Inferior or "nasal"
White stuff |
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Temporal Pigment Crescent
(where do you see this? what color?) |
At edge of disc
Black |
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About how many feeder vessel are there on a healthy nerve?
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~12
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Myopic Crescents
(seen where? What color) |
Temporal
White (kind of shiny/sparkly) |
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Cup Type I
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-Flat
-Small Cup -Central Bifurcation -Small, flat feeder vessels without deflection -CD: 0 - .15 -Depth <1 D |
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Cup Type II
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Cylinder
-Temporal Rim -Central Bifurcation -Feeder Vessels bend/follow rim -CD: .2 -.8 -Depth: 4 D |
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Cup Type III
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Slope
-NO temporal rim -Central Bifurcation -Feeder vessels DO NOT bend/jog -CD: .1 - .7 -Depth: 1-3 D |
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Cup Type IV
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Hook
-NO temporal rim -NO central Bifurcation -Vessel climb over rim -CD: .15 - .6 -Depth: 1-2 D |
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Cup Type V
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Pot
-Thin temporal rim -Central Bifurcation? -Vessels climb over rim -Rim rolled 360 -Lamina Dots seen -CD: >.8 -Depth: 3-5 D |
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Estimate the CD by:
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Color AND feeder vessels
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Fundus Colors
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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) |
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Method for giving size and distance:
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Disk Diameters (DD)
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A/V ratio for healthy? Abnormal? (indicates what?)
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2/3 or 45
1/2 indicates HTN |
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What is the only place in the body that the vascular bed can be directly seen?
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Retina
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Ratio of the reflective light off the vessel to the blood column is called:
Normal is: Abnormal is: (this indicates what?) |
Arterial Light Reflex (ALR)
1/4 1/2 (HTN & Arteriosclerosis) |
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When vein changes direction as it crosses artery at 90 degrees is called:
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Banking
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An apparent tapering of a vein as it crosses under an arteriole: (is a sign of...)
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Nicking
HTN and Arteriosclerosis |
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What should you ask yourself if you see tortuous vessels?
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Is this normal? Or is it HTN? (look for other signs such as tapering, nicking etc)
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White stuff WITHIN a vessel
(plaque that's been thrown off of heart or carotid) |
Emboli
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White stuff AROUND a vessel
(soft or hard, "cotton wool") |
Exudates
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White stuff AWAY from vessels (small deposits of retinal waste)
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Drusen
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White stuff:
-Infarcations -"cotton wool" fuzzy -single |
Soft Exudates
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White stuff:
-Stasis secondary infiltrates -small, discrete, distinct -numerous |
Hard exudates
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4 basic types of hemorrhages (red stuff)
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1. Pre-retinal
2. Dot & Blot 3. Flame 4. Sub Retinal |
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Under Red-Free filter, retina appears:
Blood appears: |
Green
Black |
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RPE blocks out _____ light
So if this color is used, what happens? |
Green
Any finding BELOW the RPE will disappear |
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D-shape hemorrhage found:
Size? Indication of: |
Pre-retinal
Large Blood dyscrasias & DM |
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Flame hemorrhage found:
Indication of: |
Nerve Fiber Layer
HTN |
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Dot and Blot hemorrhage found:
Size? Indication of: |
Inter Retinal
Small DM |
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Sub Retinal hemorrhage found:
Size? Indication of: |
Choroid
Large Chorioretinitis, ARMD |
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Macula
a) Pigmentation: b) FLR: c) White Stuff: d) Red stuff e) Black stuff |
a) Darker, even pigmentation
b) Foveal Light Reflex c) Atrophy, Dry degeneration, Drusen d) Blood e) Pigmented lesions |
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Where is the Macula found in relation to the Disc?
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2 DD Temporally
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If you find black stuff around Macula:
a) nerve untouched b) Papillary choroiditis |
a) Toxoplasmosis
b) Histoplasmosis |