Case history Flashcards
What are the main components of a case history?
Chief complaint and history of presenting illness
Additional History
Ocular history and visual demands
Medical history
Social history
What are the 4 types of exams?
Comprehensive
Consultations/referrals
Emergency
Follow up
What is important to maintain during case history?
Be conversational
Eye contact
When during the exam should case history occur?
Continue throughout the exam
How is a spectacle Rx written?
Sph followed by Cyl
Signs
3 digits
X for axis (no degree sign)
Amount of prisms and direction of base
What are some specifications that can be made regarding spectacles?
BC (base curve)
Material
Coatings
Tints
Multi focal vs single vision
High Rxs (vertex distance)
What are some factors to consider when prescribing spectacles?
Who is your patient (organized, careless with glasses, sensitive)
Where and how do they use their spectacles
Refractive error
What are the rules for prescribing lenses?
Rules can be broken
Listen to your patient
Trial frame
Rarely reduce minus at distance or plus at near
Never modify cyl without considering sph
Tell al patients that they may need time to adjust to new glasses
Add is not limited to +2.50
Patient’s last doctor may be wiser then you think
What is important to understand regarding your patient before prescribing glasses?
Understand the patient’s visual needs
Consider to effect of new glasses on those needs
When a patient needs changes of a diopter or greater how should the physician approach this?
Change in stages
Explain to the patient
Do not give it all at once
With high refractive errors what should we be careful about changing?
Lens types
What is the limitation of max plus to BCVA refractions?
Patients will not accept more (+) at distance than is
consistent with good VA
