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Ophthalmology Viva Exam Questions with 100% Correct Answers
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Ophthalmology Viva Exam Questions with 100% Correct Answers What precautions would you normally take before dilating a patient prior to indirect ophthalmoscopy? (10 things) - 1. IOP 2. Examine the anterior chamber (van herricks grade 2 or less at risk so that's a ratio of 1: <.5 3. Check t...

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  • October 22, 2024
  • 41
  • 2024/2025
  • Exam (elaborations)
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  • Ophthalmology Medical Assistant

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©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

Ophthalmology Viva Exam Questions

with 100% Correct Answers


What precautions would you normally take before dilating a patient prior to

indirect ophthalmoscopy? (10 things) - ✔✔1. IOP

2. Examine the anterior chamber (van herricks grade 2 or less at risk so

that's a ratio of 1: <.5

3. Check their visual acuity and pupil responses

4. 4d's: drug, dose, date, disposal

5. If the patient has had any prior adverse reactions to the drug

6. Marfan's Syndrome patients → could have a misaligned crystalline lens

7. Iris clipped intraocular lens

8. If patient is taking pilocarpine for glaucoma

9. For phenylepherine (sympathomimetic) it should also be noted that

patients on trycyclic antidepressants and MOA inhibitors could be at risk of

a rise in blood pressure if drug instilled, and take care with patients with

systemic hypertension

,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

10. Talk about the effects of the drugs and how long it will take to wear off

What would you do after assessing the eyes of a patient you have dilated?

(4) - ✔✔1. IOP (if difference over 5mmHg between pre and post or

between eyes, keep an eye on patient till pressure drops)

2. Measure openness of anterior chamber

3. Inform patient about signs of adverse reactions that may occur, what

precautions to take if they were to occur, and talk through what activities

patient should avoid. Also ask patient to bring large brimmed hat, and

sunglasses which will help with the photophobia.

Apart from patients who have extremely narrow angles, who else would

you not dilate and why? (6) - ✔✔1. If IOP higher than 21mmHg

2. Patients with iris clipped lens, as you could rip the iris and displace the

intraocular lens

3. Patients using pilocarpine for glaucoma (could be closing the trabecular

meshwork and causing increase in IOP in a patient with glaucoma)

4. Marfans syndrome patients with translated lens

5. Patients that may have had adverse reaction before

,©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

6. For phenylephrine - tricyclic antidepressants, MAO inhibitors (do not use

within 21 days of MAO inhibitor), and hypertension → sympathomimetic

could cause increase in blood pressure

What could you use to dilate a patient prior to examining them with and

indirect

ophthalmoscope technique? (4) - ✔✔1. Tropicamide (.5% or 1%) - 1% for

patients with darker iris, as pigment absorbs drug

2. Atropine - antimuscarinic

3. Phenylephrene (2.5% or 10%) (avoid 10% with young and elderly)

4. Combination of drugs - Tropicamide and phenylephrine (use lower

concentrations)

5. Which drug gives maximal dilation? - ✔✔If we were to use only one drug

it would be tropicamide 1%, as tropicamide works by acting as a

antimuscarinic. It acts as a competitive antagonist on muscarinic receptors

to acetylcholine inhibiting the miotic response of sphincter muscle,

therefore giving an unopposed action by the dilator muscle. But you can

achieve maximal dilation by using combination of tropicamide and

phenylephrene.

, ©JOSHCLAY 2024/2025. YEAR PUBLISHED 2024.

What could you do to speed up the dilation process? (5) - ✔✔1- Turn off

the lights

2- Use a higher concentration of drug

3- Combination of drugs

4- Use topical anesthetic

5- Press up against lacrimal sac so drops don't drain out with tears

What are the '4 Ds' with regard to the safe use of ophthalmic drugs? -

✔✔dosage

disposal

drug

date

Name the typical instruments used to examine the central 45 degrees of

retina (5)? - ✔✔Head mounted BIO

Slit lamp BIO

Indirect monocular

direct monocular

modified monocular

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