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Nursing Skills 2 > Eye Exam > Flashcards

Eye Exam Flashcards

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1
Q

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

A

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

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2
Q

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

A

Accessory structures of the eye

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

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3
Q

What is
OS
OD
OU

A

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

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4
Q

Describe the visual exam of the globe

A

Overall size: bulging, recessed/sunken

Cornea: cloudiness, haziness, redness, blood vessels

Anterior chamber

Pupil size: dilated, constricted, asymmetrical

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5
Q

What are the different secretions of the eye

A

Serous (watery)

Mucous

Mucopurulent/purulent (pus, green/yellow)

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6
Q

True or false

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

A

FALSE

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7
Q

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

A

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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8
Q

What is the ophthalmoscope exam used for

A

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

May require dilating the pupil

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9
Q

What is the schirmer’s test test

A

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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10
Q

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

Variation by manufacturer

A

Dogs: 12-15 mm/min

Cat: 10mm/min

Horses: 20mm/min

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11
Q

Alcaine is a commonly used

A

Topical anesthetic

Blocks local nerve conduction to control pain

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12
Q

When is alcaine used in eye exams

A

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

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13
Q

Describe a conjunctival swab of the eye

A

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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14
Q

Describe conjunctival scrapings

A

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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15
Q

How do you apply a topical anesthetic to the eye

A

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

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16
Q

What is tonometry

A

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

Identifies inflammation and glaucoma

17
Q

What is uveitis and what does it do to IOP

A

Inflammation of the anterior chamber in the eye

Causes a drop in IOP

18
Q

What is glaucoma

A

Increased pressure in the eye

19
Q

What is the normal range for IOP among all species

What is it specifically in dogs, cats and horses

A

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

20
Q

What is schiotz tonometry

A

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

21
Q

What does anxiety do to IOP

A

Increases BP and therefore increases IOP

22
Q

What does pressure on the neck while restraining do you IOP

A

Increases IOP

23
Q

What is the tonopen

A

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

24
Q

What is the tonovet

A

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

25
Q

What are the most common meds used for pupil dilation

When should they be used

A

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

26
Q

What is the fluorescein stain

A

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

27
Q

What is Tonicity

A

Effects on the volume of the cell

28
Q

True or false

The eye needs to be cleaned before applying medications

A

True

29
Q

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

A

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)

30
Q

What are the rules for eye medications

A

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

31
Q

True or false

It is okay to touch dispenser right the he

A

False

Can cause damage and contamination and infection

32
Q

How much of an eye ointment do you typically give

A

3-5 mm ribbon on the upper sclera

33
Q

What signs tell you to discard an eye medication

A

Cloudiness
Contain particles
Color change

34
Q

How long and often are e collars worn with eye medications

A

24 hours a day every day typically for 7-14 days

Rechecks are done at 10-14 days

35
Q

Treatment and medications are prescribed by the

A

DVM

36
Q

What is the role of the RVT

A

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
37
Q

When do you need to flush the nasolacrimal ducts

A

When the fluorescein test indicates they are not functional

38
Q

How do you flush the nasolacrimal ducts

A

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

Nursing Skills 2 (5 decks)

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