Clinical Flashcards
What conditions is referral department medical retina for?
AMD; DR; vascular occlusion; syndromes/hereditary disorders
What conditions is referral department eye casualty for?
acute eye disease; trauma; post op complications
What conditions is referral department vitreo-retina for?
RD; tears; vitrectomy; macula hole; membranes; intraocular FB
What conditions is referral department corneal/ant segment/external for?
KCN; dystrophy; refractive surgery
What conditions is referral department paediatric for?
Squint assessment; paed eye disease; surgery
What conditions is referral department oculoplastic/adnexal for?
Lumps/bumps; trauma; eyelid malposition; surgery
What conditions is referral department adult ocular-motility/neuro-opthalmology/ocular oncology for?
Nerve palsy; squint surgery; stroke; tumour; ICP; trauma
What conditions is general A+E for?
control of vascular causes
What conditions is referral department general opthalmology/primary care for?
miscellaneous
What eligibility for SI?
VA 3/60- 6/60 with full VF
VA up to 6/24 with moderate contraction of VF
VA 6/18 or better with marked VF defect
What eligibility for SSI?
VA worse than 3/60 with full VF
VA 3/60-6/60 with contraction/severe reduction VF
VA better than 6/60 with clinically significant contracted field of vision
What are the different van Herick grades and risk of angle closure on dilation?
Grade 0 closed
Grade 1 <1/4 very likely
Grade 2 1/4-1/2 possible
Grade 3 1/2-1 unlikely
Grade 4 >=1 very unlikely
What is the MOLES scoring and grading and management?
To check if a naevus is a risky melanoma
M- mushroom shape (absent=0, unsure/early growth through RPE= 1, present=2)
O- orange pigment (absent=0, unsure/trace=1, confluent clumps=2)
L- large size (<3DD=0, 3-4DD=1, >4DD=2)
E- enlargement (none=0, unsure=1, definite=2)
S- subretinal fluid (absent=0, trace=1, definite= 2, assume SRF if unexplained visual loss)
Final score:
0= common naevus monitored with usual ST
1 = low risk naevus, refer non-urgently to HES
2= high risk naevus, refer non-urgently to HES
3= probable melanoma, refer urgently to HES
What are the layers of the retina?
in new generation it isn’t only ophthalmologists examining px retina
Inner limiting membrane
Nerve fibre layer
Ganglion cell layer
Inner plexiform layer
Inner nuclear layer
Outer plexiform layer
Outer nuclear layer
External limiting membrane
Photoreceptor layer
Retinal pigment epithelium
Bruch’s membrane
Choroid
When would you consider making a partial change to cylinder?
Axis change are less tolerated than cyl change so may set axis midway between current and optimal
cyl change is >0.75
axis change >30 for cyls up to 1DC, >15 for cyls 1-2DC, >7.5 for cyls over 2DC
What are the tentative adds for different ages?
45yrs = +1.00D
50yrs= +1.50D
55yrs= +2.00D
60YRS= +2.25D
What is LogMAR acuity for 6/12?
0.30
What is LogMAR acuity for 3/60?
1.30
What is LogMAR acuity for 6/60?
1.00
What is LogMAR acuity for 6/24?
0.60
What is LogMAR acuity for 6/18?
0.48
What is the group 1 driving visual standard?
ordinary driving licence
6/12 binocular or in the one good eye
adequate field of vision
What is the group 2 driving visual standard?
vocational drivers, large goods vehicles and passenger carrying
minimum 6/7.5 in best eye and 6/60 in worse eye
uninterrupted horizontal visual field of at least 160 degrees with extension of at least 70 degrees left and right and 30 degrees up and down- no defects in central 30 degrees
spectacle rx must be +8 or below- cl are okay
What field does the estermann check for Group 1?
120 degrees horizontal and 40 degrees vertically
What is the fail criteria for group 1 estermann?
A cluster of 4 missed points within central 20 degrees
OR
A cluster of 3 missed points and 1 other point within the central 20 degrees
OR
Any loss within central 20 degrees that is an extension of a hemianopia or quadrantonopia
What field does the estermann check for group 2?
160 degrees horizontal and 60 degrees vertical
What is the fail criteria for group 2 estermann?
Any missed point in the central 30 degrees
OR
4 missed points outside of the central 30 degrees regardless of cluster or not
