Eye and ear exam Flashcards
How should you examine the eyes generally?
Observation Hands on lights on Hands on lights off Distance direct opthlamoscopy Close direct opthalmoscopy
What should you be looking at when examining the eye during close direct opthalmoscopy?
Fundus (back)
Retina
Tapetum lucidum
Optic disc
What are the different type of beam selector? What is each beam used for?
Circular beams - use size appropriate for pupil
Slit beam - for anterior eye
Blue light - for fluoroscein dye
Red free (green light) - for examining blood vessels and retina
Graticule - grid to measure lesions
What are the types of lens magazine?
Normal = normal eyesight
+ or - to compensate for practitioners eyesight
What should you do for the first stage of an eye exam - observation?
Observe in day light
Check for blepharospasm, photophobia or pain
Cotton wool ball test to follow with eyes
Look at eyelid position, discolouring, strabismus, nystagmus
Symmetry and pupil size
What are strabismus and nystagmus?
Strabismus - misalignment of eyes
Nystagmus - involuntary eye movement
What should you do during the hands on lights on exam?
Check bulbar conjunctiva (covers eyeball)
Check palpebral conjunctiva (lines eyelids)
Protrude nicitating membrane
Check lacrimal punctae
Observe pupil size, symmetry
Corneal reflex (look at reflection of eye - should be smooth and sharp)
Gently retropulse globe through upper eyelid - movement should be symmetrical and non-painful
What should you do during the hands on lights off exam?
Use pen torch and possibly magnifying glass
Check adnexa - accessory structures e.g. eyebrows, lacrimal apparatus
Check cornea, anterior chamber, iris, lens, pupillary light reflex
Do dazzle test - use bright light for momentary stimulation, should flinch and blink rapidly
What should you do when doing distance direct opthalmoscopy?
Place hand on chin at arms length
Set opthalmascope to +1 or +2D and look at tapetal reflex (green reflection)
Any opacity between examiner and tapetum is a black patch
What is a common finding with older animals during the distance direct opthalmoscopy?
Nuclear sclerosis - shiny ring within the lens
Relatively normal
What should you do when doing close direct opthalmoscopy?
Examine fundus
Ensure light is not too bright
Set opthlamascope from -1 to +1D
Have opthalmascope touching your face and close to patient
Look at optic disc, retinal blood vessels, retina, anterior segment of eye
How should you do a basic ear exam?
Examine externally first then internally
Should be able to see bottom of horizontal canal by extending pinna (NOT with auroscope)
Tympanic membrane should be visible
What does a full ear exam require?
Sedation or GA
What can a full eye exam require?
Sedation
Pupil dilating medication
