CS 2 - Lecture 15 Questions
33- How much + would you prescribe if there is 3.00D Latent hyperopia?
0.75 to dry refraction Because of rule of thumb
34- If you patient's Dry RX = +1.50 and the Wet RX = +3.50, what should you prescribe?
1) +2.00 a) 3.50-1.50= 2.00 b) +1.25 —-- +2.00 —---- +0.50 D added to dry c) +0.50 + 1.50 = +2.00
25- The patient has adequate cycloplegia when there is _______ of residual accommodation.
2D or less
24- What % of glaucoma patients have a significant increase in IOP following dilation?
3.6% —experienced greater than 5 mmHg 23% w primary open angle glaucoma 2% without glaucoma
Manifest hyperopia = ____ + ________
Absolute + Facultative
32- Whether to prescribe depends on what 3 things?
Age Amount of hyperopia Pt complaints
15- What are the top three strongest cycloplegic drops?
Atropine Scopolamine cyclopentolase
11- What other effects does Phenylephrine have on the eye?
Conjunctival vasoconstriction/ blanching of any hyperemia Widen palpebral fissure (stimulates Mueller's muscle in upper eyelid)
4- How long does Proparacaine anesthetize the eye?
Duration 10-15 minutes
20- Name 2 anticholinergic systemic reaction?
Fever Unable to sweat Facial flushing Tachycardia Dry mucous membranes CNS toxicity Delirium
31- What refractive error does the majority of the population have?
Hyperopic
7- Phenylephrine affects which iris muscle?
Iris dilator Increases pupil size by contraction of iris dilator
8- Tropicamide affects which iris muscle?
Iris sphincter It inhibits action of iris sphincter
23- 96.4% of normal patient have an elevation in IOP in routine dilation of how much?
Less than 5 mmHg
Total Hyperopia = ___ + _____
Manifest + Latent
6- What is the difference between Mydriasis and Cycloplegia?
Mydriasis= dilated pupils (dilator contraction or sphincter relaxation) Cycloplegia= blurred vision at near due to paralysis of ciliary muscle (loss of accommodation)
13- After which medication use do older patients have a release of pigment granules?
Mydriatic- Phenylephrine
14- Name 3 contraindications to Phenylephrine
Narrow angles Hypersensitivity Iris fixated IOL Pts taking MAO inhibitors Tricyclic anti depressants REserpine Guanidine Methyldopa
19- Name 3 contraindications to cycloplegic
Narrow angles Known allergy to drug Iris fixed IOP Down syndrome (esp w atropine)
9- Which routine dilating drop is a sympathomimetic med?
Phenylephrine
2- How can you avoid systemic absorption of drops?
Pressure over inner canthus
3- What happens when the Vagus nerve is overstimulated?
Pt can faint Body's peripheral blood vessels dilate which lowers BP and heart slows down Decreases ability of the heart to pump blood upward to the brain so no O2 sent to the brain
5- What are some adverse effects of anesthetics?
Punctate keratitis Corneal edema Conjunctival hyperemia Stinging/ lacrimation Delayed corneal healing Tear film instability Decreased reflex tearing Reduced blink rate Epithelial / endothelial toxicity
21- Acute Angle closure is usually secondary to
Pupillary block
1-What is the cap color on the bottle of a mydriatic agent?
RED
12- Name 3 indications for dilation with mydriatics
Recent onset of floaters or flashing lights Sudden decrease in VA Unexplained loss of VF Ocular pain or redness of unknown etiology (idk why theres 4)
18- With ant. seg. inflammation, cycloplegia stabilizes what?
Restores the blood aqueous barrier
17- Name 3 indications for the use of cycloplegics
Suspected latent hyperopia Suspected pseudo myopia (accom spasm) Young children (cyclopentolate) Inconsistent subjective responses Pts that do not correct to 20/20 with no pathology High heterophoria Accommodative asthenopic symptoms Pts who have visual signs that do not correlate w RE Unreliable pts/ hysterical pts Anterior segment inflammation treatment
22- Treatment for an acute angle closure is
Suspected medication must be discontinued Individuals IOP should be lowered with ocular hypotensive medications
26- Name 3 Cycloplegic side effects
Transient stinging Angle closure attack Transient IOP elevation Allergic reactions Visual hallucination Increased BP/ tachcardia Flushing, fever, drowsiness, dry mouth
10- Which routine dilating drop is a parasympatholytic med?
Tropicamide
16 - What is the weakest cycloplegic drop?
Tropicamide
27- What method will we use to determine residual accommodation in the lab?
Yasuna's method Distance correction ini phoropter Add +3.00 D OU Occlude one eye so pt is MONOCULAR Target= 0.5 M at 33 cm
30- On manifest refraction, you determine a prescription of +4.00D. If the patient's total hyperopia is +6.50D, what is the amount of facultative hyperopia?
to be announced