Eye Exam Flashcards
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
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
What is
OS
OD
OU
OS: left eye
OD: right eye
OU: both eyes
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
What are the different secretions of the eye
Serous (watery)
Mucous
Mucopurulent/purulent (pus, green/yellow)
True or false
You can clean the eye before any tests are run or before the vet has looked at it
FALSE
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)
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
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
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
Alcaine is a commonly used
Topical anesthetic
Blocks local nerve conduction to control pain
When is alcaine used in eye exams
Painful eyes
Cytology/scraping/debridement
Eye surgery
Schiotz IOP test
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
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
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
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
