Eye examnation

Question 1

What is general approach to examination?

Answer 1

Wash hands and PPE, consent fo rexam,..

Question 2

What are the parts of opthalmoscope?

Answer 2

Filers blue green normal, vieing window filter apaetur and switch rheostat for brightness, diopter dial, brow rest vieing window diopter power dispola on off switch

Question 3

What are filters and appetures for on opthalmoscope?

Answer 3

Cobolt blue looking for corneal lesions red free black for blood vessels. flter, micro small large and slit aperture usually medium or large

Question 4

What ot look for in general inspection?

Answer 4

Eyeids ptosis anhidrosis ectropion and entropion can cause dry eye or irritation, eyelashes loss of eyelashes sign of malignac trichiasisi rubb on cornea, peri-orbital region, oedema and erythema are signs of peri-orbital cellulitis medical emergency, cornea haze white infiltrates flourescein staining. Anterior chaber hyphaemia hypopyn puss in anterior chamber, discharge watery discharge allergic viral conjunctivitis purulent discharge bacterial conjunctivitis, red eye painful scleritis uveitis corneal abraions, abrasions ulcers acute closed angle glaucoma foreing bodies, panless conjunctivitis subconjunctival haemorrhage episcleritis dry eys

Question 5

How to asses pupils?

Answer 5

Size symetry and shape

Question 6

What is the red reflex?

Answer 6

Should see red light back from eyes through opthalmoscope, can be white in cataracts retinoblastoma, and absent red reflex is ocular misalignment refractive errors retinoblastoma retinal detachment

Question 7

What is fundoscopy how to do/

Answer 7

Warn will get quite close, use right eye with right left eye with left. 10-15 degree angle, identify bloodvessels orientate yourslef

Question 8

What to look for in fundoscopy?

Answer 8

optic disc contour colour and cupto disk ratio, superuor arcades inferior arcades macula retina

Question 9

What to look for in arcades?

Answer 9

haemmorages hard soft exudates aneurysms, neo-vascularisation sliverr

Question 10

What to look for in macula/

Answer 10

Drusense neo-vascularisation,

Question 11

How to tell artery from vein in the eye?

Answer 11

veins are usually darker and arteries paler

Question 12

What are mydriatic eye frop?

Answer 12

Dilate pupil but can’t drive for 3-4 hours after.

Question 13

What else to checkwith eye other than eye?

Answer 13

Cranial nerve exam and BP slit lamp assessment

Question 14

What are 4 stages of diabetic retinopathy?

Answer 14

Background, pre-proliferative, proliferative and

Question 15

What is pre proliferative retinopathy?

Answer 15

Little red dits icroaneurisms

Question 16

What is proliferative retinopathy?

Answer 16

Hard exudates yellow ish blobas around retina, cotton wool spots softer exudates.

Question 17

What are neovascularisation?

Answer 17

When had poor vasculature from aneurisms and new vessels grow which can cause loss of vision

Question 18

What is vitreous hamorrhage?

Answer 18

Later stage of proliferative retinopathy. where large haemorrhage happens

Question 19

What are grades of hypertensive retinopathy?

Answer 19

1234/malignant with symptoms

Question 20

What is grade 1 hypertensive retinopathy?

Answer 20

Silver wiring,

Question 21

What is grate 2 hypertinsive retiopathy?

Answer 21

AV nipping a dilation of veins around crossing of artery

Question 22

What is grade 3 hypertension?

Answer 22

Flame haemorrhage, can get visual loss

Question 23

What is mallignant hypertension?

Answer 23

Papiloedema, optic disc swelling,

Question 24

What is glaucoma?

Answer 24

Cup to disc ratio is much larger than should be

Question 25

What is age related macular degeneration?

Answer 25

most common caue of irriversibleblindgess olfer dry presence of drusens no exudates or neovascularisation

Question 26

What to look at outer ear?

Answer 26

general inspection, pinna, smooth regular, Scars at front and back of ear, lymphnodes just behind and in front of ymph nodes. battle’s sign base of skull fracture, facial nerve pals

Question 27

How do you look at middle ear?

Answer 27

Otoscope, pen grip left hand for left cheek right hand for right little finger agianst cheek pina manipulation up and back

Question 28

What to look for in tympanic membrane?

Answer 28

External auditory meatus? debris wax discharge foreign bodies inflammation, Tympanic membrane shape colour position bulging retraction, perforations fluid line tympanostomy muringotomy tube ossivles light reflex 5pm right 7pm left

Question 29

What are features of normal tympanic membrane?

Answer 29

pars tensa pars faccida, lateral process of malleus, bulge of TMJ, Handle o malleus

Question 30

Can you look at the inner ear?

Answer 30

MRI or CT immaging or test function

Question 31

How to test hearing?

Answer 31

Rinne and weber’s test. tuning fork smallest 512 Hz Rinne hold in front of ear, can hear air louder than bone conduction on mastoid process. Weibers test, place in middle of forhead, conduction lodest in damaged senorineural loss is louder in good side