Mad Skillz Flashcards
Case History question headings
-chief concern
-history of present illness
-ocular history (self and immediate family)
-medical history (self and immediate family)
-Medications
-Allergies
-Occupation and hobbies
-social activities
AIDET for px interaction
-Acknowledge
-Introduce
-Duration
-Explanation
-Thank you
FOLDARS for history of present illness
Frequency (how often?)
Onset (when start?)
Location (where is?)
Duration (how long does it last?)
Associated symptoms (other stuff that happens)
Relief (what makes it better?)
Severity (how much does it bother you?)
SOAP and exam notation
Subjective: info from px perspective
Objective: info from doctors perspective
Assessment: Diagnosis
Plan: Tx plan
Categories of telephone triage
-Emergency: px needs IMMEDIATE attention
-Urgencies: serious, but px is not in immediate jeopardy
-Routine: conditions that are mild/inconvenient
Examples of emergencies
-blow to the eye
-foreign body in eye
-chemicals in eye
-sudden vision disturbance/pain
-flashes and floaters
-cloudy veil/halos
Examples of urgencies
-contact lens problems
-swelling/bumps on eyelid
-redness or irritation w/o pain
-visual disturbances that develop over days/weeks
-lost/broken eyeglasses
Examples of routine concerns
-gradual change in vision
-mild irritation, tearing, twitching
-slight red eye w/o pain
-recall appointment
Methods of positive verbal communication
– Tone and clarity of voice
– No jargon and technical terms or acronyms
Methods of nonverbal communication
– Facial expression
– gestures
Examples of active listening
– Front facing
– eye contact
– acknowledging what the patient has said
How to communicate with children
– Speak directly to the child
– ease into the process with small talk
– present entrance tests as games for younger children
– enlist the parents help if needed
Communicating with the elderly
– Always speak directly to the patient
- Respect possible hearing challenges
– listen to family members or caregivers
Communicating with patient with physical impairments
– Ask how to help patient
– make room for physical aids like walkers or wheelchairs
– ask permission to touch assistive devices
How to check for patient understanding
– Use plain common language
– explain acronyms if you have to use them
– use analogies
– draw diagrams offer paperwork for them to read later
– translate terms if needed
Three aspects For consent to be met
– Must be voluntary
– patient must have the mental capacity to understand the risks and benefits
– patient must be properly informed of test or procedure
implied consent
– Informal occurs through the actions of the patient rather than directly with words
Express consent
– When patient directly communicates explicit consent
Elements of informed consent
– Patient shall be provided a diagnosis
– patient shall be informed of procedure or treatment And success rates for the procedure
– Discussion of alternate treatment options
– discussion of risk associated with not proceeding with procedure or treatment
– Opportunity for patient to ask questions
patient expectations: new prescription
Plus power
– magnification
– against motion
Minus power
– minification
-with motion
Cylinder power
– scissors motion
Patient expectations: new frames
– Larger versus smaller frame
– metal versus plastic frame
– nose pads versus no nose pads
Patient expectations: new lens type
– Single vision lenses
-Full-time wear versus part-time wear
-bifocal and trifocal lenses
– Progressive lenses
-distance and reading glasses
– wraparound lenses
– Prism lenses

Patient expectations: visual adaptation
– Depth perception
– fishbowl for pincushion effect
Any trouble finding the correct zone in a progressive lens
– eyestrain or headaches
How to gain a patient’s trust when taking case history
– First impression is important
– let patient know everything is private
– clear communication
– open body language
Lifestyle consulting questions
– Occupation
– hobbies
– General activities
How to clean optomap
Clean the main Mirror only when necessary use a dry cloth and gently wipe the invisible mirror surface in a diagonal downward stroke
Clean the PC monitor and touchscreen with a glass cleaning agent
Use a slightly damp cloth to clean the plastic surfaces

Autorefractor
-tests refraction
-Measure an approximation of a patient’s refractive error and are used as a starting point for the final prescription
-An automatic phoropter
Phoropter (refractor)
-Tests refraction
- a big machine with lenses that the doctor puts on your face
-They measure refractive error trial lenses are still used in cases where a phoropter isn’t feasible or to show a patient a potential prescription
Slit-lamp biomicroscope
-For corneal evaluation
-Allows the examiner to view anterior structures of the eye and view of the posterior structures is possible with a handheld lens
Keratometer
-Used for corneal evaluation
-Measures curvature of the cornea
Topographer
-Used for corneal evaluation
-Measures surface shape of the cornea
Pachymeter
-Used in corneal evaluation
-Measures corneal thickness (pachy=thick)
Non-mydriatic fundus camera
-For imaging
-Doesn’t need dilation of pupils
-Takes images of the retina there are adaptors available to do anterior segment photography
Optomap
-For imaging
-Doesn’t require pupil dilation
Tonometer
-Measures Intraocular pressure Using a puff of air or probe

Gold standard of tonometers
Goldmann applanation tonometer
Visual field analyzers
-Evaluate a patient’s range of vision
Optical coherence tomographers
Creates a cross-section image of the retina or anterior segment like an ultrasound
Ophthalmic ultrasound and optical biometers
Measure and evaluate internal structures of the eye
-Will touch the eyeball
Definition of cleaning
Soap and water to remove dirt and germs
Definition of disinfecting
Using chemicals or a process to kill germs
Definition of sterilizing
Using hospital grade chemical or physical processes to eliminate all germs
Retinoscope
Measures refractive error
Ophthalmoscope
For viewing the retina
Transilluminator
Fancy penlight also called muscle light
Exam chair and stand
-Hydraulic
-Can lift 300 to 350 pounds
-Handhelds can charge in the stand
-Chair glides allow patient to remain in a wheelchair
Acuity chart
-Used for refraction
-Some also have images or videos as a fixation point for a child
Lensometer
Measures eyeglass and contact lens powers. some auto lensometers also map out a power topography of the lens or measure UV transmittance
Pupillometer
-Measures distance between a patient’s pupils this can also be done with a ruler and a pen light
Lens edging
-Trace frame to get the shape and size
-Lens blank ground down to fit into frame
-Some models will groove the lens edge and drill holes
Disinfecting ophthalmic instruments: retinal camera
-Clean for headrest chin rest body cover between patients
-Don’t get the internal parts wet
-Clean outside casing with soft dampened cloth
Disinfecting ophthalmic instruments: slit lamp biomicroscope
-Disinfect headrest and chin rest between patients
-Use canned air to rid mirrors of dust
-If mirrors are dirty take them out and wipe them with glass cleaner do not use alcohol
-Lubricate all moving parts
-Cover when not in use
Disinfecting ophthalmic instruments: keratometer
-Disinfect the head rest and chill and rest between patients
-Use canned air to remove dust from the measurement window or wipe with glass cleaner
-Should be covered when not in use
-To calibrate oil the calibration balls place a sheet of white paper in the background and calibrate the cross hairs for your own refractive error
Disinfecting ophthalmic instruments: Icare
-Do not clean the tips
-The probe is the only part that touches the eye and it’s disposable
-You can clean the surface or handle with disinfectant wipes but not the base
-Does not need to be calibrated
Disinfecting ophthalmic instruments: Tonopen
-Remove the tip and use canned air to blow into for three seconds
-Must be calibrated each day before use
Types of distance visual acuity tests
-Tumbling Es
-Landolt’s broken rings
-Snellen charts
-Alan pictures
-Lea numbers and symbols
-Autorefractor
