Ophthalmology Q 1-3

Direct ophthalmoscopy in a mouse allows excellent screening/overview of the fundus.

False

Once a cornea is ruptured, the eye must be removed.

False

Proparacaine numbing drops are a valuable addition to the medical management of corneal ulceration as it addresses pain.

False

Symblepharon is defined as abnormal adhesion of conjunctiva to conjunctiva or conjunctiva to cornea, and it is most commonly caused by recrudescence of feline herpes viral infection conjunctivitis in adult cats.

False

The STT is irritating and best performed after application of topical anesthetic.

False

The STT provides a reliable assessment of the quality of the patient's tears.

False

The auriculopalpebral nerve blocks the ophthalmic branch of CN V thereby paralyzing the orbiculares oculi muscle, reducing the patient's ability to close the eyelids, thus facilitating examination.

False

The bulbar aspect of the TEL can usually be examined without application of topical anesthetic.

False

The prognosis for a dog with KCS with STT of 1 mm/min of wetting OU is equal to that of one with a STT of 5 mm/min of wetting OU.

False

Tonovet tonometry is irritating and best performed after application of topical anesthetic.

False

A patient presents with a functionally blinding complete cataract and fixed small pupil due to associated uveitis OD. The dazzle reflex is negative OD. The direct PLR OS is positive. The consensual PLR OS is negative. Is this patient likely to be a good candidate for cataract removal surgery (ie, is there indication of a potential for vision restoration OD)?

No

Correct spelling of Drs. Diehl and Myrna's discipline:

Ophthalmology

The forced ruction test helps differentiate between neuromuscular and mechanical/restrictive causes of abnormal ocular motility.

True

Which of the following treatments would be appropriate for a 2 YO cat with a chronic flare-up of feline herpes viral conjunctivitis? a) Cidofovir topical anti-viral therapy to the affected eye(s) twice daily b) L-lysine supplementation via treats that the cat eats eagerly c) Famciclovir oral anti-viral therapy d) NeoPolyBac ointment QID

a (Cidofovir topical anti-viral therapy to the affected eye(s) twice daily) b (L-lysine supplementation via treats that the cat eats eagerly) c (Famciclovir oral anti-viral therapy)

Which of the following are described ophthalmic uses for fluorescein dye? Select ALL CORRECT statements. a) Fluorescein can be used to assess the quality of the tear film by flooding the tears with fluorescein, blinking the eyelids and timing how long it takes for a dry spot to appear in the green tear film. This is called a tear film breakup time. b) It is a test for corneal ulceration. Proper use involves applying fluorescein in the cornea then rinsing it off. Corneal ulceration will fluoresce bright green under a cobalt blue light. c) It can be used to assess nasolacrimal latency. This is referred to as a Jones Test. d) It can be used to look for aqueous leakage in a corneal wound. This is called a Seidel Test. e) It can be used to highlight devitalized or dead corneal epithelial cells.

a (Fluorescein can be used to assess the quality of the tear film by flooding the tears with fluorescein, blinking the eyelids and timing how long it takes for a dry spot to appear in the green tear film. This is called a tear film breakup time.) b (It is a test for corneal ulceration. Proper use involves applying fluorescein in the cornea then rinsing it off. Corneal ulceration will fluoresce bright green under a cobalt blue light.) c (It can be used to assess nasolacrimal latency. This is referred to as a Jones Test.) d (It can be used to look for aqueous leakage in a corneal wound. This is called a Seidel Test.)

Select ALL TRUE statements regarding conjunctiva: a) Follicular enlargement on the conjunctiva is suggestive of immune-mediated inflammation b) culture and sensitivity of the discharge in a conjunctivitis case is always indicated as a diagnostic c) conjunctiva is sterile d) conjunctiva houses meibomian cells that are responsible for mucin production contributing to the tear film e) conjunctivitis in dogs is usually bacterial in nature

a (Follicular enlargement on the conjunctiva is suggestive of immune-mediated inflammation)

Concerning ophthalmic terminology please select ALL CORRECT answers: a) abbreviation O.U. (oculi uterque) means both eyes b) abbreviation O.S. (oculus sinister) means left eye c) abbreviation O.D. (oculus dexter) means left eye d) abbreviation O.D. (oculus dexter) means right eye

a (abbreviation O.U. means both eyes) b (abbreviation OS means left eye e (abbreviation OD means right eye)

Which of the following tests assess vision? Select ALL CORRECT answers. a) cotton-ball test b) menace response c) pupillary light reflex d) dazzle reflex e) maze test

a (cotton-ball test) b (menace response) e (maze test)

For which of the following disease states is a conjunctival flap a reasonable therapeutic intervention? Select ALL correct answers. a) descemetocele b) dog with absolute KCS c) superficial ulcer d) infected corneal ulcers of greater than 50% depth e) sterile melting ulcer 75% through thickness of the cornea

a (descemetocele) d (infected corneal ulcers of greater than 50% depth) e (sterile melting ulcer 75% through thickness of the cornea)

Which of the following equipment and supplies are essential for a complete ophthalmic exam in general practice? Select ALL that apply. a) finoff transilluminator b) slit lamp biomicroscope c) cytobrushes d) rose bengal stain e) indirect ophthalmoscopy headset f) ophthalmoscope g) fluorescein stain

a (finoff transilluminator) f (ophthalmoscope) g (fluorescein stain)

Which of the following is LEAST likely to cause Horner's Syndrome? a) hepatic neoplasia b) brachial plexus avulsion c) aggressive ear cleaning d) intracranial vascular accident

a (hepatic neoplasia)

Facial nerve paralysis is most likely to result in which of the following eyelid changes? a) inability to close the eyelids/blink b) entropion c) drooping of the upper eyelid d) ectropion

a (inability to close the eyelids/blink)

Which of the following are common complications/sequelae to ocular proptosis? Select ALL CORRECT answers. a) lateral strabismus b) medial strabismus c) KCS d) cataract formation

a (lateral strabismus) c (KCS)

A 10 YO Lab with historically and currently totally normal OD, but entropion secondary to a corneal ulcer OS. a) temporary eyelid tacking b) permanent surgical correction

a (temporary eyelid tacking)

A rapidly growing four month old Chow Chow puppy with entropion OU and a painful corneal ulcer OD. a) temporary eyelid tacking b) permanent surgical correction

a (temporary eyelid tacking)

Use of the slit beam to create Purkinje images during ophthalmic exam may allow determination of which of the following? Select ALL correct answers. a) the amount of loss of thickness in a corneal ulcer b) differentiation of corneal lipid from mineral deposits c) qualitative tear film deficiency d) localization of a lesion to the cornea e) localization of lesion within the thickness of the cornea

a (the amount of loss of thickness in a corneal ulcer) d (localization of a lesion to the cornea) e (localization of lesion within the thickness of the cornea)

Which of the following statements concerning the orbit of the dog IS NOT correct? a) the canine orbit has a complete bony floor b) the orbit of the dog is composed of the frontal, sphenoid, palatine, zygomatic, maxillary, and lacrimal bones c) the globe can be pulled back into the orbit via the retractor bulbi muscle d) CN III, IV, VI and the ophthalmic nerve enter the orbit by the orbital fissure e) the orbit of the dog is referred to as an incomplete (open) orbit

a (the canine orbit has a complete bony floor)

Which of the following is NOT a typical CS of conjunctivitis? a) conjunctival hyperemia/injection b) exophthalmos c) rubbing at the eyes d) ocular discharge e) chemosis

b (exophthalmos)

Which of the following ophthalmic exam tests is most important to perform on the affected eye in a case of ocular proptosis? a) menace response (assessing for vision and blink reflex) b) fluorescein stain (assessing for corneal ulceration) c) tonometry (IOP measurement) d) fundic exam (assessing poster segment especially the retina)

b (fluorescein stain)

A 1.5 YO Newfoundland with inferior lateral entropion and keratitis OU. a) temporary eyelid tacking b) permanent surgical correction

b (permanent surgical correction)

enlargement of the globe due to elevate IOP

buphthalmos

Which of the following are helpful in differentiating orbital myositis FROM OTHER orbital disease? Select ALL CORRECT answers. a) resistance to retropulsion b) third eyelid position c) bilaterality d) response to immuno-modulative/immunosuppressive therapy

c (bilaterality) d (response to immuno-modulative/immunosuppressive therapy)

What nerve is blocked to elicit eyelid akinesia in horses? a) supraorbital b) frontal c) palpebral d) zygomatic

c (palpebral)

What is the mechanism of action of tropicamide? a) direct acting parasympathomimetic b) indirect acting parasympathomimetic c) parasympatholytic d) sympathomimetic e) sympatholytic

c (parasympatholytic)

Which of the following is NOT a method of ocular lesion localization? a) use of Purkinje images b) axis of rotation c) retroillumination d) object overly e) all fo the choices are methods of lesion localization

c (retroillumination)

How long should it take for an uncomplicated, uninfected, superficial corneal abrasion to heal? a) 24-48 h b) 10-14 d c) no average d) 3-5 d

d (3-5 days)

The menace response is used to evaluate which of the following cranial nerves? a) CN II and CN V b) CN V and CN VII c) CN II and CN III d) CN II and CN VII e) CN V and CN VI

d (CN II and CN VII)

Which of the following statements is TRUE regarding ophthalmoscopy? a) degree of magnification with indirect ophthalmoscopy increases with a higher dioptric strength lens b) field of view with indirect ophthalmoscopy gets bigger with a lower dioptric strength lens c) image seen with direct ophthalmoscopy is more magnified with a bigger eye d) image seen with indirect ophthalmoscopy is inverted e) image seen with direct ophthalmoscopy in inverted

d (image seen with indirect ophthalmoscopy is inverted)

You perform an ophthalmic exam on a dog and find: normal PLR (positive direct and consensual) OU, negative menace response OU, normal palpebral reflexes OU, and normal corneal reflexes OU. In addition, the dog has normal ocular motility in both eyes. Based on these ophthalmic findings, which of the following statements is NOT correct? a) CN II and CN III are functional in both eyes b) CN V and CN VII are functional in both eyes c) a lesion afferent/above/posterior to the optic chiasm (a central lesion) d) the orbicularis oculi muscle contributed significantly to closure of the eyelids e) a retinal or optic nerve lesion is the cause of the dog's visual deficit

e (a retinal or optic nerve lesion is the cause of the dog's visual deficit)

A dog is show in the eye with a BB along the same path as the arrow in the picture. Which of the following best describes the path of the BB as it passes through the anatomical structures of the eye? a) cornea, anterior chamber, lens, vitreous, retinal pigmented epithelium, neurosensory retina, tapetum, sclera b) cornea, anterior chamber, pupil, lens, vitreous, posterior chamber, neurosensory retina, retinal pigmented epithelium, choroid, tapetum, sclera c) cornea, anterior chamber, pupil, posterior chamber, lens, vitreous, retinal pigmented epithelium, neurosensory retina, sclera d) cornea, anterior chamber, pupil, posterior chamber, lens, vitreous, tapetum, neurosensory retina, choroid, sclera e) cornea, anterior chamber, pupil, posterior chamber, lens, vitreous, neurosensory retina, retinal pigmented epithelium, tapetum, choroid, sclera

e (cornea, anterior chamber, pupil, posterior chamber, lens, vitreous, neurosensory retina, retinal pigmented epithelium, tapetum, choroid, sclera)

Which of the following is NOT a classic/common CS of KCS in dogs? a) red eye b) ropy mucoid ocular discharge c) corneal pigmentation d) corneal vascularization e) corneal lipid deposits

e (corneal lipid deposits)

What are the components of the uvea? a) iris, ciliary body, choroid, retina b) iris, ciliary body, retina c) pupil, ciliary body, choroid d) scleral vessels, iris, ciliary body, choroid e) iris, ciliary body, choroid

e (iris, ciliary body, choroid)

Which of the following is LEAST likely pertinent to help refine a differential diagnosis list for an ophthalmic condition? a) patient age b) patient coat color c) patient travel hx d) patient breed e) patient "occupation"/use

e (patient "occupation"/use)

What is the most common symptom of ocular pain? a) rubbing at the eye b) ocular cloudiness c) ocular discharge d) head tilt e) squinting the eye

e (squinting the eye)

sinking of the globe into the orbit

enophthalmos

removal of the globe

enucleation

removal of the globe and all orbital contents

exenteration

protrusion of the globe forward in the orbit

exophthalmos

Which of the following is NOT a potential cause of corneal edema? a) Vx with a CAV-1 instead of a CAV-2 strain resulting in an allergic uveitis with antigen/antibody complexes deposited on the corneal endothelium. b) loss of the corneal epithelium exposing corneal stroma c) anterior uveitis resulting in corneal endothelial cell inflammation and dysfunction d) IOP elevation (glaucoma) that inhibits corneal endothelial pumps, allowing fluid to accumulate in the cornea e) corneal vascularization with associated vascular leakage f) all listed choices are potential mechanisms of corneal edema

f (all listed choices are potential mechanisms of corneal edema)

inability to completely blink

lagophthalmos

congenitally small globe

microphthalmos

small globe secondary to chronic IOP

phthisis bulbi

protrusion of the globe with eyelid entrapment posterior to the globe equator

proptosis

deviation of the globe

strabismus