Eye Diagnostic Tests Overview

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Questions and Answers

What does the Snellen chart primarily assess?

Refractive error in the eye

Intraocular pressure

Visual acuity (correct)

Pupil dilation

What is the purpose of dilating the pupils during a refractive exam?

To enhance color perception

To increase the sensitivity of the retina

To improve visual acuity measurements

To provide a better view of the internal structures (correct)

Which instrument is used to determine the need for glasses?

Tonometer

Slit lamp

Phoropter (correct)

Ophthalmoscope

What is myopia?

Light rays focus in front of the retina Signup and view all the answers

How does a slit lamp function?

It directs a beam of light to view anterior eye structures Signup and view all the answers

What condition is known as conjunctivitis?

Inflammation of the conjunctiva Signup and view all the answers

What is the role of a tonometer?

To measure intraocular pressure Signup and view all the answers

What type of vision correction uses two lenses in one?

Bifocals Signup and view all the answers

What describes astigmatism?

Light rays focus on two different points on the retina Signup and view all the answers

What do contact lenses do?

Fit directly on the cornea and float on tears Signup and view all the answers

What is the primary cause of a hordeolum, also known as a stye?

Clogged oil or sweat gland Signup and view all the answers

Which treatment is generally recommended for angle-closure glaucoma?

Eye drops to increase aqueous outflow Signup and view all the answers

What is a common sign of cataracts?

Seeing halos around lights Signup and view all the answers

What characterizes dry macular degeneration compared to wet macular degeneration?

No cure available Signup and view all the answers

What is the function of a mydriatic medication in eye treatment?

To dilate the pupil Signup and view all the answers

What symptoms are most commonly associated with glaucoma?

Visual field deficits and central vision loss Signup and view all the answers

What typically causes corneal abrasions?

Sharp objects like tree branches and fingernails Signup and view all the answers

In which layer of the eye does cataract formation primarily occur?

Lens Signup and view all the answers

What is the main difference in treatment protocols for external and internal foreign bodies in the eye?

Internal bodies typically require surgery, while external do not Signup and view all the answers

What is the condition characterized by a drooping eyelid called?

Ptosis Signup and view all the answers

What is the main reason for vision loss when the retina detaches?

It cannot supply blood to the layers above. Signup and view all the answers

Which of the following is a common cause of conductive hearing loss?

Obstruction in the auditory canal. Signup and view all the answers

What is the typical procedure for ear irrigation?

Straighten the ear canal before inserting the syringe. Signup and view all the answers

Which of the following is a major complication to prevent after eye surgery?

Report any facial paralysis or ptosis. Signup and view all the answers

What is the purpose of avoiding sudden movements post-eye surgery?

To avoid increased intraocular pressure. Signup and view all the answers

What is the main treatment for recurrent otitis media?

Tympanoplasty. Signup and view all the answers

Which of the following actions is appropriate for preventing hearing problems?

Using earplugs for all swimming activities. Signup and view all the answers

What usually causes impacted earwax?

Pushing the wax deeper with foreign objects. Signup and view all the answers

Which medication class is known for causing ototoxicity?

Aminoglycoside antibiotics. Signup and view all the answers

What is the primary symptom of Ménière's disease?

Hearing loss. Signup and view all the answers

Study Notes

EYES - Diagnostic Tests

Visual Acuity: Snellen chart used; person stands 20 ft away, reads lines until able to identify letters. 20/20 vision means someone can see at 20 ft what most people see at 20 ft.
Refractive Exam: Determines refractive error. Anticholinergics are used to dilate pupils, providing better view of internal structures. Phoropter measures the need for glasses; different lenses are shown, and the person identifies the clearest view.
Ophthalmoscopic Exam: Examiner looks through pupils to view the retina/internal structures using an ophthalmoscope.
Slit Lamp: Microscope directing light onto the cornea to view the conjunctiva, cornea, anterior chamber, iris, lens, and anterior vitreous.
Tonometer: Measures intraocular pressure (IOP). A small cone touches the numbed cornea to measure the force to flatten it.
Refractive Errors (Table 80-1):
Myopia: Light focuses in front of the retina; distant vision blurred.
Hyperopia: Light focuses behind the retina; close vision blurred.
Astigmatism: Light focuses at two different points on the retina; distorted vision.
Presbyopia: Light focuses behind the retina; decreased close vision.
Correction of Refractive Errors: Glasses or contacts.
Types of Glasses: Bifocals (two lenses), Trifocals (three lenses).
Contact Lenses: Fit directly on the cornea, float on tears.

EYES - Inflammatory/Infectious

Conjunctivitis ("Pink Eye"): Inflammation of the conjunctiva; caused by bacteria, viruses, or allergies. Symptoms: pain, redness, swelling, itching, sometimes discharge. Treatments: antibiotic/antiviral eyedrops/ointments. Key teaching point: prevent eye rubbing, and do not touch dropper to eye.
Hordeolum ("Stye"): Acute inflammation of eyelid oil/sweat gland. Caused by clogged gland. Symptoms: red, raised, swollen, painful, with pus. Treatment: warm compresses, topical antibiotic ointment. Severe cases need incision and drainage.

EYES - Structural Disorders

Ectropion vs. Entropion: Ectropion - eyelid turns out; Entropion - eyelid turns in. Common in older adults due to aging.
Ptosis: Drooping eyelid.
Glaucoma: Increased fluid pressure within the eye.
Open-Angle Glaucoma: Most common type; inadequate drainage of aqueous humor through trabecular meshwork. Symptoms may be unnoticeable until late stages (IOP fluctuation, visual field deficits, central field vision loss). Treatment: hypotensive agents (beta-blockers, miotics, carbonic anhydrase inhibitors).
Angle-Closure Glaucoma: Aqueous humor blocked by iris bulge. Risk factors: diabetes, cardiovascular disease, hypertension, steroid use. Treatment: eye drops or oral medication (e.g., acetazolamide).
Medications for Glaucoma:
Acetazolamide (Diamox): Decreases aqueous humor production.
Timolol maleate (Timoptic): Beta-blocker to lower IOP.
Travoprost (Travatan Z): Increases aqueous outflow.
Pilocarpine: Suppresses aqueous humor inflow.
Cataracts: Opacity/cloudiness of the lens. Early symptom: seeing halos around lights. Other symptoms: diplopia, halos. Causes: age-related chemical changes in lens proteins. traumatic (foreign objects). Treatment: surgery (extracapsular cataract extraction/ultrasonic fragmentation).
Macular Degeneration: Degeneration of the central retina.
Age-related Macular Degeneration (AMD): Most common form, typically in those older than 60.
Causes: Formation of drusen (yellow cellular deposits/debris). Other risk factors: smoking, aging, family history, hypertension, cholesterol, obesity, female gender. Symptoms: blurred vision, trouble seeing faces/colors, distorted vision, decreased visual acuity, presence of drusen.
Dry vs. Wet AMD: Dry progresses slowly, no cure. Wet involves fragile blood vessels behind the macula that leak.

EYES - Trauma

Contusion/Hematoma: Blunt eye injury causing swelling and bleeding around the orbit. Caused by blunt force trauma. Treatment: cold packs, then warm packs after 48 hours.
Foreign Bodies:
External: On corneal/conjunctival surface. Treatment: topical anesthetic.
Internal: Penetrate cornea/sclera, inside the eye. Treatment: surgery.
Hyphema: Hemorrhage into the anterior chamber of the eye. Cause: blunt trauma. Dangerous because it can lead to glaucoma/vision loss.
Mydriatic vs. Miotic Meds: Mydriatic dilates; miotic constricts.
Corneal Abrasions: Outer layer of cornea damaged. Caused by branches, fingernails, paper, contact lens injuries. Diagnostics: not explicitly stated. Treatment: antibiotic eye drops/ointment, pressure patching.
Detached Retina: Separation of the retina from choroid. Causes: trauma, myopia, degeneration, surgery, tumors, retinopathy, extreme hypertension. Vision loss occurs after blood supply is cut off from the layers above it. Symptoms: blurry, no vision. No pain (reason not explicitly stated.)

EYES - Eye Surgery

Pre-op Education: Steps of surgery, client's role, whether procedure is awake/asleep. Post-operative care review.
Post-op Education: Avoid sudden movements, pressing on the eye, bending.
Nursing Interventions: Client and family teaching emphasizing documentation and clarity for all clients especially older/confused clients.
Major Post-op Complication: Report of any facial paralysis/ptosis immediately.

EARS - Diagnostic Tests

Otoscopic Examination: Uses a lens and light to examine the external ear canal, tympanic membrane, and ear features.
Audiometry (Pure Tone): Hearing test involving headphones connected to a machine used to diagnose conductive and sensorioneural loss.

EARS - Ear Irrigation

Purpose: Rinse drainage, meds, remove wax/foreign bodies.
Steps: Warm solution to body temperature, drape client, straighten ear canal, expel syringe air, insert syringe into meatus, irrigate, lie client on side, dry canal and ear.

EARS - Hearing Loss

Conductive Hearing Loss: Disrupts sound waves to hearing organs. Most common cause: problems in auditory canal, eardrum, or ossicles.
Sensorineural Hearing Loss: Disturbance of inner ear organs/transmitting nerve.
Sensory - cochlear.
Neural - 8th cranial nerve.

EARS - Hearing Loss Prevention

Avoid excessive noise, keep volume down, wear protection. Protect ears, use ear plugs for swimming and in dusty environments. Do not place foreign objects in ears, dry ears after water exposure or swimming. Do not pick/pull ears or excessively clean them. Treat infections promptly. Get ear piercing from a professional.

EARS - External Ear

Impacted Earwax: Often caused by pushing wax further in with foreign objects. Can lead to injury or infection. Treatment: irrigation. Education: do not attempt removal with objects like Q-tips.
Foreign Bodies: Most common in children. Food becomes problematic due to moisture causing swelling and pain. Insects can sometimes be removed with a light or a small amount of ethanol.
External Otitis (Otitis Externa): Inflammation of the external ear often due to chronic external ear inflammation. Treatment: antibiotics. Prevention: use earplugs in water activities.
Punctured Tympanic Membrane: Could be caused by gunshot sounds or drastic pressure changes. Concern for the middle ear (eardrum).

EARS - Middle Ear

Otitis Media: Middle ear inflammation. Cause: Fluid buildup in the middle ear. Children susceptible due to shorter/smaller auditory tubes. Common symptoms: crackling, fullness, hearing loss. Tools: otoscope. Treatments: antibiotic use or myringotomy. Recurring OM: tympanoplasty. Medications: (pain/fever) antipyretics; (infection) antibacterials.

EARS - Inner Ear

Ototoxicity: Hearing and balance problems from medications. Medications include aminoglycoside antibiotics, macrolide antibiotics, loop diuretics, antimalarials.
Ménière Disease: Inner ear's semicircular canals disrupted. Function: balance. Causes: (not clear, theories about herpes simplex). Symptoms: vertigo, nausea/vomiting, tinnitus. Treatment: antivirals, anti-vertigo medications. Medication classes: antiviral (e.g., acyclovir); anti-vertigo (e.g., meniett). Client Education: avoid sudden movements/loud noises, bright lights.

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Description

This quiz explores various diagnostic tests used in ophthalmology, including visual acuity tests, refractive exams, and methods for assessing intraocular pressure. Participants will learn about the purpose and procedure of each test, as well as common refractive errors. Perfect for students in the field of eye care or anyone interested in understanding eye examinations.