history and symptoms Flashcards
Why do we bother taking history and symptoms
- you dont know nothing about the person inside
- need to identify any problems
- ascertain baseline
- ensure approprait tests are carried out
- establish good rapport
- ensure no test are missed out
- appear as if you know what you are doing
- litigation
what is an open question?
How are you today? -good -terrible -much better more than one answer
what is a closed question ?
yes/no limited choice of answer
What is funnel questioning?
- answer a open question
- narrow the questions
- response
what is the order of history and symptoms?
..Reason for attendance ..current ocular and optical status ..previous ocular history ..previous family ocular history ..general health ..previous family general health ..medication ..allergies ..lifestyle and occupation
what is the difference between symptoms and signs?
- -symptom is what patient feels and sees
- -signs is what the optician sees
what three categories of symptoms are there?
1) what the px sees
2) what the px sees in the mirror
3) what the px feels
examples of typical complaints?
- visual
- aches, pain
- inflammation, redness, congestion
- lumps, mass, swelling
- crustiness, flakes on lids
- eyelid problems
- squint, nystagmus
- visual defects
What does FLOADS stand for ?
F- frequency L- location O- onset A- association D- duration S- severity
why do we ask about double vision and headaches?
px might have bv problems
tumour
vascular problems
why do we ask about previous ocular history ?
to expect a long standing problem
if px has had operations in the pasts or tendencies such as conjunctivitis
why do we ask about family ocular history?
certain diseases more like to be within family, inherited
10-20% of POAG px report FH
siblings with POAG than 4x more likely
parent with POAG 2x more likely
why do we ask about general health?
know what illnesses are associated withe the eyes
why do we ask about medications?
- some medication effect the eyes
- need to know to look for them
why do we ask about allergies?
allergies associated with certain eyes condition such as hayfever
why do we ask if the px drives?
drivers need to be under the driving standards to drive otherwise cause accidents
why do we ask q about their occupation?
need to know if they meet occupational standards or require safety specs
what are standard for the police?
unaided vision binocularly -6/36
corrected visual acuity -6/12
near VA corrected binocularly -N6 AT 40CM
refractive surgery - if visual standard is met
colour vision - yes
other - retinal detachment and glaucoma is not acceptible
why do we ask about vdu?
need to know what advice to offer as blink rate reduces eyes tend to get dry reduced eyelid coverage employers require eye check
what does asthenopia cause?
sore eyes
tired eyes
eyes pull
visual discomfort
why doe we ask about hobbies?
need to know what to advice?
what question do we always finish with?
is there anything else i need to know about your eyes?
NOC
why do we need a good history and symptoms report?
can save you from being banned from the practice
