1
Q
What does excessive eye rubbing, blinking, or tearing during close tasks indicate?
A
accomm deficiency
2
Q
a student notes intermittent blur at distance after prolonged reading. What’s the likely issue?
A
Accommodative Deficiency
3
Q
What condition is suspected when a patient reports blur or fluctuating vision at near?
A
accomm deficiency
3
Q
a student notes intermittent blur at distance after prolonged reading. What’s the likely issue?
A
Accommodative Deficiency
4
Q
A child reports intermittent diplopia, especially while reading. What does this suggest?
A
vergence deficiency
5
Q
A student is observed covering or closing one eye during reading tasks. What’s the likely issue?
A
Vergence Deficiency
6
Q
A patient has difficulty aligning columns of numbers, especially when copying from a book. What does this point to?
A
vergence deficiency
7
Q
A child reports intermittent diplopia, especially while reading. What does this suggest?
A
vergence deficiency
8
Q
What condition is likely if letters or words appear to jump, float, or move around when reading?
A
Vergence Deficiency
8
Q
A patient has difficulty aligning columns of numbers, especially when copying from a book. What does this point to?
A
vergence deficiency
9
Q
A child shows excessive head movement while reading. What kind of visual deficiency does this indicate?
A
Ocular Motility Deficiency
10
Q
A patient frequently loses place while reading. What is the most likely cause?
A
Ocular Motility Deficiency
11
Q
A student is skipping lines and omitting words while reading. What does this symptom suggest?
A
Ocular Motility Deficiency
11
Q
A child shows excessive head movement while reading. What kind of visual deficiency does this indicate?
A
Ocular Motility Deficiency
12
Q
A patient frequently loses place while reading. What is the most likely cause?
A
Ocular Motility Deficiency
13
Q
A child needs to use a finger or marker to keep their place while reading. What visual issue might be present?
A
Ocular Motility Deficiency
14
Q
A patient has poor reading comprehension despite normal intelligence. What is a likely visual cause?
A
Ocular Motility Deficiency
15
Q
A child needs to use a finger or marker to keep their place while reading. What visual issue might be present?
A
Ocular Motility Deficiency
16
Q
It is the distance between the centers of the entrance pupils of the eyes, also known as interocular distance.
A
interpupillary distance (PD)
17
Q
What is the clinical significance of measuring PD accurately?
A
To ensure proper alignment of the optical centers of spectacle lenses and avoid unwanted prism effects.
18
Q
IPD measurement method wherein patient fixates on the examiner’s eye for distance PD and on the examiner’s nose for near PD.
A
anatomical
19
Q
IPD measurement method wherein penlight is used to create a corneal reflex; the examiner aligns a millimeter rule with the reflected image (Purkinje image) of the light.
A
catoptric
20
Q
What is the name of the reflected image used during the catoptric method of interpupillary distance measurement with a penlight?
A
purkinje image
21
Q
It is the distance from the near point of convergence to the midpoint between the centers of rotation of both eyes.
A
near point of convergence
22
It is the closest point at which the eyes can maintain binocular single vision through maximum convergence.
npc
23
What is the average PD range in children?
Usually between 50–60 mm, but can be as low as 45 mm.
24
What is the average PD for adult males
Men: 59–70 mm
25
What is the average PD range in children?
Usually between 50–60 mm, but can be as low as 45 mm.
26
It is the distance between the centers of the entrance pupils of the eyes, also known as interocular distance.
interpupillary distance (PD)
27
What is the average PD for adult female
55–56 mm
28
Overall adult PD average
64mm
29
What adjustment is made when the patient has anisocoria (unequal pupil sizes)?
Measure from the center of each pupil, regardless of size.
30
How is PD taken in a patient with strabismus or faulty binocular fixation?
Measure each eye separately while occluding the other eye.
31
Overall adult PD average
64mm
31
factors to be considered to ensure accuracy in taking the PD
1. Lines of sight of the patient should be parallel to each other.
2. Lines of sight of the examiner should intersect the measuring rule from identical angle for both reading
32
How is PD taken in a patient with strabismus or faulty binocular fixation?
Measure each eye separately while occluding the other eye.
33
What visual ability does the Near Point of Convergence (NPC) test assess?
maximum convergence ability
34
What symptoms might a patient with reduced NPC report during near work?
Ocular discomfort, headaches, diplopia, fatigue, asthenopia, and reduced reading comprehension.
35
What are some common instruments used to measure NPC?
RAF rule
Pencil
Penlight or transilluminator
Accommodative target
White-headed pin
Narrow edge of a plastic rule
36
What is the clinical interpretation of an NPC result closer than 5 cm?
It may suggest convergence excess.
37
What is the normal NPC range expected in clinical testing?
6 to 10 cm
38
According to Scheiman & Wick, what is the normal NPC break and recovery when using an accommodative target?
Break: 5 cm ± 2.5
Recovery: 7 cm ± 4.0
39
According to Scheiman & Wick, what is the normal NPC break and recovery using a penlight or red lens?
Break: 7 cm ± 4.0
Recovery: 10 cm ± 5.0
40
What might be indicated if no doubling occurs during the NPC test?
Possibly suppression or wandering attention
41
Which condition may show excessive convergence during NPC testing?
Basic esophoria or SOP with high AC/A ratio (excessive convergence).
42
It is the reciprocal (in meters) of the NPC distance multiplied by the patient’s PD in cm.
amplitude of convergence
43
What is the normal NPC range expected in clinical testing?
6 to 10 cm
44
It is the measurement of pupil size under constant stimulus conditions (e.g., fixed lighting and no accommodation).
static pupil evaluation
45
It is the measurement of changes in pupil size in response to changing stimuli, such as light or accommodation.
dynamic pupil evaluation
46
What stimulus conditions can trigger dynamic changes in the pupil?
Light intensity and accommodative effort.
47
What does static pupil testing help rule out?
Conditions like anisocoria, pharmacologic dilation, or tonic pupils under stable conditions.
48
What clinical signs are best assessed with dynamic pupil testing?
Light-near dissociation, pupil reactivity, or neurologic pupil abnormalities.
49
Careful evaluation of pupil size and reactivity gives information about the integrity of which structures?
The iris, optic nerve, posterior visual pathways, oculomotor nerve (CN III), and the sympathetic pathway.
50
What is the normal pupil size range in bright light?
2 to 4 mm
51
What is the normal pupil size range in darkness?
4 to 8 mm
52
What pupil size difference may suggest a possible neurologic disorder?
An anisocoria of ≥ 0.5 mm in either light or dark conditions.
53
What does a pupil size of 2 mm usually indicate?
Miosis, which may be associated with hyperopia, astigmatism, or presbyopia
54
Miosis, may be associated with what refractive conditions
hyperopia, astigmatism, or presbyopia.
55
What does a pupil size of 5 mm usually indicate?
mydriasis
56
mydriasis, is commonly seen in what ref error
myopia
57
What is the average pupil size in room lighting?
4.0 mm (range: 2.5 to 5.0 mm)
58
What is the average pupil size in near total darkness?
6.5 mm (range: 5.0 to 8.5 mm)
59
What is the average pupil size under direct light?
3.0 mm (range: 2.0 to 4.5 mm)
60
A condition where the pupils are unequal in size, which may be physiological or pathological
anisocoria
61
tests to assess for strabismus by observing the position of the corneal light reflex.
corneal reflex test
62
What is the instrumentation used for the corneal reflex test?
A penlight, transilluminator, or ophthalmoscope bulb.
63
At what distance is the light typically held for the corneal reflex test?
At about 40 cm from the patient
64
used to estimate ocular alignment by observing the position of the corneal light reflex in relation to the center of the pupil. It helps detect and estimate the angle of strabismus
hirschberg test
65
Where is the corneal reflex located in a normal patient?
Slightly nasal to the center of the pupil in both eyes (about 0.5 mm). This is considered orthophoria or no deviation
66
What does a nasalward (temporal displacement) of the reflex indicate?
Exotropia — the eye is turned outward, so the reflex appears nasally.
67
What does a nasalward (temporal displacement) of the reflex indicate?
Exotropia — the eye is turned outward, so the reflex appears nasally.
68
How many prism diopters (PD) does 1 mm of corneal reflex displacement equal?
Approximately 15–22 PD per mm, but clinically 1 mm = 15–22Δ is estimated.
For quick bedside estimate: 1 mm = 15 PD
69
Test uses prisms to neutralize the corneal reflex displacement.
krismky test
70
What does a temporalward (nasal displacement) of the reflex indicate?
Esotropia — the eye is turned inward, so the reflex appears temporally.
71
How many prism diopters (PD) does 1 mm of corneal reflex displacement equal?
Approximately 15–22 PD per mm, but clinically 1 mm = 15–22Δ is estimated.
For quick bedside estimate: 1 mm = 15 PD
72
If the corneal reflex is at the center of the pupil, how many degrees or prism diopters of deviation are present?
Approximately 5°, which corresponds to ~10 prism diopters (Δ).
73
If the corneal reflex is at the pupillary margin, what is the estimated angle of deviation?
About 15 degrees, which equals approximately 30Δ.
This indicates a moderate strabismus, commonly seen in manifest deviations.
74
If the corneal reflex is at the center of the pupil, how many degrees or prism diopters of deviation are present?
Approximately 5°, which corresponds to ~10 prism diopters (Δ).
74
If the corneal reflex is halfway between the pupil and the limbus, what is the estimated deviation?
75
If the corneal reflex is halfway between the pupil and the limbus, what is the estimated deviation?
Roughly 30 degrees, equal to about 60 prism diopters (Δ).
This corresponds to a large-angle strabismus.
76
If the corneal reflex is halfway between the pupil and the limbus, what is the estimated deviation?
Roughly 30 degrees, equal to about 60 prism diopters (Δ).
This corresponds to a large-angle strabismus.
76
If the corneal reflex is located at the limbus, how much deviation does this suggest?
Approximately 45 degrees, which is about 90Δ.
This suggests a very large strabismic deviation, usually constant and possibly sensory in nature.
77
What if the corneal reflex is beyond the limbus?
This indicates a deviation of more than 45 degrees or >90 prism diopters, seen in extreme strabismus such as large-angle exotropia or esotropia, often associated with amblyopia or sensory causes
78
What if the corneal reflex is beyond the limbus?
This indicates a deviation of more than 45 degrees or >90 prism diopters, seen in extreme strabismus such as large-angle exotropia or esotropia, often associated with amblyopia or sensory causes
78
are binocular, conjugate eye movements in which both eyes move together in the same direction (e.g., left, right, up, down). They test yoke muscle pairs.
version
79
refers to monocular eye movements. It helps assess the full range of motion of each individual eye in isolation.
duction
80
What does it mean if one eye “lags behind” in versions?
A paretic muscle
A restriction (mechanical)
Need to perform ductions next to isolate the defective eye
81
refers to monocular eye movements. It helps assess the full range of motion of each individual eye in isolation.
duction
82
What are the 9 cardinal positions of gaze used for?
To test yoke muscle pairs — helps identify which muscles are overacting or underacting in binocular vision.
83
A reflexive pattern elicited by continuous motion in the visual field; consists of a slow drift (like pursuit) and quick reset saccades, creating a sawtooth pattern
Optokinetic Nystagmus (OKN)
84
A reflexive pattern elicited by continuous motion in the visual field; consists of a slow drift (like pursuit) and quick reset saccades, creating a sawtooth pattern
Optokinetic Nystagmus (OKN)
85
helps identify paretic vertical muscle in hypertropia by analyzing deviations in gaze and tilt positions — aids neuro-ophthalmic localization
Parks–Bielschowsky three-step test
86
Hypometric (undershoot) or slow saccades → often indicates
pontine or midbrain lesions.
87
Convergence paralysis suggests what conditions
midbrain lesions, PSP, or Parkinsonism.
88
Hypermetric saccades → suggest
cerebellar dysfunction.
89
Divergence weakness may occur in what conditions
pontine pathology or conditions like Miller Fisher syndrome or neurosyphilis
90
Impaired Vestibulo ocular reflex (e.g., corrective “catch-up” saccades on head impulse) suggests
peripheral vestibular dysfunction.
91
Preserved VOR despite gaze palsy suggests
supranuclear lesions
92
Asymmetry or poor OKN may indicate
vestibular or cerebellar pathology
93
Use a moving patterned drum or strip
Observe alternating slow pursuit and fast reset saccades in both directions; look for symmetry and normal rhythmic response.
Optokinetic Nystagmus (OKN)
94
rapid, voluntary or reflexive eye movements to shift fixation
saccades
95
smooth tracking movements used to follow a moving object
pursuit
96
simultaneous movement of both eyes in the same direction (used in EOM testing)
versions
96
rapid, voluntary or reflexive eye movements to shift fixation
saccades
96
smooth tracking movements used to follow a moving object
pursuit
97
What are two common methods to measure amplitude of accommodation?
Push-Up Method: Move a near target toward the eye until blur is reported
Minus Lens to Blur Method: Add minus lenses at near until sustained blur occurs
98
The maximum accommodative power the eye can exert, measured in diopters (D).
AA
99
If eye moves outward on uncovering, it was turned inward (esophoria/tropia) during cover
Indicates esophoria or esotropia
100
If eye moves inward on uncovering, it was turned outward (exophoria/tropia) during cover
Indicates exophoria or exotropia
101
If the eye moves up upon covering and moves down upon exposure, it indicates
hyperphoria
102
If the eye moves down upon covering and moves up upon exposure, it indicates
hypophoria
103
is the superiority of one eye over the other for visual input or motor tasks, such as aiming, sighting, or visual preference
ocular dominance
104
What are commonly used clinical tests to determine ocular dominance?
Ring Test
Hole-in-a-card test
Box Test
Triangle Hand Test (modification using patient's hands to form a triangle and look through it)
105
refer to the involuntary constriction or dilation of the pupil in response to light or accommodation stimuli, mediated by neurological pathways involving the retina, optic nerve, midbrain, and oculomotor nerve.
pupillary reflexes
106
reflex test wherein pupil constricts in the same eye when light is shone.
direct reflex
107
reflex test wherein pupil constricts in the same eye when light is shone.
direct reflex
107
reflex test wherein opposite eye constricts when light is shone in the first eye.
consensual
108
reflex test wherein (Triad: convergence, accommodation, miosis) – Pupil constricts when shifting focus from far to near.
near reflex
109
A positive swinging flashlight test, where one pupil dilates when light is moved to it, instead of constricting, indicates what defect
relative afferent pupillary defect (RAPD)—often caused by optic nerve damage or severe retinal disease.
110
If difference in anisocoria is greater in light, suspect what condions or location of lesions
parasympathetic lesion (e.g., Adie’s pupil, CN III palsy).
111
If anisocoira difference is greater in dark, suspect what lesion
sympathetic lesion (e.g., Horner’s syndrome).
112
is constriction of the pupil in the same eye when light is shone directly into that eye.
direct light reflex test
113
No response in direct light reflex indicates
Total blindness, optic nerve damage, or midbrain lesion
114
sluggish response in direct light reflex test may indicate
May occur in retinal disease, choroidal inflammation, or mild optic neuropath
115
sluggish response in direct light reflex test may occur in what conditions
May occur in retinal disease, choroidal inflammation, or mild optic neuropath
116
Paradoxical dilation before constriction in direct light reflex occurs in
Rare; possibly psychogenic (hysteria) or neuro-functional disorder
117
sluggish response in direct light reflex test may occur in what conditions
May occur in retinal disease, choroidal inflammation, or mild optic neuropath
118
This reflex tests the afferent pathway of the stimulated eye and the efferent pathway of the opposite eye.
consensual reflex/ indirect
119
The near reflex is the pupillary constriction when the eyes shift focus from far to near, as part of the near triad. what are the near triad
Accommodation
Convergence
Miosis (pupillary constriction)
120
near reflext test is useful in detecting light-near dissociation, in what conditions
Argyll Robertson pupil or Adie’s pupil
121
near reflext test is useful in detecting light-near dissociation, in what conditions
Argyll Robertson pupil or Adie’s pupil
122
used to detect a relative afferent pupillary defect (RAPD), indicating unilateral anomalies of the retina or optic nerve anterior to the lateral geniculate nucleus.
swining flashlight test
123
is a pupil that shows paradoxical dilation when a light is swung from the normal eye to the affected eye, due to a relative afferent pupillary defect (RAPD).
marcus gunn
124
is a pupil that shows paradoxical dilation when a light is swung from the normal eye to the affected eye, due to a relative afferent pupillary defect (RAPD).
marcus gunn
124
used to detect a relative afferent pupillary defect (RAPD), indicating unilateral anomalies of the retina or optic nerve anterior to the lateral geniculate nucleus.
swining flashlight test
124
What is a key observation in a patient with a Marcus Gunn Pupil during the swinging flashlight test?
The affected pupil dilates when light is swung from the normal eye to the affected eye, instead of constricting normally
125
What type of lesion does the swinging flashlight test help localize?
Lesions in the afferent pathway of the visual system (retina, optic nerve, not beyond the LGN).
126
A condition in which a person has difficulty distinguishing certain colors, usually due to absence or malfunction of one or more cone photopigments.
color vision deficiency
127
A condition in which a person has difficulty distinguishing certain colors, usually due to absence or malfunction of one or more cone photopigments.
color vision deficiency
127
What type of lesion does the swinging flashlight test help localize?
Lesions in the afferent pathway of the visual system (retina, optic nerve, not beyond the LGN).
127
red deficiency
Protanopia/protanomaly
128
What is the inheritance pattern of most congenital red-green color vision deficiencies?
X-linked recessive
129
What is the most common mode of inheritance for protanopia and deuteranopia?
X-linked recessive
130
What is the inheritance pattern of most congenital red-green color vision deficiencies?
X-linked recessive
Optometry Review 2025
flashcards
Decks in class (37)
# Cards
-
Theoretical Optics374
-
Primary Eye Care and Refraction511
-
Ocular Disease352
-
Binocular Vision198
-
Contact Lens418
-
General and Ocular Anatomy283
-
Ocular and General Pharmacology458
-
Pediatric Optometry87
-
Low Vision161
-
Ophthalmic Optics354
-
Theoretical Optometry47
-
Sports Vision82
-
Ethics, Jurisprudence, and Public Health305
-
Physiological Optics505
-
Nurition Of The Eye56
-
Preliminary Tests144
-
Phorometric Tests50
-
MCQs— Ocular Disease & Emergencies500
-
MCQs — Binocular Vision and Pediatrics239
-
MCQs — Theoretical Optics230
-
MCQs — Ocular Pharmacology542
-
MCQs — Contact Lens500
-
MCQs — General Pharmacology386
-
MCQs — Ocular Pharmacology II506
-
MCQs — Nutrition of the Eye61
-
MCQs — Low Vision229
-
MCQs — Contact Lens II258
-
MCQs - Physiological Optics502
-
MCQ - General Anatomy455
-
MCQ’s Ocular pharma W/ therapeutics368
-
MCQs OCULAR PHARMACOLOGY III90
-
MCQ- ETHICS144
-
MCQs - Ocular Anatomy449
-
MCQs - Ocular Disease II457
-
MCQ - Primary Eye Care and Refraction181
-
MCQs — Ophthalmic and Mechanical Optics174
-
Kahoot Queations (Prelim)1
