Case 1 Flashcards
How do you properly control accommodation in ret?
make sure you blur the eye that you are not testing to the point you see an against movement, don’t just assume a WD lens is enough
In case 1, how do we know the patient is myopic?
-they have reduced uncorrected DV
-young do should have good accommodation
-they have normal near vision
In case 1, what is the most important information in the Hx?
-the RFV is reduced DV
-c/o of red eyes
-uses computer alot but has no issues
-is learning to drive soon
in case 1, why is FH age-related ocular disease less relevant
as it depends on the disease
in case 1, what are the unclear aspects about the Hx?
-dont know if the Px wore an eyepatch as a child - POH
-dont know if they ever used to wear glasses - POH
-wether they smoke as in wales if the patient is over 16 you have to ask
-if the red eye is actually due to swimming and not anything else
why learn barrett’s method of ret?
-allows ret to be done in shorter rooms
-makes it easier to be done if the examiner is amblyopic
what is one of the rare cases that monocular ret is used?
when the patient has a large angle strabismus
what are the advantages of binocular refraction?
-accommodation is balanced so relaxed until subjective refraction
-it is quicker than monocular refraction
-don’t need to occlude so no latent nystagmus gets induced
-requires patients to make less decisions which patients appreciate
what are the disadvantages of binocular refraction?
-it is difficult in patients with a highly dominant eye
-your starting point needs to be close to the final Rx
who is binocular refraction good for?
patients with active accommodation
who is binocular refraction not good for?
-patients without active accommodation (so >60s and pseudophakes)
-patients without binocular vision
what should you be careful of when doing binocular refraction?
strong eye dominance
what methods of binocular refraction are used?
-monocular fogging (method of choice)
-polaroid refraction procedure
-turville infinity balance
what is the legal requirement for a Px to have after a sight test, which act are these specified in?
-confirm completion of sight test
-whether a referral to medical practitioner has been made and why if applicable
-patient’s spectacle prescription
Opticians Act 1989
What should be included in the patient management plan?
-whether the patient is being referred to a different healthcare practitioner
-self management resources
-targeted health/ behaviour messages
-social prescribing referral if necessary
-minimum interval to next examination
