Eye Review Chapter 14 Flashcards

Questions and Answers

When inspecting the sclera of a dark-skinned patient, what is an expected finding?

Small, brown macules on the sclera

What does anisocoria indicate?

Normal presence of pupils with two different sizes

What color do you expect Mr. Sternberg's optic discs to be on examination?

Creamy yellow-orange to pink

How do you interpret findings of blinking and pupillary constriction in a newborn?

The lower portion of the visual apparatus is intact Signup and view all the answers

What are you checking when you ask a patient to focus on a distant object and then on your finger held 7 to 8 cm from their nose?

Accommodation Signup and view all the answers

What direction should a patient be told to look during an ophthalmoscope examination?

Keep looking at one spot on the wall across from you Signup and view all the answers

What is meant by accommodation in the notation 'PERRLA'?

Adaptation of the eye for near vision Signup and view all the answers

Which phrases describe the optic disc? (Select all that apply)

Ranges from creamy yellow to pink Signup and view all the answers

How should you document a patient's pupil size before and after the light reflex if before it is 4 mm and after it is 2 mm?

Right 4/2 = 4/2 Left Signup and view all the answers

Why should the room be darkened before an ophthalmic examination?

To promote pupil dilation Signup and view all the answers

What should you tell Mr. and Mrs. Green about their newborn's vision?

At birth, eye function is limited; peripheral vision is present but most neonates are farsighted. Signup and view all the answers

What term might you use to document an abnormal growth of conjunctiva over the cornea?

Pterygium Signup and view all the answers

What is arcus senilis?

A gray-white arc or circle around the limbus due to lipid deposition Signup and view all the answers

What are xanthelasma?

Soft, raised yellow plaques occurring on the lids Signup and view all the answers

What are pingueculae?

Yellowish elevated nodules common to the sclera Signup and view all the answers

What finding is expected in an individual with very dark irises?

A darker retina Signup and view all the answers

What condition is caused by a generalized decrease in the diameter of the arteries?

Retinitis pigmentosa Signup and view all the answers

What does photophobia mean?

Inability to tolerate light. Signup and view all the answers

What does the confrontation test assess?

Peripheral vision Signup and view all the answers

Who should be tested for color blindness?

A 5-year-old white male Signup and view all the answers

What does the Hirschberg test assess?

The parallel alignment of the eye Signup and view all the answers

What meaning do you attach to a gray-white circle around the limbus in an elderly patient?

Normal age changes are occurring Signup and view all the answers

What does the disappearance of the red reflex while using the ophthalmoscope indicate?

You need to find the pupil again Signup and view all the answers

What condition might you find alongside epicanthal folds in a child of Irish descent?

Pseudostrabismus Signup and view all the answers

What is the likely cause of a slight blue tinge to a newborn's sclera?

Thinness of the sclera at birth Signup and view all the answers

What is papilledema?

A condition with increased intracranial pressure affecting the optic disc Signup and view all the answers

What are congenital cataracts associated with?

An absent red reflex Signup and view all the answers

What does bilateral miosis occur with?

Use of pilocarpine drops for glaucoma treatment, narcotics, iritis, and brain damage Signup and view all the answers

What does a unilateral dilated pupil with no reaction to light or accommodation suggest?

Cranial nerve III damage Signup and view all the answers

The six pairs of extraocular muscles maintain parallel or ___________ movement.

conjugate Signup and view all the answers

The elliptical opening between the eyelids is known as the ________ fissure.

Palpebral Signup and view all the answers

Which part of the ocular fundus should be examined last?

Macula Signup and view all the answers

What are normal findings when examining retinal blood vessels?

Artery - to vein width ratio = 2:3 Venous pulsation near the disk = Normal Paired artery and vein = Going to each quadrant Signup and view all the answers

What is a normal finding on an Allen test?

A child can name three of seven cards in three to five trials at a distance of 15 feet. Signup and view all the answers

What pattern of vision loss is associated with homonymous hemianopsia?

Loss of the same half of the visual field in both eyes Signup and view all the answers

What is a physiologic function of the retina?

Transform light waves into nerve impulses Signup and view all the answers

What occurs at the optic chiasm?

Fibers from the nasal portion of the retina cross over to form the optic tracts. Signup and view all the answers

In the Snellen chart, what does the numerator of 20 represent?

Distance in feet between the patient and the chart. Signup and view all the answers

What are you assessing when you perform the confrontation test?

Peripheral vision Signup and view all the answers

What is the diagnostic positions test an indicator of?

Extraocular muscle function Signup and view all the answers

What is an expected finding when performing the cover test on a 5-year-old?

The covered eye maintains its position when uncovered. Signup and view all the answers

Study Notes

Eye Examination Overview

Expected finding for African-American patients: Small brown macules on the sclera are common and should not be mistaken for foreign bodies; may also observe a gray-blue or muddy sclera.
Anisocoria is a normal condition where pupils are of different sizes.
Optic discs should appear creamy yellow-orange to pink during routine exams.

Eye Reflexes and Functions

In newborns, blinking and pupillary constriction in response to bright light indicate intact lower visual pathways, but do not confirm visual capability.
Accommodation is tested by asking patients to focus on distant objects and shift gaze to near objects, leading to pupil constriction.
For an ophthalmoscopic exam, patients should keep their gaze fixed on a distant point to aid pupil dilation.

Pupil Reactions

PERRLA: Pupils are equal, round, and reactive to light and accommodation, indicating proper eye function.
Documenting pupil size should indicate the size before and after testing, e.g. Right 4/2 = 4/2 Left.

Arcus senilis: A gray-white arc due to lipid deposition, generally harmless to vision.
Normal changes with age include increased visibility of a gray-white circle around the limbus in older adults.
The macula develops steadily after birth, with binocularity established by 3 to 4 months.

Abnormal Conditions

Pterygium involves abnormal conjunctival growth over the cornea, potentially obstructing vision.
Pingueculae are yellowish nodules caused by environmental exposure and are differentiated from pterygium.
Papilledema indicates increased intracranial pressure, characterized by disc elevation and redness.

Vision Testing and Conditions

Color blindness testing is essential for young white males, particularly ages 4 to 8.
Conditions like Horner's syndrome are indicated by unilateral small pupils that react normally to light.
Homonymous hemianopsia results in loss of the same half of the visual field in both eyes.

Specialized Eye Tests

Hirschberg test assesses eye alignment through light reflection on corneas.
Confrontation tests measure peripheral vision effectively.
The cover test should demonstrate that a covered eye retains its position upon uncovering.

Retinal Examination Insights

Retinal blood vessels should show a normal artery-to-vein width ratio of 2:3 with potential venous pulsation.
The optic chiasm is where fibers from the nasal retina cross, forming optic tracts.

Snellen Chart and Visual Assessment

The numerator of 20 in the Snellen chart measures distance from the chart, indicating the visual acuity assessment.
Peripheral vision is assessed through confrontation tests, and the diagnostic positions test evaluates extraocular muscle function.

Important Definitions

Photophobia: Intolerance to light.
Bilateral mydriasis results from sympathetic activation or drug use.
Congenital cataracts present with an absent red reflex, indicating serious vision issues.

Newborn Considerations

Newborns may exhibit a slight blue tinge to the sclera due to scleral thinness at birth.
Eye movements are often uncoordinated in neonates, but vision develops significantly within the first year.

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Description

Test your knowledge with these flashcards focused on Chapter 14 of the eye review. Explore important observations and expected findings during eye examinations, particularly for diverse populations. Perfect for medical students and professionals aiming to enhance their understanding of eye health.