Eye examnation Flashcards
What is general approach to examination?
Wash hands and PPE, consent fo rexam,..
What are the parts of opthalmoscope?
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
What are filters and appetures for on opthalmoscope?
Cobolt blue looking for corneal lesions red free black for blood vessels. flter, micro small large and slit aperture usually medium or large
What ot look for in general inspection?
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
How to asses pupils?
Size symetry and shape
What is the red reflex?
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
What is fundoscopy how to do/
Warn will get quite close, use right eye with right left eye with left. 10-15 degree angle, identify bloodvessels orientate yourslef
What to look for in fundoscopy?
optic disc contour colour and cupto disk ratio, superuor arcades inferior arcades macula retina
What to look for in arcades?
haemmorages hard soft exudates aneurysms, neo-vascularisation sliverr
What to look for in macula/
Drusense neo-vascularisation,
How to tell artery from vein in the eye?
veins are usually darker and arteries paler
What are mydriatic eye frop?
Dilate pupil but can’t drive for 3-4 hours after.
What else to checkwith eye other than eye?
Cranial nerve exam and BP slit lamp assessment
What are 4 stages of diabetic retinopathy?
Background, pre-proliferative, proliferative and
What is pre proliferative retinopathy?
Little red dits icroaneurisms
What is proliferative retinopathy?
Hard exudates yellow ish blobas around retina, cotton wool spots softer exudates.
What are neovascularisation?
When had poor vasculature from aneurisms and new vessels grow which can cause loss of vision
What is vitreous hamorrhage?
Later stage of proliferative retinopathy. where large haemorrhage happens
What are grades of hypertensive retinopathy?
1234/malignant with symptoms
What is grade 1 hypertensive retinopathy?
Silver wiring,
What is grate 2 hypertinsive retiopathy?
AV nipping a dilation of veins around crossing of artery
What is grade 3 hypertension?
Flame haemorrhage, can get visual loss
What is mallignant hypertension?
Papiloedema, optic disc swelling,
What is glaucoma?
Cup to disc ratio is much larger than should be
What is age related macular degeneration?
most common caue of irriversibleblindgess olfer dry presence of drusens no exudates or neovascularisation
What to look at outer ear?
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
How do you look at middle ear?
Otoscope, pen grip left hand for left cheek right hand for right little finger agianst cheek pina manipulation up and back
What to look for in tympanic membrane?
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
What are features of normal tympanic membrane?
pars tensa pars faccida, lateral process of malleus, bulge of TMJ, Handle o malleus
Can you look at the inner ear?
MRI or CT immaging or test function
How to test hearing?
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
