Eye Exam Flashcards by Emily Ulrich

What do you watch for in a distance exam for eye problems

Bumping into things
Hesitancy
Hugging the wall (using as guide)
Odd reaction to distant objects

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You must do a visual exam of the adnexa , what is this and what structures does it include

Accessory structures of the eye

Eyelids, eyelashes, skin, secretions, conjunctiva, sclera, 3rd eyelid

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What is
OS
OD
OU

OS: left eye
OD: right eye
OU: both eyes

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Describe the visual exam of the globe

Overall size: bulging, recessed/sunken

Cornea: cloudiness, haziness, redness, blood vessels

Anterior chamber

Pupil size: dilated, constricted, asymmetrical

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What are the different secretions of the eye

Serous (watery)

Mucous

Mucopurulent/purulent (pus, green/yellow)

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True or false

You can clean the eye before any tests are run or before the vet has looked at it

FALSE

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What are some of the reflexes of the eye that are tested

Menace (if this response is abnormal, check palpebral to see which nerve is damaged)
Palpebral
Pupillary light reflex (direct and indirect)
Nystagmus (horizontal movement when moving the head is normal)

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What is the ophthalmoscope exam used for

To assess the condition inside of the anterior chamber, the lens and the fundus

May require dilating the pupil

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What is the schirmer’s test test

Measures tear production of the eye

Should be done FIRST before eyes are cleaned or flushed

Fold sterile strip at the notch, put folded notch into the bottom eyelid

Time 1 minute and record the measurement of how far the dye has moved on the strip (can do 30 sec and multiply distance)

Record as mm/min

Must be done to both eyes

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What are the normal ranges of the schirmer’s tear test

Variation by manufacturer

Dogs: 12-15 mm/min

Cat: 10mm/min

Horses: 20mm/min

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Alcaine is a commonly used

Topical anesthetic

Blocks local nerve conduction to control pain

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When is alcaine used in eye exams

Painful eyes
Cytology/scraping/debridement
Eye surgery
Schiotz IOP test

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Describe a conjunctival swab of the eye

Sterile swab taken from lower conjunctiva

Used to diagnose infection with PCT and culture tests

Must use aseptic technique (can moisten swab with saline) avoid hair and eyelid margins

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Describe conjunctival scrapings

Collecting cells from the conjunctiva for analysis

Indicated for chronic conjunctivitis, ocular discharge, masses, or when distemper or chlamydia is suspected

Requires topical anesthetic

Make 3rd eye lid emerge, take scraping from conjunctival and 3rd eyelid membrane

Put sample onto glass slide for cytology or in to sterile saline for PCR test

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How do you apply a topical anesthetic to the eye

Put 2 drops into the eye
Wait 30 seconds
Put another 2 drops into the eye

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What is tonometry

Measuring intraocular pressure (the pressure exerted against the walls of the eye ball from the contents inside)

Identifies inflammation and glaucoma

What is uveitis and what does it do to IOP

Inflammation of the anterior chamber in the eye

Causes a drop in IOP

What is glaucoma

Increased pressure in the eye

What is the normal range for IOP among all species

What is it specifically in dogs, cats and horses

All species: 15-25 mmHg
Dogs: 15-18 mmHg
Cats: 17-19 mmHg
Horses: 17-28 mmHg

What is schiotz tonometry

Measures the amount of indentation of the cornea by applying a calibrated weight and measuring the deflection the weight produces on the scale

The greater the indent the lower the IOP

Contraindicated with ulcers

Nose of the patient must be up and cornea is parallel to the floor

Needs topical anesthetic

Needs 3 readings from each eye, taking the average of them, and discarding any outliers

What does anxiety do to IOP

Increases BP and therefore increases IOP

What does pressure on the neck while restraining do you IOP

Increases IOP

What is the tonopen

Determines the force required to flatten a given area of the cornea with a button pushed on the eye

The tonopen must be perpendicular to the floor and held 1/2 inch away from cornea

3 taps are required to give an average reading

What is the tonovet

Rebound tonometer: small probe in the unit with a magnet, pushed out to rebound off the cornea. IOP is calculated by current created on the rebound

Probe must be parallel to the floor and perpendicular to the cornea 1/6 inch away

Requires 6 readings to provide an average

Does not require topical anesthetic

Very accurate

What are the most common meds used for pupil dilation When should they be used

Tropicamide: 20 minutes Atropine: 12 hours Used to give a better view of the lens and fundus Apply AFTER the vet has examined the anterior chamber and reflexes of the eye

What is the fluorescein stain

Orange stain that illuminates under blue light Used to detect breaks/scratches in the corneal epithelium Intact cornea has high lipid content and prevents the dyefrom adhering, any damage allows the dye to adhere Also tests patency of the nasolacrimal ducts (will see it drop out of nose) Always done as the LAST part of the eye exam Need a dark room and blue light If there is an ulcer: best practice is to take a picture or draw and very accurately describe it

What is Tonicity

Effects on the volume of the cell

True or false | The eye needs to be cleaned before applying medications

True

How do you prevent hair from getting into the eye if you need to shave around the eye

Cover the eye with eye lube, shave and then rinse out eye and eye lube (lube adheres to hair and will wash away all the hair)

What are the rules for eye medications

Always triple check the medication :when you grab it, when you apply it, and when you put it back Always check the dose and indicate which eye it goes into Always give drops first and then ointments (ointments create a protective coating and prevents drops from absorbing) Wait at least 5 minutes (beat practice is 15 mins) between medications

True or false | It is okay to touch dispenser right the he

False Can cause damage and contamination and infection

How much of an eye ointment do you typically give

3-5 mm ribbon on the upper sclera

What signs tell you to discard an eye medication

Cloudiness Contain particles Color change

How long and often are e collars worn with eye medications

24 hours a day every day typically for 7-14 days Rechecks are done at 10-14 days

Treatment and medications are prescribed by the

DVM

What is the role of the RVT

Review meds with owners and demonstrate how to do it ``` Tell owner about: Order of meds Cleaning Reasons for meds Follow up instructions Making dosing schedule for more than 3 meds ```

When do you need to flush the nasolacrimal ducts

When the fluorescein test indicates they are not functional

How do you flush the nasolacrimal ducts

Nasolacrimal cannula (23-27 gauge) May require sedation Or topical anesthetic Flush the punctum near the medical canthus and observe it running out of the inferior punctum and should run out of the nostril when you occlude the inferior punctum If it does not come out of the inferior punctum, flush it