History and Examination Flashcards
What are the common presentations in ophthalmology?
Visual loss Infection/conjunctivitis Red eye Dry eyes Watery eyes Double vision Trauma/abrasion Foreign body
How can we take a ophthal history?
Like a pain hx - SQITARS!
Ask what the other eye is up to!
Hx as usual - PMH, DHx, Allergies, SHx, FHx
If a patient presents with a red eye, what is the most appropriate eye examination to do?
Lid examination + lid inversion Lacrimal system Conjunctiva Cornea Pupil Anterior chamber
If a patient presents with a foreign body in the eye, what is the most appropriate eye examination to do?
Everted eyelids
Conjunctiva
Cornea with particular attention to iris as marks may be missed.
If a patient presents with reduced vision, what is the most appropriate eye examination to do?
Whole visual and refractory axis:
- Cornea to fundus
- Functional testing of pupils
- Optic nerve
- Macula
- Visual fields and acuity
If a patient presents with double vision, what is the most appropriate eye examination to do?
- Fundus and optic nerve
- Extraocular muscle function
If a patient presents with headaches, what is the most appropriate eye examination to do?
Fundus
Optic nerve
Pupillary functions and blood pressure
Neurological examination
O/E of the external eye lids, what signs might we see?
Ptosis Redness +/- swelling Lacerations Lumps/bumps Ulceration Rashes Other skin lesions
Why would we evert the eyelids?
Suspicion of a foreign body, and to evaluate papillae/follicles.
How is lid eversion performed?
With topical LA and 2 clean cotton buds:
- Ask pt to look down, hold eyelashes with one hand, and place cotton bud at base of lid with other hand.
- Gently pull lid down and out while keeping cotton bud in place, then lift lid up.
- Pt needs to keep looking down. Clean any debris with 2nd cotton bud.
