MCPHS CLIN MED I OPHTHALMOLOGY EXAM QUESTIONS AND
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Visual acuity
Vital sign of the eye
Check before initiating any tx to establish baseline
Test each eye independently
Eye patching
Close eye and patch SNUGLY
+ Abx ointment (no patching of infx'd eyes)
Macula/Fovea
Area of highest visual acuity
Most densely packed rods and cones
Few blood vessels
Optic nerve pathway
Light in temporal side - same side through whole pathway
Light in nasal side - crosses over at optic chiasm
Ocular muscles- movements and innervation
CN VI - Lateral rectus (abduction for lateral gaze)
CN IV - Superior oblique (depresses and rotates)
, CN III - Medial inferior rectus, medial superior rectus, inferior oblique (depress, elevate, adduct for
medial gaze)
Diplopia
Double vision d/t eyes not moving in tandem
Closing either eye alleviates
Anisocoria
Pupillary asymmetry
20% of population
Epiphora
Excessive tearing
Consensual light reflex
Contralateral pupil constricts with light shone in other eye d/t "crossing over" of some optic nerve fibers
Pupillary accommodation
Pupil constricts to let in less light, focus on nearby object
Marcus Gunn pupil / Relative Afferent Pupillary Defect (RAPD)
Affected pupil constricts consensually but no accommodation
Intraocular pressure (IOP)
Pressure in eye, generally anterior chamber
Normal: 8-21 mmHg
ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
Visual acuity
Vital sign of the eye
Check before initiating any tx to establish baseline
Test each eye independently
Eye patching
Close eye and patch SNUGLY
+ Abx ointment (no patching of infx'd eyes)
Macula/Fovea
Area of highest visual acuity
Most densely packed rods and cones
Few blood vessels
Optic nerve pathway
Light in temporal side - same side through whole pathway
Light in nasal side - crosses over at optic chiasm
Ocular muscles- movements and innervation
CN VI - Lateral rectus (abduction for lateral gaze)
CN IV - Superior oblique (depresses and rotates)
, CN III - Medial inferior rectus, medial superior rectus, inferior oblique (depress, elevate, adduct for
medial gaze)
Diplopia
Double vision d/t eyes not moving in tandem
Closing either eye alleviates
Anisocoria
Pupillary asymmetry
20% of population
Epiphora
Excessive tearing
Consensual light reflex
Contralateral pupil constricts with light shone in other eye d/t "crossing over" of some optic nerve fibers
Pupillary accommodation
Pupil constricts to let in less light, focus on nearby object
Marcus Gunn pupil / Relative Afferent Pupillary Defect (RAPD)
Affected pupil constricts consensually but no accommodation
Intraocular pressure (IOP)
Pressure in eye, generally anterior chamber
Normal: 8-21 mmHg
