COA study

patanol, pataday, allaway, bepreve, lastacaft

introduced b/c of significant side effects of topical corticosteroids- acular (ketorolac), nevanac (nepafanac), Bromday (bromfenac)

ratio of the speed of light in a vacuum to its speed in a specific substance

the point somewhere along the principal axis of a lens at which the pariaxial rays converge or diverge

the distance between the focal point and the lens

the unit of measure of the power of a lens

converges, diverges

the normal refractive state of the eye in which light rays from distant objects are focused clearly on the retinal by relaxed lens without any accomidation

abnormal refractive state of eye, in which light rays from distant objects cannot be focused clearly on retina due to refractive error

refracts light rays toward its base

refractometry and clear judgement

+ convex

to correct diplopia caused by visual misalignments

• cosopt-dorzolamide/timolol
• combigan-brimonidine/timolol
• duotrav-travaprost/timolol
• 1/2 of glauc pts require more than one type of medication to lower pressure

• antibiotics, antivirals, antifungals
• -antibiotics kill/inhibit bacterial growth
• bacitracin ung, tobramycin gtts/ung (tobrex),
• mycin ung, azithromycin (azasite), gentamycin, sulfonamide

ciprofloxacin(ciloxan), ofloxacin(ocuflox), levofloxacin(quixin, iquix), gatifloxacin(zymar, zymaxid), moxifloxacin(vigamox), besifloxacin(besivance)

• poly-trim or trimethoprim-polymyxinB
• maxitrol polymyxinB-dexamethasone-neomycin
• tobramycin-dexamethasone or tobradex

inhibit the ability of virus to reproduce- used to treat herpes simplex/zoster virus

kill fungi and used to treat a variety of external ocular fungal injections-natamycin, ketoconazole, voriconozole

Chief use to reduce inflammation and treat allergic reactions.prednisolone acetate(PF, M, Omnipred)fluorometholone(FML, Fluor-op, FML forte)loteprednol etabonate(Alrex, Lotemax)difluprednate(Durezol)

• constrict superficial blood vessels in the conj but do nothing to treat the cause of redness
• visine, murine, Ak-nefrin, clear eyes

topical, inj, oral

solutions, suspensions, ung/gtts, inserts

tearing, redness, pain

drugs that paralyze iris sphincter and dilate pupil

dilate pupil

decrease IOP by drawing fluid out of aqueous and vit humors by mechanism of osmosis (the creation of fluid force across permeable membrane)  Oral:glycerin(osmoglyn) or inj:mannitol(osmitrol) in case of acute angle closure and during intraocular sx

a single evening effective in lowering IOP, also side effects include eyelash growth, hyperemia, pigment change

decrease the rate of aqueous humor production and can be used alone or in combo with other gtts but may cause itching red eyes, UL elevation, mildly dilated pupils.  brimonidine .2% .15% .1% (alphagan)

decrease formation and secretion of aqueous humor, may cause tingling of the extremeties, appetite loss, metallic taste, kidney stones. Azopt, trusopt, oral Diamox, neptazane

• infrequently used in US
• increases aqueous flow
• used to use epinephrine but now only dipivefrin is rx'd

• decrease aqueous production
• often rx as adjunct to or in combo with prostaglandins.
• potential to decrease heart rate-avoid in pt with obstructive lung disease: timolol, betaxolol, levobunolol, carteolol, metipranolol

cause iris sphincter to contract constricting pupil and opening of trab mesh drainage system- pilocarpine

sphero-cylindrical

process of measuring one's refractive error and determining the optical correction required to provide clear vision.

outward(abduction) temporal

downward (secondary excyclotorsion)

inward (nasal) adduction

upward (secondary inclyclotorsion)

up+out (excyclotorsion)

down+in (incyclotorsion)

2.5x

eyelids, orbit, muscles, lacrimal apparatus

abberometry

taper, cutting, reverse-cutting, spatula

• versions-observing with ou open
• ductions-occluding one eye and observing uncovered and vice versa

when basic assessment reveals deficiency or oph condition

inferonasal

90* temporal, 60* nasal, inferior, superior

• area of reduced sensitivity-shallow:mild defect
• deep-serious defect
• absolute-could not elicit response from the largest, brightest target available on particular machine

ability to discern visual detail

misalignments have different degrees of deviation in different fields of gaze

can reveal whether a pts below normal va is result of refractive error or is due to another cause

curvature of lens can change becoming rounder to focus images of objects that are closer to the eye

2-4 years

tearing, redness, pain

bacteria, fungi, viruses

an antibiotic used to treat bacterial infections

• Optic nerves merge at optic chiasm
• Axon fibers from N retina cross opposite sides while T retina axons cont on respective sides
• Realigned axons emerge from chiasm as LR optic tracts ending@LR lateral geniculate bodies
• Axons connect to optic radiations which travel to RL halves of visual cortex of brain

bacteria, protozoa, fungi, viruses

to prevent the spread of infection to staff and pt

handwashing, gloves, gown, special recepticles, sterilization of objects in contact between pts, disposing of materials with bodily fluids

• sterilization-destroys all microorganisms
• disinfection-inactivates or eliminates most microorganisms

• right and up
• right
• right and down
• left and up
• left
• left and down

to measure deviation of eye misalignment

for APD

cones

insulin, thyroid hormone, estrogen, testosterone

separation of sensory and pigment layers of retina

infection of vitreous and adjacent tissues

tumor, stroke, trauma, inflammation

central k thins causing cone shaped k affecting vision

• less severe symptoms
• dense k opacity
• dendritic appearance

moist heat & ethylene oxide gas

to reveal both existing and potential problems even in the absence of specific symptoms

CC, HPI, ocular hx, general med/social hx, family ocular/med hx, allergy meds vits or supplements

cat, trauma, high refractive error, k scarring, AMD, glauc, onchocerciasis, BDR, congenital ROP

<20/60 and = or better than 20/40 in better eye

• inflammation and microscopic nodules (granulomas) that affect almost all systems in the body
• *commonly causes uveitis

both eyes simultaneously move in the same direction

both eyes simultaneously move in opposite directions

observing movements of ou together

• lens thickness
• sph pwr
• k readings
• diameter/bc
• material
• water content
• tint
• wearing sched

• cleaning-removes protein, deposits, debris that blur/irritate eye
• disinfection-prevents bacterial, viral, fungal growth on lens

heat, chemical

up and out

down and in

edema, ulcer, abrasion, vascularization, keratitis, infection

warping is a semi-permanent change in k curvature caused by improper fit, usually due to RGP

irritation, fogging, redness, tearing, decreased wearing time, blurry va

chronic autoimmune disease that interferes with proper nerve transmission in skeletal muscles

CMV, herpes zoster, Kaposi sarcoma

rubella retinitis

optic neuritis (inflammation of the optic nerve)

describes substances that permit passage of light s significant disruption

in front of the retina

has a power of 2.00 D

+3.00-2.00x180

retinoscopy-finding the lens power that affects the movement of retina reflex filling pupil with light (objective refraction)

focusing the eyepiece

mydriatics and cycloplegics

reduce IOP by contraction ciliary body muscle, opening outflow channels for aqueous

neomycin, sulfonamides, bactrim

mydriatic

beta blockers

infection caused by contaminated metal fragment penetrating eye

person to person thru close personal contact

one reservoir to many people ie: contaminated gtts

caused by organism that transmits pathogen to hose ie: trachoma via flies

used to measure deviation in misaligned eye

powers the lateral rectus muscle

a k light reflex used for strabismus detection

• levator palpebral
• inferior oblique
• medial rectus
• superior rectus
• inferior rectus
• LP, IO, IR, MR, SR

laser or special light beams to project parallel lines onto macula

target of given size in VF+gradually increasing brightness until pt sees

from the center of one pupil to the center of the other

center to the bridge of each then add results

fitting top of bifocal segment level with lower lid margin

< 20/60 ou

oxygen only thru tear pump

rhomboid shaped used in k and sclera where plane of penetration must be precise

steepens the k

treat- early KCN, low myopia and ectasia post lasik sx

production of spherical abberations

bowman's layer

dx

80%

hruby

koeppe lens

central 3.3 mm of k in 2 meridians

determine va potential in pts with cataracts

mixture of 1-10 dilution of bleach to water for 5 min

• oil-prevents evaporation of moisture from aqueous layer
• aqueous-provides moisture, oxygen, and nutrients to k
• mucin-inner promotes even spread of tear film

cone shaped on round shaft used for soft tissues

triangular cutting edge (common)

2 side cutting edges +bottom sutting edge for resistant tissue

pt to wear light polarizing spectacles

Hirschberg- to detect strabismus

• single evening dose very effective in lowering IOP
• lash growth, hyperemia, increased iris pigmentation and lid skin
• (lumigan, travatan, xalatan)

rods+cones receive light rays that generate electric nerve impulses that are transferred to brain where visual images are converted to sensation of sight

A therapeutic drug used in intravitrial inj that targets vascular endo growth factor.  Acts by diminishing the stimulus for abnormal new vessel growth (angiogenesis) a known cause for wet amd

• inflammatory           
• ischemic
• metabolic                 
• infectious
• traumatic                 
• congenital
• allergic
• degenerative
• neoplastic
• developmental

• anterior chamber angle
• trab mesh
• canal of schlemm

• scl- diffuse oxygen and c dioxide thru material w min tear pump
• PPMA-deliver oxygen only by pumping tear under lens
• RGP- provide oxy and cd diffusion thru lens material and tear pump

• allow oxygen
• promote flushing waste
• sustain integrity of epithelium
• normal k temp

• pigment dispersion
• pupillary block
• cataract

• -low degrees of hyperopia
• -monovision, induction of myopia in ND eye of one with emmetropic presbyopia

• pupil centration
• size under various lighting

• eliminates accommodation
• exact refraction

the point somewhere along the principal axis of a lens at which the paraxial rays converge and diverge

25

germicide

2.5x

flap is too thin

2 years

eye infx caused by Chlamydia Trachomatis and transmitted by flies

key components- hx, exam, med decision making

has disfigured eyes

40cm

observing versions

to protect intraocular contents

to produce and secrete aqueous humor

supply blood and nourish outer retina layers

• shock absorber
• maintain spherical shape of globe

• rods-dimly lit vision (night) +peripheral
• cones-sharp central vision and color perception

increased orbital volume resulting in protrusion of eyeballs

produce/drain tears

lacrimal gland produces tears that are then collected by the lacrimal sac draining into the nasal cavity by way of the nasolacrimal duct

outer skin, middle fibrous muscle layer, inner conj

evaluates diplopia, visual function, particularly in infants and children, as well as muscle disorders

• keratometry
• sph power
• diameter
• bc
• thickness
• material
• wearing sched

glare

• superior rectus
• inferior rectus
• medial rectus
• inferior oblique

lateral rectus

reflex light testing can be confounded by deformed pupils or abnormal retinal architecture

• circles off center
• radial meridians

ranibizumab

• no peripheral va but good cva
• no cva but good peripheral va
• less than 20/200 va
• only portions of VF perceived
• LP only
• NLP
• fluctuations in vision

• acid
• organic solvent
• alkali

contracting the ciliary body and opening outflow channels for aqueous humor

• vision testing in pt with media opacities
• testing for k structure/disease
• photog ext and fundus
• ultrasonography

about 15* off center on the 0* or 180* horizontal meridian in the temporal field

a contour of the vf obtained with a single target of particular size and brightness representing a line of = or better sensitivity to stimulus

dilate: fibers of dilator muscle extending from pupil to boundary of iris contract to dilate pupil

constrict: sphincter muscle contracts and makes pupil smaller

• inflammatory and autoimmune
• infetions
• metabolic
• vascular
• malignant

fine depth perception and qualify it in terms of binocular cooperation

to determine whether the eyes are aligned and if so, whether brain acknowledges visual info from ou or suppresses info from one eye, test reveals diplopia 

chronic autoimmune disease that interferes with proper nerve transmission in skeletal muscles causing muscle weakness

often ptosis, diplopia and limited eye movements are reported

medical necessity

ratio of the speed of light in a vacuum to its speed in a specific substance

absorbable-collagen, surgical gut, polyglactin 910

non absorbable-silk, nylon, polypropylene, polyester

• occupational requirements
• cosmetic/recreational needs
• cl intolerance
• unsafe in an emergency without glasses

lasik-flap, stromal, laser tx

prk-bowman's membrane ablated

• # new/established pts
• # pt per hr per dr
• # visits per tx room per hr
• # wk ups per asst
• revenue generated per pt visit
• annual revenue per full time equivalent staff
• annual revenue per full time equivalent tech

10

cleansing operative site with germicidal solution

• sterile table/trays containing instruments
• portions of pt that have been prepped/draped
• portions of surg personnel that have been cleansed and gloved

provide clean operating field and sterile area personnel may rest hands and instruments on

reduce microorganisms that come in contact with wound, minimizing infection risk

7%

clot of cholesterol, blood cells or calcium

• cytomegalovirus
• herpes zoster

mucopurulent discharge

watery discharge, palpebral conj is covered with small bumps

light reflects off of object focused by k and lens to produce upside down image on retina which then convers image to electric impulses carried by optic nerve to brain's visual cortex producing sensation of sight

• protect
• exclude light
• lubricate

eye misalignments constant in all fields of gaze

grossly swollen lids, redness

eye penetrated by metal fragment

big black or grey screen stare at central point target in from different points

+3.00D

"lol"

sign-objective (seen by doctor)

symptom- subjective (experienced by pt)

informed consent

try getting head below the heart

• allergy
• des
• ptery
• nervous/emotional temperment
• poor blinking

• uncontrolled oc surface or other eye disease
• immunosuppression
• autoimmune diseases that alter healing
• corneal ectasias
• cl induced warpage

ocularist

subspecialist

cot

evaluates double vision

Joint Commission on Allied Health Personnel in Ophthalmology

inward toward the nose

palpebral conjunctiva

iris, ciliary body, choroid

anterior chamber angle, through trabecular meshwork, to canal of Schlemm

a sign

esophoria

carbon dioxide

myasthenia gravis

25

type 2

optic neuritis

thyroid eye disease

transparent

2.00 D

add

+300 –200 × 180

finding the lens power that affects movement of the retinal reflex and fills the pupil with light

subcutaneous

mydriatics and cycloplegics

contracting the ciliary body muscle and opening the outflow channels for aqueous humor

• neomycin
• sulfonamides
• -------------nystatin
• bacitracin

a mydriatic

beta adrenergic blockers