NBEO Part II flashcards

33 cards. Read the term and the definition here. The deck at the top of this page is optional.

Amaurosis fugax

Transient monocular vision loss lasting seconds to minutes, often described as a curtain descending; suggests ipsilateral carotid or cardiac embolic source and warrants urgent vascular workup.

Hutchinson sign

Vesicles on the tip or side of the nose in herpes zoster ophthalmicus, indicating involvement of the nasociliary branch and higher risk of ocular disease.

Spherical equivalent

The sum of the sphere power plus half the cylinder power; used to estimate the spherical component of a spherocylindrical prescription for contact lens conversion.

Duochrome test

A red-green balance test at the end of refraction; if the red target is clearer the patient is under-minused, and if green is clearer the patient is over-minused.

AC/A ratio

The change in accommodative convergence per diopter of accommodation; calculated as IPD in centimeters plus the difference between near and distance phoria divided by accommodative demand.

Cherry-red spot

A red macula surrounded by pale retina seen in central retinal artery occlusion; the fovea remains red because it is thin and receives choroidal circulation.

Shafer sign

Pigment cells in the anterior vitreous, sometimes called tobacco dust, suggesting a retinal tear or detachment and prompting urgent dilated fundus examination.

Relative afferent pupillary defect

A pupillary defect detected with the swinging flashlight test, indicating asymmetric optic nerve or extensive retinal disease; the affected pupil dilates when light swings to it.

Papilledema

Bilateral optic disc edema from elevated intracranial pressure; early findings include blurred disc margins, venous engorgement, and an enlarged blind spot with spared central vision.

Horner syndrome

A triad of ptosis, miosis, and anhidrosis caused by sympathetic pathway disruption; postganglionic lesions typically spare facial sweating.

4-2-1 rule

A grading rule for severe nonproliferative diabetic retinopathy: hemorrhages in all four quadrants, venous beading in two or more, or IRMA in one or more quadrants.

Shaffer grading

A gonioscopy grading system for the anterior chamber angle, from grade 0 (closed) to grade 4 (wide open, 35 degrees or more).

Nasal step

An early glaucomatous visual field defect at the nasal horizontal meridian, reflecting damage to retinal nerve fiber bundles entering the optic disc.

Target intraocular pressure

An individualized IOP goal, often a 20 to 30 percent reduction from baseline for mild glaucoma, set to slow progression of optic nerve damage.

Giant cell arteritis

A large-vessel vasculitis in patients over 50 causing headache, jaw claudication, and elevated ESR/CRP; can cause anterior ischemic optic neuropathy and requires immediate high-dose corticosteroids.

Argyll Robertson pupil

A pupil that constricts with accommodation but not to light, classically associated with neurosyphilis; the lesion is in the midbrain.

Thyroid eye disease

An autoimmune orbitopathy causing lid retraction, proptosis, and restrictive strabismus, most often involving the inferior rectus; optic neuropathy is a vision-threatening complication.

Prostaglandin analogs

First-line glaucoma drops such as latanoprost that lower IOP by increasing uveoscleral outflow; side effects include iris darkening and eyelash lengthening.

Timolol contraindications

Topical beta-blockers are avoided in asthma, COPD, and heart block because systemic absorption can cause bronchospasm and bradycardia.

Acetazolamide risks

Oral carbonic anhydrase inhibitors can cause hypokalemia, paresthesias, metabolic acidosis, and kidney stones; monitor electrolytes with chronic use.

Pilocarpine effects

A miotic that increases trabecular outflow and causes brow ache and miosis; can precipitate angle closure in eyes with a shallow anterior chamber.

Dk/t

Oxygen transmissibility of a contact lens, equal to oxygen permeability divided by lens thickness; higher values reduce corneal hypoxia during wear.

Giant papillary conjunctivitis

An inflammatory reaction to contact lens wear with itching, mucus, and papillae on the upper tarsal conjunctiva; treated by lens discontinuation and mast cell stabilizers.

Keratoconus fitting

Rigid gas permeable lenses are fitted with apical clearance or a three-point touch pattern; monitor for corneal thinning, scarring, and progression.

Leukocoria

A white pupillary reflex in a child; the differential includes retinoblastoma, congenital cataract, Coats disease, persistent fetal vasculature, and toxocariasis.

Amblyopia treatment

Patching or atropine penalization of the better eye; the critical period ends around age 8 to 10, but older children may still benefit.

Low vision magnification

Magnification equals the dioptric power of the magnifier divided by 4; required magnification equals desired acuity divided by current acuity.

Endophthalmitis

An intraocular infection after surgery or trauma causing pain, decreased vision, and hypopyon; requires emergent intravitreal antibiotics and ophthalmology referral.

Chemical burn irrigation

Immediate irrigation with saline for at least 30 minutes, checking pH until neutral; alkali injuries are more severe because they penetrate tissue.

SBAR communication

A structured handoff format: Situation, Background, Assessment, Recommendation; used for referrals and urgent calls to other clinicians.

HIPAA minimum necessary

The principle that protected health information disclosed for treatment, payment, or operations should be limited to the minimum needed for the purpose.

Informed consent

A documented discussion of the risks, benefits, and alternatives of a procedure, plus the patient's questions and agreement, required before treatment.

Mandatory reporting

Legal obligations to report suspected child abuse, certain communicable diseases, and in some states impaired drivers, regardless of patient objection.