Patient History and Ophthalmic Examination Techniques Flashcards

Before instilling dilating drops in a new patient, which condition MUST be screened for to avoid precipitating acute angle-closure glaucoma?

Answer: Narrow anterior chamber angle

Patients with narrow anterior chamber angles are at risk for angle closure when pupils are dilated, so gonioscopy or penlight assessment of anterior chamber depth should precede dilation.

Which slit-lamp illumination technique is best for detecting corneal edema and stromal haze?

Answer: Sclerotic scatter

Sclerotic scatter illuminates the cornea via total internal reflection from the limbus, making stromal haze and edema visible as a glow against a dark background.

The Schirmer test without anesthesia (Schirmer I) primarily measures:

Answer: Reflex tear secretion plus basal secretion

Schirmer I without anesthesia measures total tear production, including reflex tearing stimulated by the filter paper strip, plus basal secretion.

During pupil examination, anisocoria that is greater in dim light suggests the abnormal pupil is:

Answer: The larger pupil (dilator paresis)

Anisocoria greater in dim light (when dilation is expected) indicates the larger pupil cannot dilate, suggesting Horner syndrome (dilator paresis) on that side.

A patient reports sudden onset of flashes and floaters. What is the MOST important next step for the ophthalmic technician?

Answer: Dilate the patient immediately and alert the ophthalmologist

Acute flashes and floaters may indicate posterior vitreous detachment or retinal tear/detachment, requiring urgent dilated fundus examination by the ophthalmologist.

When using fluorescein sodium dye in the clinic, which light source is used to best visualize corneal staining?

Answer: Cobalt blue light

Cobalt blue light excites fluorescein dye, causing it to fluoresce bright green, making areas of epithelial breakdown or staining clearly visible.