ADVANCED DIAGNOSTIC TECHNIQUES

Size: px

Start display at page:

Download "ADVANCED DIAGNOSTIC TECHNIQUES"

Alaina Chambers
5 years ago
Views:

1 DIVISION OF VISION SCIENCES SESSION: 2008/2009 DIET: 1ST ADVANCED DIAGNOSTIC TECHNIQUES VISP216 LEVEL:2 MODULE LEADER: DR GUNTER LOFFLER B.Sc/B.Sc. (HONS) OPTOMETRY MAY 2009 DURATION: 2 HOURS CANDIDATES SHOULD ATTEMPT FIVE QUESTIONS PLEASE READ THE QUESTIONS CAREFULLY Students for whom English is not their first language are permitted to use a Standard English/Foreign Language dictionary, e.g. French/English/English/French. Please ensure that the dictionary does not contain any notes or other materials and note that electronic dictionaries are not permissible MATERIALS TO Lined Examination Script Books BE SUPPLIED/ALLOWED: Unlined Examination Script Books Other Materials, e.g. Graph paper, statistical tables (please specify) Page 1 of 6

2 Page 2 of 6 This page is left blank intentionally

3 1. Provide a detailed explanation of the examination of the pupil reflexes in the following situations and discuss possible findings: a) Routine check on all patients in your practice. (5) b) A 50 year old male smoker with unequal pupil sizes. (8) c) A 20 year old female who notices she has unequal pupil sizes in her holiday photographs. (7) 2. Your practice has been selected to participate in a shared care scheme for glaucoma patients which would require an annual examination and report to the hospital. a) Detail how you would quantify the visual field results for use in serial analysis of patients on glaucoma medical therapy. (12) b) Describe briefly the other investigations or tests you would wish to include in your annual review of each patient. (8) 3. A patient you referred 6 months ago with suspected diabetic retinopathy has had the diagnosis confirmed and has undergone several session of laser phatocoagulation therapy and has had his driving licence revoked by DVLA pending visual field assessment. He has contacted your practice to have the visual field assessment carried out. a) Describe in detail the instrumentation and test protocol which DVLA require for this purpose. (14) b) What are the pass / fail criteria for this test? (6) Page 3 of 6

4 4. You are using the slit-lamp to investigate a patient s left eye. a) You are using direct illumination and a medium sized slit (about 1mm). The illumination is positioned at about 50 temporarily, the microscope in the straight position and the light strikes the cornea close to the temporal limbus (about 1mm inside the limbus). Sketch the image you would see with medium magnification. Label all ocular structures, which you would typically see. (5) b) What is this illumination technique called? (2) c) What is the main advantage of this technique? (3) d) You are using an optical section under direct illumination and are currently focused on a foreign body embedded in the central cornea (just outside the nasal margins of the small pupil). You now want to visualise the foreign body with retro illumination. Explain, with the aid of diagrams, all the steps involved, including all changes with respect to the position as well as settings of both the illumination and the observation systems. (10) 5. a) You want to perform indirect opththalmoscopy on a patient s right eye, using a 66D Volk lens and the slit lamp. Describe the steps required to focus on the patient s disc, including instructions to the patient, set-up of the slit-lamp and the use of the Volk lens. (5) b) You are now focused on the optic disc of this patient s right eye. Sketch an image of the disc as it appears to you through the slit-lamp. The disc is characterised (when using direct ophthalmoscopy) by the following features: C/D ratio: 0.5 Deep cup (2D) with lamina cribrosa visible. Disc shape: horizontal ellipse. Disc margins: well defined with pigmentation extending from 4 to 8 o clock. NRR (neuroretinal rim): follows ISNT rule. Splinter haemorrhage crossing the disc margin at 9 o clock. (7) c) What do you have to do to move from the disc to the patient s macula when using the Volk lens? (3) d) When your dilated patient is looking up and to his left, you notice a black lesion in his right eye that has the shape of the letter T as seen through the microscope. Sketch the fundus of a typical, normal right eye and add the above lesion, indicating its shape and approximate location. (5) Page 4 of 6

5 6. a) Using a diagram, explain the principle upon which a Scanning Laser Polarimeter measures the Retinal Nerve Fibre Layer. (5) b) What is physically being measured and how does this relate to the thickness of the retinal nerve fibre layer? (4) c) At which part of the retina is the thickness of the retinal nerve fibre layer measured with commercially available instruments? (2) d) Comparing the thickness in different quadrants relative to the central part of the measurement, where is a typical, normal retina thickest, and where is it thinnest? (4) e) Which ocular condition is primarily being investigated when performing Retinal Nerve Fibre Analysis? (2) f) Name 3 factors that can have a negative effect on the measurement. (3) END OF PAPER Page 5 of 6

6 Page 6 of 6 This page is left blank intentionally

PHYSIOLOGICAL OPTICS VISP325 MODULE LEADER: PROF A LOGVINENKO

PHYSIOLOGICAL OPTICS VISP325 MODULE LEADER: PROF A LOGVINENKO DIVISION OF VISION SCIENCES SESSION: 2007/2008 DIET: 1ST PHYSIOLOGICAL OPTICS VISP325 LEVEL: 3 B.Sc./B.Sc. (HONS) OPTOMETRY MODULE LEADER: PROF A LOGVINENKO MAY 2008 DURATION: 3 HOURS CANDIDATES SHOULD