Want To Be An Ophthalmologist? Take This Quiz!

Babies should have their first eye exam done at 6 months or earlier. This is because early detection of any potential eye problems is crucial for their overall visual development. By examining a baby's eyes at this age, any issues such as refractive errors or eye diseases can be identified and treated promptly, ensuring that the baby's vision develops properly.

According to the lectures, the only age range in which it is okay for a patient to go 3 years without an eye exam is 18-40 years old.

you get paid for it regardless of if it is done or not. the reimbursement amount does not change.
however, it is best practice to complete a dilated fundus exam for quality patient care

this exam would be unacceptable; NO preliminary/entrance tests were completed. entrance testing consists of EOMS, NPC, CVF, pupils BP/HR, Cover test etc.
an AR/AK does not count as entrance testing (even though it was done at the beginning)

The correct answer is 50-70%. This means that when using direct ophthalmoscopy (DO), we are able to visualize approximately 50-70% of the fundus. Direct ophthalmoscopy involves using a handheld instrument called an ophthalmoscope to examine the back of the eye, including the retina, optic nerve, and blood vessels. While DO provides a limited view compared to other imaging techniques, it is still a valuable tool for assessing the health of the eye and detecting certain eye conditions.

however, when you do math it should be around 11mm 1/90=0.011

To start evaluating the eyelids, approximately +20.0D of power should be dialed into the DO.

When evaluating the anterior segment, the DO uses compensating lenses to adjust the focus and clarity of the different structures. Since the DO is starting at the lids and lashes and moving towards the retina, decreasing the plus power of the compensating lenses would be the appropriate adjustment. Decreasing the plus power helps to bring the focal point closer to the DO, allowing for a clearer visualization of the cornea, conjunctiva, iris, lens, vitreous, and retina.

to examine the lens you would need to dial in ~+3.00D in compensation lenses and stand around arms length away.

ill try not to focus on disease in this one (even though most of the lectures a HEAVILY disease based) but what im trying to convey is that pathologic causes of indistinct ONH margins look feathery. compared to non pathologic indistinct margins.

The indistinct appearance of the optic nerve head (ONH) is likely due to the degeneration of the short posterior ciliary artery. The ONH is supplied by the ciliary arteries, which provide the necessary blood flow to the optic nerve. When the short posterior ciliary artery degenerates, it can lead to a decrease in blood flow to the ONH, resulting in an indistinct appearance. This can affect the visual function and potentially lead to vision problems.

ONH pallor refers to the pale appearance of the optic nerve head, which can be indicative of optic nerve damage. Ptosis, or drooping of the eyelid, is not typically associated with ONH pallor. The other characteristics listed, such as reduced BVCA (best visual corrected acuity), APD (afferent pupillary defect), VF (visual field) defect, color desaturation, and compromised circulation, are all commonly associated with ONH pallor.

The correct answer is OS ONH notch @ 6:00. This means that in the fundus photo, the left eye (OS) has an optic nerve head (ONH) notch located at the 6 o'clock position.

To judge the c/d (cup-to-disc) ratio of a patient with an obliquely inserted optic nerve head (ONH), one would use the vertical limits. The vertical limits refer to the upper and lower boundaries of the cup, which can be assessed by comparing the height of the cup to the height of the disc. This is important in determining the extent of cupping and evaluating for possible glaucoma. The horizontal limits and the apexes of the "kidney bean" shape may also provide valuable information, but the vertical limits specifically help in assessing the c/d ratio.

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Retinal arteries do indeed lie above retinal veins. This is due to the difference in blood flow direction. Arteries carry oxygenated blood away from the heart and towards the tissues, while veins carry deoxygenated blood back to the heart. In the retina, the arteries bring oxygenated blood into the tissue, and they are positioned above the veins, which carry the deoxygenated blood out of the retina.

A Hollenhorst plaque is a type of plaque that is commonly found in the retinal artery. It is composed of cholesterol and other fatty substances that can break off and travel to smaller blood vessels in the brain, leading to a blockage. This blockage can cause an impending stroke, as the blood flow to the brain is compromised. Therefore, the presence of a Hollenhorst plaque is a common indicator of an impending stroke.

i know, i know supposedly there is no pathology on the final but there really isnt much else from Dr. Tong

Central retinal artery occlusion is responsible for the image because it causes sudden, painless, and complete loss of vision in one eye. This occurs due to a blockage in the central retinal artery, which supplies blood to the retina. The lack of blood flow to the retina leads to ischemia and subsequent damage to the retinal cells, resulting in vision loss. The cherry red spot, which refers to a red spot in the center of the macula against a pale retina, is a characteristic finding in central retinal artery occlusion.

The term "cotton wool spot" refers to a white, fluffy lesion that appears on the retina of the eye. The question suggests that the newer the cotton wool spot, the characteristic it is of being "fluffier". This means that when the lesion is more recent, it is more likely to have a softer, less defined appearance.

The macular region consists of the perifovea, parafovea, fovea, and foveola. These are different areas within the macula, which is the central part of the retina responsible for central vision and color perception. The perifovea is the outermost region surrounding the fovea, followed by the parafovea which is the intermediate region. The fovea is the central area of the macula and contains the highest concentration of cone cells, which are responsible for detailed vision. The foveola is the smallest and most central part of the fovea, where visual acuity is the highest.

The foveola is the central part of the fovea, which is a small depression in the retina of the eye. The foveola is the area of the fovea that contains the highest concentration of cone cells, which are responsible for sharp central vision. The given answer of 0.35mm indicates the size of the foveola, suggesting that it is a small area within the fovea.

Hard exudates are yellowish-white deposits that occur in the retina and are typically seen in conditions such as diabetic retinopathy. The photoreceptor layer, which contains the rods and cones responsible for vision, is not a common location for the presence of hard exudates. Therefore, it is unlikely to find hard exudates in the photoreceptor layer.

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The statement "IF IT AINT RED...IT AINT A HOLE" suggests that macular holes are only characterized by redness. However, this statement is false. Macular holes are actually characterized by a loss of central vision, distortion of straight lines, and a dark spot in the center of the visual field. Redness is not a defining characteristic of macular holes. Therefore, the correct answer is False.

her chief complaint is vision related she has vision insurance and ketchum health takes VSP- so she is good to go.

pt has medicare

a "hole" in your vision can mean many different things, so in order to have the most comprehensive exam possible, DILATE!!!! this is likely an issue involving macular edema

Some patients with glaucoma may have IOP

During GAT (Goldmann Applanation Tonometry), the diameter of the applanation area when the IOP (Intraocular Pressure) has been successfully measured is 3.06mm.

To get the most accurate measurement during GAT on Jim, you should rotate the prism tip so the holder's red line is lined up with the 45o mark on the prism tip. This ensures that the probe is aligned correctly with the axis of Jim's eye, allowing for an accurate measurement of his high cylindrical prescription.

If you see something in the oculars during GAT, it means that the object you are observing is not centered in the field of view. To adjust the position, you need to move to the right, which will bring the object closer to the center horizontally. Additionally, you need to move slightly up to bring the object closer to the center vertically. Therefore, the correct adjustment is to move to the right and slightly up.

The findings suggest diurnal variation, which refers to the natural fluctuation of intraocular pressure (IOP) throughout the day. In this case, the patient's IOP levels were higher in the morning and lower in the afternoon, indicating a normal pattern of fluctuation. This is a common occurrence in individuals without glaucoma. The other options, such as the patient not having glaucoma, being apprehensive, or not taking their drops regularly, are not supported by the given information.

during the early stages of uveitis the ciliary production of aqueous is reduced (due to the inflammation), as the inflammation continues, cellular debris falls into the TM and clogs it up creating an increase in pressure (i think it was about a week after or so) then as the inflammation resolves the ciliary body ramps up aqueous production again but the debri is still clogging the TM, so pressure increases again even more

This scenario is an example of a consultation because the optometrist refers Jim to another physician for further evaluation and care. The optometrist suspects that Jim may have glaucoma but does not have the necessary equipment to make a definitive diagnosis. Therefore, they send Jim to another physician who can provide the appropriate diagnostic evaluation. The optometrist also provides notes for Jim to return to their office for continued care, indicating that the consultation is part of an ongoing treatment plan.

this question is really asking what vision insurance would cover (but that's too easy) vision insurance will cover "routine Vison related" tests. i like to think of it as, if the patient is benefiting/ getting something from the test somehow, then vision insurance will likely cover it (with an appropriate diagnosis ie. myopia, astigmatism etc). for a diagnostic refraction; you can do a refraction whenever the heck you want to: you dont always have to give the final Rx to the patient. when a refraction is done and no Rx is given, all the information still goes into the chart. so you may refer back at a later date to determine pertinent changes. But if the patient wants the Rx to get glasses, someone has to pay for that. gotta make that monayyy!

The correct answer is 92015, 92014. This is because during an eye wellness exam, the optometrist or ophthalmologist may perform a refraction test to determine the patient's prescription for glasses or contact lenses (CPT code 92015). They may also perform other pertinent related tests, such as a comprehensive eye exam (CPT code 92014), to evaluate the overall health of the patient's eyes. Therefore, both CPT codes 92015 and 92014 are appropriate to bill for this scenario.

you want to try to keep your CC as close to what the patient says, as close to their own words as you can. its ok to use abbreviations where appropriate. in this example, the patient did not elaborate on history of present illness until prompted, so including FOLDARS in the CC would be inappropriate.

According to the lectures, in order to bill for 92004/92014, a minimum of 4 HPI (History of Present Illness) categories need to be covered/asked.

The FOV (Field of View) of a direct ophthalmoscope is 2dd in terms of disc diameters. This means that when looking through the ophthalmoscope, the field of vision will cover an area that is equivalent to two disc diameters.

Increasing working distance can actually help maximize the field of view (FOV) of depth of field (DO). When the working distance is increased, the area that can be seen in focus expands, allowing for a larger FOV. Therefore, this option is not an exception and can help maximize the FOV of DO.

High myopia refers to severe nearsightedness, where distant objects appear blurry. In this context, the question is asking how high myopia affects the field of view (FOV) of depth of field (DO). The FOV refers to the extent of the visual area that can be seen without moving the eyes or head. Since high myopia causes blurry vision, it means that the individual's ability to see clearly and sharply within their FOV is reduced. Therefore, high myopia will decrease the FOV of DO.

Increasing the dioptric power of the condensing lens or decreasing the slit lamp magnification will result in an increase in the field of view (FOV) during fundus biomicroscopy. This is because a higher dioptric power or lower magnification allows for a wider area of the fundus to be seen, increasing the overall FOV.

The 78D condensing lens would give the best balance between magnification and field of view (FOV) for fundus biomicroscopy. This lens provides a moderate level of magnification while still allowing a wide enough FOV to capture a sufficient amount of the fundus. The 90D lens may provide a larger FOV but at the expense of magnification, while the 60D and 20D lenses may offer higher magnification but with a narrower FOV.

Increasing the power of the condensing lens in SL biomicroscopy will increase the field of view (FOV) because a higher power lens allows for a wider area to be viewed. However, it will decrease the magnification because a higher power lens spreads out the light rays, resulting in a smaller image size.

A red-free filter is used in ophthalmology to enhance the visibility of certain structures in the eye by blocking out red light. It accentuates the contrast between different components of the eye, making them easier to distinguish. Choroidal melanoma, retinal nerve fiber layer, and blood vessels are all structures that can be accentuated by a red-free filter. However, choroidal nevi are not accentuated by this filter, meaning they do not stand out as much compared to the other structures.

the reason why up and towards your nose is incorrect is because... we have two eyes, our nose is in the middle of said eyes. when you tell a patient to look towards their nose, they dont know which direction to look, its left for the right eye but right form the left eye, its just confusing. much easier to just tell the patient to look in a direction