Indications and Contraindications Flashcards
P.C indications for BIO:
visual disturbance, photopsia, floaters, metamorphosia, metachromatopsia, shadows, veils, curtain of reduced vision, scotoma, VF deficit, headache, diplopia, lid ptosis, pupil abnormalities, tramua (hyphema)
G.H/systemic indications for BIO:
diabetes/hypertension/cancer/high cholesterol/lupus
General indications for BIO:
reduced best corrected VA/VF, Fundus exam, Indications for DFE (stereo and mid-periph retina), Myopia -6 diopters or worse, history of retinal lesions predisposing to ret. degen. (lattice, etc.), cataract
Contraindications for BIO:
- any contraindications for dilation or fundus (since done together)
Indications for Tonometry/measuring IOP:
- first time/40 yr olds (esp. prior to dilation)
- glaucoma (risk factors, FOH, diagnosed, signs + symptoms, management tx)
- ocular conditions
- recent refractive change in one eye
- systemic conditions: diabetes, HT, migraine
- (previous) surgery or ocular injury
Frank Does Gardening On Relatively Sunny Sundays
Contraindications for Tonometry:
- Infections
- Central corneal epithelial defects
- Epithelial basement membrane dystrophy
- Sensitivity to local anaesthetics/sensitive patients
- Trauma to eye/perforation of globe
INCEST
Indications for Dilating:
- new patient/routine every 2 years
- flashers/floaters
- unexplained vision loss/reduction
- progressive retinal diseases
- systemic conditions
- hx: of head injury, eye trauma/surgery, chronic uveitis, periph. ret. degen,
- refractive error: myopia to high myopia, hyperopia, anisometropia
- limited view of posterior pole
New systemic routine flashes are progressive and unexplained. Check patient’s refractive error and history for disease and injury
Contraindications for Dilating:
- Angle Closure Glaucoma
- Pilocarpine for Glauc tx
- Dislocation of lens crystallin, or IOL lens
- Fixed iris
- Hyphema (blood in A.C)
- Acute corneal diseases
- Hypersensitivity to dilating eye drops
**HAHA PDF*
Possible but not necessarily contraindications for Dilating:
- pregnancy/lactation
- narrow AC angle
- petite/anorexic people
- kids/children
- sick people
pregnant petite kids are sick and narrow
Indications for measuring corneal shape:
- screening tool
- CL practice
- stability of cornea and tear film
- diagnosis/monitoring of corneal pathology
- pre/post refractive surgery/orthoK evaluation
- estimating astig when unreliable refraction
- IOL determination for cataract surgery
screen contact stability is the gold standard for surgery evaluation and estimating astig and IOL pathology
P.C Indications for Fundus Lens Examination:
visual disturbance, photopsia, floaters, metamorphosia, metachromotopsia, shadows, veils, curtain of reduced vision, scotoma, VF deficit, headache, diplopia, ptosis, pupil abnormalities, trauma (hyphema)
same as BIO
POH and FOH indications for Fundus lens exam:
- ocular conditions
- diabeties, glaucoma, AMD
GH indications for Fundus lens exam:
Diabetes/Hypertension/Cancer/High Choloesterol/Lupus
General indications for Fundus:
Same as BIO
Contraindications for Fundus:
any contraindication for dilation
Indication for Fan and Block:
When JCC doesn’t work
Indications for Gonioscopy:
- narrow angle (VH less than 0.3, iris shadow more than 0.5)
- glaucoma suspect + signs of ACG
- iris neovascularisation
- retinal ischaemia
- iris anomalies
- uveitis
- trauma (iridodialysis, angle recession)
List 8 contraindications for Gonioscopy:
- anaesthetic reaction
- lacerated/perforated globe (pressure will cause aqueous to drain out)
- hyphaema (will cause a rebleed)
- pregnancy (reduced corneal healing)
- corneal/conjunctival infection or epithelial basement membrane dystrophy
- corneal epithelium already weak
- OCT
What 7 structures are viewed using direct illumination
lids, lashes, cornea, lens, conjunctiva, iris, AC
What 7 structures are viewed with diffuse illumination
corneal deposits, CL deposits, CL fit, external eyelid/lash abnormalities, conjunctival cornea
What 6 structures are viewed with PPD?
cornea/lens epithelium, cornea/lens endothelium, corneal integrity, depth + extent of corneal abrasion, CL fit, and surface tear film
PPD is the common technique to assess cornea
2 uses for small spot
- examine anterior chamber
- detection of floating debris and A.C cells and flare
3 uses for indirect illumination
- detect faint irregularities
- deeper areas of tissue
- foreign bodies
What 4 structures are examined in specular reflection?
- corneal endothelium
- lens capsule
- tear film
- surfaces
(specifically looks at tear film quality, corneal endothelium, and anterior lens surface, ant. lens surface looks like orange peel)
What corneal condition can be seen with specular reflection?
Corneal guttata. Is associated with Fuch’s dystrophy. Appears as dark spots on corneal endothelium.
What 3 things can be seen with sclerotic scatter?
any area of abnormality including: scars, oedema (stromal), particle/FBs
Indications for Colour Vision Assessment:
- first visit/new patients (legal requirement)
- when advice needed to tailor the learning needs of kids
- when advice needed for day-to-day visual tasks
- when vocational advice needed (can I be a pilot)
- when a certificate of fitness has been requested (e.g. for an occupation or licence)
- when an ocular disease is suspected (acquired CV defect)
