Case Studies in Ophthalmology
Cases for the Ophthalmology Clerkship
Note to Medical Students on the Ophthalmology Rotation at the University of Iowa:
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Return the printed copy with your answers to Michelle Snyder or Dr. Kemp via campus mail (11290 PFP) or scan as a pdf and email to Michelle at michelle-r-snyder@uiowa.edu or Dr. Kemp at pavlina-kemp@uiowa.edu.
Case #24 Phoropter
History
A 20-year-old student comes to your office because he was just playing basketball at the field house and was hit in the face with a ball. His glasses were shattered and he now has a swollen eye lid. His visual acuity without his glasses is 20/100.
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Question #1
What tests could you perform with the phoropter in order to tell whether his vision was reduced due to an uncorrected refractive error?
Question #2
Does the size of the pin hole in the phoropter or with the hand held occluders make any difference?
Question #3
In what situations would the visual acuity with the pin hole be the same or worse?
Question #4
During a refraction, does the distance of the patient’s eyes from the phoropter make a difference in your findings?
Question #5
If both of your auxillary lens dials are set on OC, what will the patient report that they see?
Question #6
Is a phoropter the only instrument that can be used for a refraction?
Question #7
What other examination(s) should be done at this time?
References
Rubin, ML: Optics for Clinicians, ed 2, Gainsville, Fl, Triad Scientific Publishers, 1974.
Duane TA (ed): Clinical Ophthalmology, Vol (1), Chpt 37, 1987.
Michaels, DD: Visual Optics and Refraction: A Clinical Approach, St Louis, CV Mosby, 1980.