Optometry Exam 2
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1. Anterior Segment: From anterior hyaloid face, forward or from lens/zonules forward.
2. Posterior Segment: Area behind the lens/lens zonules or area behind the anterior hyaloid.
3. Slit Lamp Examination procedure moves...: anterior to posterior.
Lids/lashes/Lacrimal, Conjunctiva, Sclera, Cornea, Angeles, Iris, Lens, anterior vitreous.
4. Lids/Lashes/Lacrimal system: Magnification: low to moderate
Illumination: diffuse or broad parallelpiped.
1) Have patient close eyes and sweep across upper lid and eyelashes. (note any abnormalities)
2) Have patient open eye and pull down to expose lid margin and scan lower lid margin, lashes and puncta. Then pul
down lid further to expose palpebral and bulbar conjuncativa, scan this layer.
3) Have patient look down, hold upper lid and scan bulbar, have patient look to the right and to the left to scan nasal
and temporal bulbar.
Note qualit of lid margins, glands, and position of lids, look for complete blink and a lid lag.
5. Entropian: Eyelids fall or curl into the globe. can cause corneal disruption, no tears, bacterial growth is a huge
issue.
6. Ectropian: Eyelids fall away from the globe.
7. Lacrimal system: tears, drainage. Should have only 1 puncta.
8. 3 Zones of Lid: Palpeberal: inside of lids.
Bulbar: lays on top of the globe, ends at the limbus.
Fornix: the transition between palpebral and bulbar conjunctiva.
1/5
, Optometry Exam 2
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All continuous and closed.
9. Slit lamp: Conjunctiva: Have patient look up and retract the lower lid. Observe the palpebral conjunc-
tiva(notice any redness-hyperemia, lumps, papillae, follicles and cysts) and the bulbar conjunctiva(lower, same as
papillae, and note any pigmentation). Then have patient look down and observe palpebral.
Magnification: low to moderate, illumination: diffuse
10. Slit Lamp: Cornea: Mag: begin with low to moderate, and only use high mag if you see something
abnormal.
Illumination: begin with diffuse or parallelepiped, if you observe something switch to an optic sextion and determine
depth.
Note regularity in thickness of the tissue, and edema, or ulcerations
11. Sodium Fluroescein: Used to determine if epithelial cells are dead or missing(intracellular) Must use the
cobalt blue filter which fluresces the NaFl bright green. Best stain for the cornea
12. Rose Bengal: Stains dead or devitalized unhealthy cells and mucus. There is no filter necessary but stain
appears pink. Large downside is that it stings, good for conjunctiva.
13. Lissamine Green: Stains dead or devitalized cells. No filter, stains dark blue, conjunctiva.
14. Van Herick's Angle estimation: Slit lamp procedure, ALWAYS needs to be done prior to dilation
procedures, because narrow angles can cause problems. Use Low to moderate magnitude, Illumination is an optic
section at the limbus. Measure grade width of cornea vs the depth of the anterior chamber.
Grade 4 CA=> SC
Grade 3 CA=1/2 with of SC
Grade 2 CA=1/4 with of the SC
Grade 1 CA <1/3 width of the SC
Grade 0 No shadow seen, closed.
15. Slit Lamp: Anterior Chamber: Should be clear, no debris floating, notice for any cells and flare(pro-
tein)
2/5
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1. Anterior Segment: From anterior hyaloid face, forward or from lens/zonules forward.
2. Posterior Segment: Area behind the lens/lens zonules or area behind the anterior hyaloid.
3. Slit Lamp Examination procedure moves...: anterior to posterior.
Lids/lashes/Lacrimal, Conjunctiva, Sclera, Cornea, Angeles, Iris, Lens, anterior vitreous.
4. Lids/Lashes/Lacrimal system: Magnification: low to moderate
Illumination: diffuse or broad parallelpiped.
1) Have patient close eyes and sweep across upper lid and eyelashes. (note any abnormalities)
2) Have patient open eye and pull down to expose lid margin and scan lower lid margin, lashes and puncta. Then pul
down lid further to expose palpebral and bulbar conjuncativa, scan this layer.
3) Have patient look down, hold upper lid and scan bulbar, have patient look to the right and to the left to scan nasal
and temporal bulbar.
Note qualit of lid margins, glands, and position of lids, look for complete blink and a lid lag.
5. Entropian: Eyelids fall or curl into the globe. can cause corneal disruption, no tears, bacterial growth is a huge
issue.
6. Ectropian: Eyelids fall away from the globe.
7. Lacrimal system: tears, drainage. Should have only 1 puncta.
8. 3 Zones of Lid: Palpeberal: inside of lids.
Bulbar: lays on top of the globe, ends at the limbus.
Fornix: the transition between palpebral and bulbar conjunctiva.
1/5
, Optometry Exam 2
Study online at https://quizlet.com/_vn4fz
All continuous and closed.
9. Slit lamp: Conjunctiva: Have patient look up and retract the lower lid. Observe the palpebral conjunc-
tiva(notice any redness-hyperemia, lumps, papillae, follicles and cysts) and the bulbar conjunctiva(lower, same as
papillae, and note any pigmentation). Then have patient look down and observe palpebral.
Magnification: low to moderate, illumination: diffuse
10. Slit Lamp: Cornea: Mag: begin with low to moderate, and only use high mag if you see something
abnormal.
Illumination: begin with diffuse or parallelepiped, if you observe something switch to an optic sextion and determine
depth.
Note regularity in thickness of the tissue, and edema, or ulcerations
11. Sodium Fluroescein: Used to determine if epithelial cells are dead or missing(intracellular) Must use the
cobalt blue filter which fluresces the NaFl bright green. Best stain for the cornea
12. Rose Bengal: Stains dead or devitalized unhealthy cells and mucus. There is no filter necessary but stain
appears pink. Large downside is that it stings, good for conjunctiva.
13. Lissamine Green: Stains dead or devitalized cells. No filter, stains dark blue, conjunctiva.
14. Van Herick's Angle estimation: Slit lamp procedure, ALWAYS needs to be done prior to dilation
procedures, because narrow angles can cause problems. Use Low to moderate magnitude, Illumination is an optic
section at the limbus. Measure grade width of cornea vs the depth of the anterior chamber.
Grade 4 CA=> SC
Grade 3 CA=1/2 with of SC
Grade 2 CA=1/4 with of the SC
Grade 1 CA <1/3 width of the SC
Grade 0 No shadow seen, closed.
15. Slit Lamp: Anterior Chamber: Should be clear, no debris floating, notice for any cells and flare(pro-
tein)
2/5
