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Ophthalmology > Basic Diagnostic Methods > Flashcards

Basic Diagnostic Methods Flashcards

1
Q

List the process when examining ophthalmic cases

A
  1. History
  2. Physical exam (general)
  3. Ophthalmic exam
  4. Additional diagnostic techniques
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2
Q

What should you consider during the general physical exam in ophthalmic cases

A
  • Systemic diseases
  • Neurologic diseases

Both may be accompanied by ocular signs

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3
Q

What should be considered before performing the ophthalmic exam?

A

Restraint for examination

  • Manual restraint
  • Sedation

General anaesthesia is usually a drawback in the ophthalmic exam

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4
Q

Give the steps of the ophthalmic exam

A
  1. Examination of head, periocular area & globe
  2. Preliminary ocular exam
  3. Detailed physical exam of eye
  4. Additional diagnostic techniques
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5
Q

Ophthalmic exam: Examination of head & periocular area

A

Inspect & palpate in a light room

Normal:

  • Periocular area is symmetric, no gap, scar or inadequate movement of the bones.
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6
Q

Ophthalmic exam: Globe

A

Inspect & palpate in a light room

Normal:

  • Both globes are the same size & shape; symmetric, tightly undulating & painless
  • Optical axes of the globes meet on a demonstrative object.
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7
Q

Give the steps of the preliminary ocular exam

A
  1. PLR (Pupillary Light Reflex)
  2. STT (Schirmer Tear Test)
  3. Specimen collection
  4. Vision evaluation
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8
Q

Preliminary ocular exam: PLR (Pupillary light reflex)

A

Light → Constriction of the pupil

  • Inspect the speed & intensity
  • Normal: Symmetric reaction with equal intensity
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9
Q

Preliminary ocular exam: STT (Schirmer Tear Test)

A
  • Semiquantitative measurement of tear production
  • Indication: Dry-eye inflammation (KCS)
  • Test strip applied for 1 minute
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10
Q

Preliminary ocular exam: Interpretation of the Schirmer tear test

A

Normal = > 14 mm/min

Apparent disease = < 5 mm/min

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11
Q

Preliminary ocular exam: Specimen collection

A
  • Indication: Severe purulent inflammation; resistance to therapy; melting corneal ulcers; inflammation of the eyelids
  • Cytological or microbiological exam
  • Samples should be taken before any topical anaesthesia is applied
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12
Q

Preliminary ocular exam: Specimen collection may be from which locations?

A
  • Cornea
  • Conjunctiva
  • Corneoconjunctival region
  • Eyelid
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13
Q

Preliminary ocular exam: Steps of the vision evaluation

A
  1. Falling cotton test
  2. Obstacle test
  3. Menace reflex test
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14
Q

Summarise the falling cotton test

A

Nomal dx: The falling cotton is visually followed

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15
Q

Summarise the obstacle test

A

Normal dx: Negotiation of the obstacles is not impaired

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16
Q

Summarise the menace reflex test

A

Normal dx: The animal blinks and/or flinches when a threatening movement is given

17
Q

Detailed physical exam of the eye: How are these exams performed?

A
  • Under magnification
  • Focal light source
  • Darkened room
18
Q

Detailed physical exam of the eye: Structures examined

A
  1. Palpebral fissure
  2. Eyelids
  3. Third eyelid
  4. Conjunctiva
  5. Lacrimal system
  6. Cornea
  7. Sclera
  8. Anterior chamber
  9. Iris & pupil
  10. Lens
  11. Vitreous body
19
Q

Detailed physical exam of the eye: Palpebral fissure

A

Normal dx:

  • Symmetric and wide in the middle
  • Ø Discharge
20
Q

Detailed physical exam of the eye: Eyelids

A

Inspection & palpation

Normal dx:

  • Skin is thin, folded and moves freely
  • Margin of the lids is regular
  • The glandular opening is seen (grey line)
21
Q

Which species are lacking the lower ciliae (eyelash)

A
  • Cat
  • Horse
  • Cow
22
Q

Which species have multiple rows of upper ciliae?

A

Dog

23
Q

Detailed physical exam of the eye: Third eyelid

A

Inspection & palpation

Normal dx:

  • Fits the globe; only the free margin is visible at the medial canthus
  • Palpebral surface: Pink, moist, slightly vascularised
  • Bulbar surface: Fresh red, velvet-like, pale-pink follicles
24
Q

Detailed physical exam of the eye: Conjunctiva

A

Inspection & palpation

Normal dx:

  • Pale pink, gently folded, moistly shining
  • Barely any visible conjunctival vessels
  • Ventral fornix is hyperaemic w/ lymphoid follicles
25
Q

Detailed physical exam of the eye: Lacrimal system

A

Inspection of the lacrimal puncta (entry to the tearduct)

Normal dx:

  • Upper & lower puncta are 3mm from the medial canthus
26
Q

Detailed physical exam of the eye: Cornea

A

Inspection & ‘palpation’

​Normal dx:

  • Uniformly glistening
  • Completely transparent & avascular
  • Animal should blink when a wisp of cotton touches cornea
27
Q

Detailed physical exam of the eye: Sclera

A

Inspection only

Normal dx:

  • Only a small part can be examined
  • Smooth, whitish; no scar or gap
  • Pigmentation from the point of the limbus
28
Q

Detailed physical exam of the eye: Anterior chamber

A

Inspection only

Normal dx:

  • Depth varies between species
  • Aq. humor is completely transparent; Ø content
29
Q

Detailed physical exam of the eye: Abnormal contents of the anterior chamber

A
  • Hypopyon: Pus in the anterior chamber
  • Hyphema: Blood in the anterior chamber
30
Q

Detailed physical exam of the eye: Iris & pupil

A

Inspection only

Normal dx:

  • Centrally placed; gentle circular pattern
  • Herbivores may have corpora nigrum
31
Q

Shapes of the pupil across the species

A
  • Horizontal elliptical: Horse, cow & pig
  • Rounded: Dog
  • Perpendicular rhomboid: Cat
32
Q

Detailed physical exam of the eye: Lens

A

Inspection only

Normal dx:

  • Purkinje’s images formed on the anterior & posterior lens capsule
  • Ø Opacity in the lens
33
Q

Detailed physical exam of the eye: Vitreous body

A

Inspection only

Normal dx:

  • Vitreous is clear - Ø Opacity
34
Q

Give the vital staining methods

A
  1. Fluorescein
  2. Rose bengal
35
Q

Vital staining: Fluorescein

A
  • Water-soluble, hydrophilic; orange colour
  • Solution/impregnated strips
    • Strips ↓ chance of infection
  • Fluorescein stains the exposed stroma bright green
36
Q

Vital staining: Indication for fluorescein

A

Assessment of the corneal epithelium’s condition

  • Suspicion of corneal ulcer/injury
  • All cases when the eye is red/painful
  • Before topical/subconjunctival steroid therapy
37
Q

Vital staining: Rose Bengal

A
  • Water soluble, hydrophilic; red colour
  • Stains the degenerated, necrotic cells & mucus red
38
Q

Vital staining: Indication for Rose Bengal staining

A

Any suspicion of dry-eye inflammation

Early dx of KCS

Ophthalmology (9 decks)

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