EASY POINTS

Visual acuity, gross examination, extraocular muscle movements, palpation tonometry, and funduscopy

What are the five steps of the basic eye examination?

Baseline visual acuity

What must always be evaluated first before performing any manipulation on a patient's eye?

Ocular chemical burn

What is the single exception where baseline visual acuity examination is deferred in favor of immediate treatment?

Palm of the patient's hand

What should be used to cover the eye not being examined during a visual acuity test?

20 feet or 6 meters

What is the standard testing distance for a distance visual acuity examination using a Snellen chart?

More than 50%

What percentage of letters on a Snellen chart line must a patient read correctly to be credited with that line's visual acuity?

Right eye (OD), left eye (OS), both eyes (OU)

What is the standard recording order for visual acuity testing?

Retake visual acuity using a pinhole

What is the immediate next step when a patient's uncorrected distance visual acuity is less than 20/20?

Uncorrected, corrected, then corrected with pinhole

What is the proper sequence of visual acuity examination for a patient who wears corrective eyeglasses?

Test distance in feet

What does the first number (numerator) represent in a Snellen visual acuity fraction?

Distance from which a normal eye can read that line

What does the second number (denominator) represent in a Snellen visual acuity fraction?

200

If a patient cannot see the largest letter at 20 feet and is moved closer until only the largest letter is visible, what is always the denominator?

Landolt C chart, Tumbling E chart, or chart using shapes

What visual acuity charts can be used for illiterate patients or young children?

Counting fingers test at 2 feet

What is the first step performed when examining a patient who cannot see the largest Snellen letter even when brought near?

6 inches

At what distance is the counting fingers test repeated if the patient cannot count fingers at 2 feet?

Moving hand test

What test is performed next if a patient cannot count fingers at 6 inches away?

Light projection test in all four quadrants

What test evaluates if a patient can determine the direction or quadrant from which light originates?

Light perception test

What test evaluates if a patient can only tell whether light is present or absent in a dark room?

Negative light perception

What finding indicates total loss of vision and represents a very end-stage ocular condition?

40 years old (or 35 years old and older)

In what age group is near visual acuity routinely tested?

Jaeger notation (J1+ to J16)

What clinical notation system ranging from J1+ to J16 is used to record near visual acuity?

J1+

What is the Jaeger notation value representing the finest, sharpest near visual acuity?

14 inches

At what standard distance is the Jaeger near visual acuity chart held from the patient's eye?

White and anicteric

What is the normal physical appearance of the sclera?

Pink

What is the normal physical appearance of the conjunctiva?

Clear

What is the normal physical appearance of the cornea?

Brisk, sluggish, or non-reactive

How is the pupillary light reflex qualitatively described?

Evert or flip the upper lid

How does an examiner inspect the palpebral conjunctiva of the upper eyelid?

Shape of a capital "H"

In what geometric pattern is the target moved during the extraocular muscle examination?

Midline

Which direction of gaze is NOT tested during the extraocular muscle examination?

Arrowheads

What symbol is used to record extraocular muscle movements for the right eye (OD)?

Circles

What symbol is used to record extraocular muscle movements for the left eye (OS)?

Suspected globe rupture

In what condition must palpation tonometry be strictly deferred?

Look down without closing the eyes

How should the patient be instructed to position their gaze during palpation tonometry?

Soft

What is the normal physical finding on palpation tonometry?

15 inches away and 15 degrees lateral

From what distance and angle does the examiner initially look toward the pupil during funduscopy?

Red-orange reflex (ROR)

What normal reflex is observed when directing the light beam of an ophthalmoscope into the pupil?

Examiner's right eye inspects patient's right eye, and examiner's left eye inspects patient's left eye

What is the rule of eye alignment between examiner and patient during funduscopy?

2 inches

At what distance from the patient's eye does the optic disc normally come into view during funduscopy?

Plus or green-numbered lenses

Which ophthalmoscope lenses are required to clearly focus the fundus in a hyperopic (farsighted) eye?

Minus or red-numbered lenses

Which ophthalmoscope lenses are required to clearly focus the fundus in a myopic (nearsighted) eye?

Superior retina

Which retinal region is examined when the patient is asked to look up?

Inferior retina

Which retinal region is examined when the patient is asked to look down?

Temporal retina

Which retinal region is examined when the patient is asked to look temporally?

Nasal retina

Which retinal region is examined when the patient is asked to look nasally?

Cross-linear polarizing filter

Which ophthalmoscope component reduces corneal light reflection by 99%?

Two disc diameters temporally

Where is the macula located relative to the optic disc during funduscopy?

Red-free filter

Which ophthalmoscope filter facilitates visualization of the center of the macula and retinal blood vessels?

0.2 to 0.5

What is the normal cup-to-disc ratio on optic nerve examination?

2:3

What is the normal arteriovenous (AV) caliber ratio in the retina?

Oculus Dexter (OD)

What is the medical abbreviation and Latin term for the right eye?

Oculus Sinister (OS)

What is the medical abbreviation and Latin term for the left eye?

Oculus Uterque (OU)

What is the medical abbreviation and Latin term for both eyes?

Patient's own words

In what phrasing should a patient's chief complaint always be recorded?

Blurring of vision

What is the single most common visual complaint presented by patients?

Metamorphopsia

What visual complaint describes distortion where straight lines appear wavy or curved?

Micropsia

What visual alteration causes objects to appear smaller than they actually are?

Macropsia

What visual alteration causes objects to appear larger than they actually are?

Monocular diplopia

What type of double vision persists even when one eye is covered, usually indicating an ocular or central lens issue?

Binocular diplopia

What type of double vision resolves when either eye is covered, indicating ocular misalignment?

Floaters

What visual complaint describes seeing specks, strands, or cobwebs moving across the field of vision?

Photopsia

What visual complaint describes seeing flashes of light?

Iridescent vision

What visual complaint describes seeing halos or rainbow-colored rings around light sources?

Foreign body sensation

What ocular discomfort is described by patients as feeling like sand or grit in the eye?

Photophobia

What ocular symptom describes pain or discomfort when exposed to bright lights?

Ptosis

What medical term describes drooping of the upper eyelid?

Proptosis

What medical term describes abnormal bulging or protrusion of the eyeball?

Esotropia

What medical term describes inward deviation or misalignment of the eye ("duling")?

Exotropia

What medical term describes outward deviation or misalignment of the eye ("banlag")?

Anisocoria

What medical term describes unequal pupil sizes between the two eyes?

DOH Administrative Order No. 2009-0011

Which Department of Health Administrative Order governs official clinical criteria for visual disability PWD ID qualification in the Philippines?

Vision of 6/18 or worse in the better-seeing eye

What is the visual acuity threshold required under the first criterion of DOH AO-2009-0011 for PWD card qualification?

Field of vision less than 10 degrees wide in the better-seeing eye

What is the visual field threshold required under the second criterion of DOH AO-2009-0011 for PWD card qualification?

Uncorrectable by eyeglasses, medication, or surgery

What mandatory third criterion must always be satisfied alongside visual acuity or visual field restrictions to qualify for a PWD card?

Republic Act No. 7277

Which 1992 legislation, known as the Magna Carta for Disabled Persons, promotes rehabilitation, self-reliance, and integration of PWDs?

Republic Act No. 9442

Which 2007 law amended RA 7277 to grant PWDs a 20% discount on medicines, goods, and services?

Republic Act No. 10754

Which 2016 legislation expanded PWD benefits by granting VAT exemptions and educational assistance?

20%

What minimum percentage discount is granted to PWDs for medicines, goods, and services under RA 9442 and RA 10754?

Better-seeing eye

Which eye's visual acuity or visual field is evaluated when determining PWD card qualification under DOH AO-2009-0011?

2.2 billion

How many people globally are estimated by the WHO to have visual impairment?

2 million

How many Filipinos were estimated in the 2018 local study to have visual impairment from uncorrected refractive error, glaucoma, and maculopathy?

Over 4 million

How many Filipinos were estimated in 2018 to have undiagnosed eye problems?

Reflection

What physical phenomenon occurs when light rays bounce off a surface and return into the same medium?

Angle of incidence equals angle of reflection

What is the second law of reflection regarding angles?

Specular reflection

What type of reflection occurs on a smooth polished surface where reflected rays travel parallel to each other?

Diffuse reflection (or irregular reflection)

What type of reflection occurs on an irregular surface causing light rays to scatter in different directions?

Total Internal Reflection (TIR)

What optical phenomenon occurs when light traveling from a denser to a less dense medium strikes the boundary at an angle greater than the critical angle?

Fiber optics

Which optical technology relies on total internal reflection to transmit light through flexible cables?

Refraction

What physical term describes the change in direction of light as it passes from one transparent medium to another?

Towards the normal

In which direction does light bend when passing from a medium of lower refractive index into a medium of higher refractive index?

Refractive index (n)

What measure equals the ratio of the velocity of light in a vacuum (c) to the velocity of light in a medium (v)?

1.00

What is the index of refraction of air?

1.33

What is the index of refraction of water, aqueous humor, and vitreous humor?

1.3375

What is the index of refraction of the cornea?

1.42

What is the index of refraction of the human crystalline lens?

1.52

What is the index of refraction of glass and silicone oil used in retinal surgery?

Snell's Law

Which physical law states that light entering a medium of higher refractive index travels slower and bends toward the normal?

Air-tear interface

At which anatomical boundary in the eye does the greatest bending of light rays occur?

Diopter (D)

What unit of optical power equals the reciprocal of the focal length expressed in meters (1/f)?

1 meter or 100 centimeters

What is the focal length of a 1 Diopter lens?