PCO 3 Exam 1
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Questions and Answers

What is the best technique for anterior and external evaluation?

  • Penlight and binocular loupe
  • Slit lamp examination
  • Penlight with practitioner's naked eye
  • Biomicroscopy (correct)

    • Which examination allows for anterior and posterior ocular structure evaluation?

  • Slit lamp examination (correct)
  • Goldmann tono evaluation
  • Gonio examination
  • Contact lens examination

    • What are the advantages of a biomicroscope?

  • Monoscopic view, fixed magnification, no camera adapters
  • No handheld models available, limited filters
  • Stereoscopic view, varying mags, camera/teaching tube adapters (correct)
  • Limited illumination options, fixed eyepieces

    • What does the biomicroscope design include?

    <p>Observation system, mechanical system, patient adjustment</p> Signup and view all the answers

    What technique is used for lens evaluation to observe the entire lens?

    <p>Optic section</p> Signup and view all the answers

    How is A/C depth estimated using the Van Herick Angle Estimation Technique?

    <p>By reducing the angular separation of the illumination source</p> Signup and view all the answers

    What is the importance of A/C depth evaluation in every patient, especially before dilation?

    <p>To prevent angle closure, which is an emergency situation</p> Signup and view all the answers

    What are the techniques for vitreous evaluation?

    <p>Observing movement and oscillatory movement</p> Signup and view all the answers

    What are the methods for finding endothelial cells and epithelial cells on the lens?

    <p>Movement observation and oscillatory movement</p> Signup and view all the answers

    What techniques are used for indirect illumination?

    <p>Sclerotic scatter and retro-illumination</p> Signup and view all the answers

    What is the specific purpose of examining inflammation cases in the anterior chamber?

    <p>To assess cells and flare in the anterior chamber</p> Signup and view all the answers

    What is the specific purpose of the Van Herick Angle Estimation Technique?

    <p>To estimate A/C depth</p> Signup and view all the answers

    What is the specific purpose of the limbal technique and split limbal technique?

    <p>To grade the angle for angle closure</p> Signup and view all the answers

    What is the specific purpose of direct illumination?

    <p>To assess cells and flare in the anterior chamber</p> Signup and view all the answers

    What is the specific purpose of sclerotic scatter and retro-illumination in indirect illumination?

    <p>To evaluate the entire lens</p> Signup and view all the answers

    What is the specific purpose of movement observation and oscillatory movement?

    <p>To evaluate the entire lens</p> Signup and view all the answers

    What is the purpose of using Sodium Fluorescein (NaFl) Staining in eye examination?

    <p>Assess corneal TBUT, rigid CL fitting, and epithelial defects</p> Signup and view all the answers

    What is the purpose of using Xanthine dye Rose Bengal in eye examination?

    <p>Staining damaged epithelial cells</p> Signup and view all the answers

    What is the purpose of Biomicroscope Anterior Segment Evaluation Process?

    <p>Recommended sequence for evaluating various eye structures</p> Signup and view all the answers

    What is the purpose of using Van Herrick in eye examination?

    <p>Estimate Anterior Chamber Depth</p> Signup and view all the answers

    What is the purpose of using Tonometer in eye examination?

    <p>Measure intraocular pressure (IOP)</p> Signup and view all the answers

    What is the purpose of Digital Tono (Palpation) in eye examination?

    <p>Estimate IOP using fingers</p> Signup and view all the answers

    What eye structure is assessed for abnormalities such as inflammation, infections, or abnormal globe apposition?

    <p>Lids and Lashes</p> Signup and view all the answers

    Which part of the eye is evaluated for abnormalities such as papillae, follicles, or hyperemia?

    <p>Conjunctiva, Sclera, and Episclera</p> Signup and view all the answers

    What is assessed in cornea evaluation?

    <p>Corneal layers, edema, scarring, pigmentation, and neovascularization</p> Signup and view all the answers

    What is necessary to evaluate in the iris?

    <p>Neovascularization and transillumination</p> Signup and view all the answers

    What is involved in Crystalline Lens evaluation?

    <p>Assessing all layers, including the anterior capsule, nucleus, and posterior capsule</p> Signup and view all the answers

    What is the purpose of using Xanthine dye Rose Bengal in eye examination?

    <p>Staining damaged epithelial cells</p> Signup and view all the answers

    What type of prism does the system utilize for achieving parfocality?

    <p>Porro-Abbe Prism</p> Signup and view all the answers

    How is the illumination arm of the system controlled?

    <p>Slit size, shape, filters, and brightness</p> Signup and view all the answers

    What type of telescope system is used for higher and changeable magnification in the microscope system principle?

    <p>Galilean telescope system</p> Signup and view all the answers

    What is utilized for 3-5 magnification changes in the system?

    <p>Galilean changer</p> Signup and view all the answers

    What does the light source offer filters for in the system?

    <p>Different viewing purposes</p> Signup and view all the answers

    What allows independent swinging along 180 degrees in the system?

    <p>Coupled biomicroscope and illumination arms</p> Signup and view all the answers

    What provides enlarged stereoscopic images and variable magnifications in the observation system?

    <p>Biomicroscope</p> Signup and view all the answers

    What is the principle involved in the microscope system design?

    <p>Using oculars with a telescope system</p> Signup and view all the answers

    What is utilized for maneuvering of the illumination and microscope in the system?

    <p>Mechanical system</p> Signup and view all the answers

    What can be adjusted for specific examination needs in the system?

    <p>Slit width, height, and rotation</p> Signup and view all the answers

    What is utilized for achieving parfocality in the system?

    <p>Common focal plane and axis of rotation</p> Signup and view all the answers

    What allows for 3-5 magnification changes in the system?

    <p>Galilean changer</p> Signup and view all the answers

    What is the technique that involves using a plunger to indent the cornea to determine intraocular pressure (IOP)?

    <p>Plunger tonometry with a 5.5g weight</p> Signup and view all the answers

    What is the approximate area of the central cornea that the Goldmann Applanation Tonometry (GAT) measures IOP by applanating?

    <p>3.06mm</p> Signup and view all the answers

    What is the Imbert-Fick Law based on?

    <p>Cornea's shape and rigidity</p> Signup and view all the answers

    What is the average range for intraocular pressure (IOP) that the tonometer is set to during Goldmann Applanation Tonometry (GAT)?

    <p>10-21mmHg</p> Signup and view all the answers

    What weight is initially used for plunger tonometry, and what weight is used if the initial reading is less than 2?

    <p>Initial: 5.5g, If less than 2: 3.5g</p> Signup and view all the answers

    What is used to disinfect the tono tip and probe during Goldmann Applanation Tonometry (GAT)?

    <p>Hydrogen peroxide and Opticide solution</p> Signup and view all the answers

    What is the purpose of educating the patient and adjusting room illumination during Goldmann Applanation Tonometry (GAT)?

    <p>To prevent corneal burns or damage</p> Signup and view all the answers

    What is the patient instructed to do during Goldmann Applanation Tonometry (GAT) to prevent blinking?

    <p>Keep their head and chin on the rest</p> Signup and view all the answers

    What type of illumination is used during Goldmann Applanation Tonometry (GAT)?

    <p>High illumination with a cobalt blue filter</p> Signup and view all the answers

    What is used to align the tonometer probe carrier with the patient's astigmatism if it exceeds 3D during Goldmann Applanation Tonometry (GAT)?

    <p>Keratometer</p> Signup and view all the answers

    Study Notes

    Biomicroscopy and Tonometer Techniques for Eye Examination

    • Sodium Fluorescein (NaFl) Staining is used to assess corneal TBUT, rigid CL fitting, and epithelial defects in the cornea or conjunctiva.
    • NaFl Staining is nonspecific and will appear if there is anything affecting the integrity of the epithelium.
    • Xanthine dye Rose Bengal is used for staining damaged epithelial cells and is useful in keratoconjunctivitis sicca (KCS) or herpetic lesions.
    • Biomicroscope Anterior Segment Evaluation Process involves a recommended sequence for evaluating various eye structures.
    • Lids and Lashes are observed for abnormalities such as inflammation, infections, or abnormal globe apposition.
    • Conjunctiva, Sclera, and Episclera are evaluated for abnormalities such as papillae, follicles, or hyperemia.
    • Cornea evaluation involves assessing corneal layers, edema, scarring, pigmentation, and neovascularization.
    • Anterior Chamber Depth is estimated using Van Herrick to prevent angle closure attacks.
    • A complete evaluation of the iris is necessary, including neovascularization and transillumination.
    • Crystalline Lens evaluation involves assessing all layers, including the anterior capsule, nucleus, and posterior capsule.
    • Tonometer is used to measure intraocular pressure (IOP) and is useful for routine exams, glaucoma diagnosis, trauma, and uveitis.
    • Digital Tono (Palpation) is a quick and easy technique to estimate IOP using fingers, but it is not a proper measurement.

    Tonometry Techniques and Procedures

    • Plunger tonometry involves using a plunger to indent the cornea, with the amount of indentation determining intraocular pressure (IOP).
    • The procedure involves testing the tonometer, calibrating it, and ensuring the patient is in a supine position with head support to prevent increased IOP.
    • The Goldmann Applanation Tonometry (GAT) is considered the gold standard and measures IOP by the force required to applanate a certain area of the central cornea, which is approximately 3.06mm.
    • GAT is based on the Imbert-Fick Law, but further considerations were made due to the cornea's shape and rigidity, leading to modifications of the law.
    • The GAT procedure involves educating the patient, adjusting room illumination, anesthetizing the cornea, and disinfecting equipment to avoid corneal burns or damage.
    • Specific disinfecting procedures involve using hydrogen peroxide for the tono tip and Opticide solution for the probe, and aligning the tonometer probe carrier with the patient's astigmatism if it exceeds 3D.
    • During GAT, the patient should be instructed to keep their head and chin on the rest, and a fixation target is given to prevent blinking during tonometry.
    • The tonometer is set to 10mmHg as the average IOP is between 10-21, and the tono arm is positioned to align the applanation prism in front of the left ocular.
    • High illumination with a cobalt blue filter is used during GAT, and the probe is directed towards the patient's cornea.
    • Plunger tonometry requires a 5.5g weight, and if the initial reading is less than 2, a 5.5g increase to 7.5g is needed, which can indicate increased IOP.
    • After obtaining the new reading with the adjusted weight, a conversion table is used to determine the IOP, providing an accurate measurement.
    • Both plunger tonometry and GAT techniques are vital for accurately measuring intraocular pressure and require careful attention to detail and patient preparation.

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