Eye exam Flashcards

Question

When to do a fluorescein stain and what materials are needed

Answer 1

* Vet will let you know if they need this test done * ALWAYS AT THE END OF THE EXAM * Materials/equipment: * Fluorescein test strip * Eye wash or sterile saline (room temperature) * Eye wash has a slightly different tonicity than 0.9% NaCl * Tissue or gauze * Blue light (ophthalmoscope) * Room that can be darkened

Answer 2

1. Open strip but leave on sterile surface 2. Moisten the end of the test strip with a few drops of sterile eyewash 3. Raise upper eyelid and touch tip of strip to the bulbar conjunctiva for 1 second (Can also touch to the sclera) 4. Allow patient to blink to move dye around surface of eye 5. Darken room and view surface of cornea with blue light. 6. Record any fluorescence * Present or not, size of stained area, shape, location, if stained throughout or areas that are not stained * Drawing a diagram (or taking a photo) is best practice 7. Can observe for stain exiting ipsilateral nares * This indicates the nasolacrimal duct is patent 8. Rinse the eye(s) well with sterile eye wash to remove unbound stain.

Answer 3

* Eyes need to be clean before applying medications * Clean the area around the eye first with a gauze moistened with warm water * NEVER use alcohol or iodine around the eyes – can cause corneal trauma * If there is excessive discharge the eye may require irrigation (flushing) with an eye wash solution * If shaving around the eye, first cover eye with eye lubricant * Shave * Rinse eye with eye wash – this will remove both the lubricant and hairs caught in it

Answer 4

Always triple check to make sure it is the right medication 1. When you pick up the medication – check that it matches the file 2. Before applying the medication – check that it matches the file 3. When returning the medication – check that it matches the file Always check the dose 1. Which eye (OS – left, OD – right, OU both) 2. Order of medications 3. Quantity/number of drops 4. Frequency ALWAYS give drops first * Ointments create a protective coating over the eye and will not allow medicated drops to be absorbed Wait at least 5 minutes between medications * 15 minutes is better * This allows for absorption of the medications

Answer 5

* Often requires two people; one to restrain and one to administer the medication * Tilt the head back * Hold the eyelids open with the thumb and index finger of one hand * Rest the hand holding the medication on the patient’s head and apply one drop of medication on the sclera of the eye * Do not touch dispenser tip to cornea * Causes contamination of bottle * May cause trauma to cornea

Answer 6

* After any drops have been given * Provides a protective coat to the eye surface * Often requires two people * Tilt the head back * Hold the eyelids open with the thumb and index finger of one hand * Apply a 3-5 mm ribbon of ointment to the (upper) sclera of the eye * Either have the patient blink or close the eyelids once or twice to spread the ointment over the eye * Never touch dispenser tip to cornea

Answer 7

* NEVER touch the eye with the tip of the dropper/ointment bottle(s) * Can damage the eye * Contaminates the eye medications which could cause an infection * If ophthalmic eye drops/solutions appear cloudy, contain particles, or have a colour change, they should be discarded * Elizabethan collars are often put on the patient to prevent the animal from rubbing or scratching at the eye(s) * They are worn for 24 hours a day, 7 days a week until issue resolved or stated otherwise by veterinarian * 7-14 days, depending on the procedure

Answer 8

* Treatment and medications are prescribed by the vet * Role of RVT to review prescribed medications with owners AND demonstrate how to administer * Give first dose in clinic when possible as demo * Have owner give in second eye * Role of RVT to tell owner about: * Order of medications, time in between each * Cleaning around the eye(s) * Reasons for the medications – increases compliance * Follow up instructions (what to look for, compliance, how to tell if improving or getting worse, etc.) <-- Ask the vet for what to tell owner if unsure * Write down a dosing schedule if 3 or more medications

Answer 9

* This procedure is performed to remove minor obstructions from the nasolacrimal duct * It is indicated when the fluorescein dye test indicates that there is not a patent nasolacrimal duct * It requires *Gauze sponges *Topical ophthalmic anesthetic *Sterile 23-27 gauge nasolacrimal cannula *3 ml syringe filled with sterile saline or eye wash

Answer 10

* The patient may require sedation * Clean the eye first * Instill 2 drops of topical ophthalmic anesthetic, wait 30 seconds and apply 2 more drops * Restrain the head and roll out the upper eyelid exposing the superior punctum * Use the lacrimal cannula and slide it along the inner lid margin toward the medial canthus * Once the cannula is well seated flush 2-3 ml of sterile saline or eye wash through the punctum * Observe fluid emerging from the inferior punctum * You should be able to see fluid coming from the nostril when you occlude the inferior punctum * If saline/eye wash does not come through the inferior punctum, cannulate the lower punctum and flush it as well

Answer 11

*Does not touch patient, so cleaning is only whenvdirty * Clean head with gauze lightly wet with alcohol – Never immerse * Wipe viewing window with a cotton swab or lens paper dipped in alcohol or lens cleaner * Be careful not to damage/move the mirror (should not require moving) *Never leave the ophthalmoscope upright on a counter/table/shelf * Dropping will damage the mirror

Answer 12

*ALWAYS turn off when not in use *Never submerge *Come with replaceable batteries or rechargeable batteries *Rechargeable batteries should be charged regularly * Most are charged by removing the head and plugging the handle into a regular socket * Change batteries when light starts to dim even after charging and with a new bulb

Answer 13

*Make sure power is off before changing *It is recommended to wear protective eyewear as halogen bulbs are pressurized *Remove bulb and replace with the proper manufacturer’s bulb * Typically, bulb location is at the base of the head where it attaches to the handle