Module 2: Pretesting Flashcards
PIPEDA
Personal Information Protection and Electronic Documents Act
The reason for the visit
Cheif complaint
FOLDAR
-Frequency
-Onset
-Laterality
-Duration
-Association
-Remediation
Personal medical history
- required to document GP and last exam
-Medications and route of administration/dose/frequency
-measurement of clarity/sharpness of eyes resolving power
-20 ft of 6 m (mirrored 10ft/3m)
-can be calibrated with projectors
-less than 15ft cause artifially high results
Visual aquity
ability to distinguish two separate objects
Resolution
-universal acuity chart
-5 x5 originally
-5x4 with 1 unit gap (current)
Snellen chart
- no illumination/ reduces contrast
-imperative chart angle same as patient
Projected VA charts
VA pupil size
-large pupils artificially decrease VA results
-small pupils artificially increase VA results
-ideal pupil size 2-5mm
-lighting should be mildly dim
VA procedure
-px should not preview
-start with uncorrected distance
-start with OD
- occlude opposite at distance of 1-2cm
-px read until misses 1 or more letters
- change letters before OS
- lastly test both eyes together
-repeat with glasses/rx
Near VA
-identical procedure to distance VA
-test distance vary on px habitual working distance
-standard test distance 40cm/16in
- Jaeger type/J type is used instead of Snellen
- adjust room to bright overhead lighting
-VA at 20 feet
- what normally can be seen at 20 feet
- doesn’t mean perfect vision
- indicates clarity or sharpness at distance
20/20 vision
-VA chart for children
- px who don’t know the alphabet
Allen and Lea symbols
- px that don’t speak english
Landolt C and Tumbling E
- CDC regulated control of infections/virus/pathogens
- does not apply to tears (unless visible blood)
Universal precautions
Handwashing
- 20 seconds long
- rinse warm water
-dry with fresh paper towel
-alternate use alcohol rubs
Personal Protective Equipment (PPE)
- forms barrier between px
- sterile gloves with sterile body parts
-exam gloves with mucous membranes
-lab coats
-masks
Masks PPE
-surgical masks for talking/coughing/sneezing
- resporators for infected px
-N: not resistant to oil
-R: resistant to oil
-P: oil proof
-filter levels 95% and 99.97%
-Critical (objects penetrate skin/mucous)
-Semi-Critical (non-intact skin/intact mucous)
-Noncritical (px doesn’t touch/ intact skin)
Spaulding’s classification system
-Autoclave
- Hydrogen peroxide 3% (10 mins)
-1/10 bleach ( 10 mins)
-70% ethanol/isopropyl (10 mins)
-chemical germicide (10 mins)
- must be rinsed in water and dried before next use
Spaulding’s cleaning system
- use for gonioscpoic CL
-tonometer bi-prisms
Hydrogen peroxide
-Hard(PMMA) 3% HP or 78-80 centigrade 10 mins
-Gas Permeable (GP) 3% HP, no heat
-Soft approved HP solution or heat
CL disinfection
Study page 16 chart
- defects are congenital or acquired
-males more commonly affected 8%
-females 0.6%
Colour vision
- 3 cone types (blue,green,red)
- trichromatic
Normal colour vision
-green deficiency
-green/purple
-red/purple
Deuteranomly
-red deficiency
-red/green
-blue/green
Protanomly
-Blue deficiency
-blue/green
-yellow/green
Tritanomaly
can see two primary cones
Dichromatic
Grey scale colour vision
Achromatopsia
-pseudo-isochromatic plates
-only red/green issues
-cant prove trichromat/dichromate
-preferred Macbeth Illuminat C lamp
-Alt. daylight/fluorescent
-dont use tungsten
Ishihara colour test
- a dichotomous test
-tests red/green and yellow/blue
-prove acquired colour issues - test monocularly
Farnsworth D-15
- glaucoma
-macular conditions - diabetic retinopathy
- medication toxicity
Acquired colour vision causes
- depth perception
-stereopsis sensitivity
-learned monocular clues
Stereoacuity
measured in seconds of arc
Stereopsis Sensitivity
-titmus stereofly
-randot stereo
- use 3D glasses with/Rx
- test distance 16in/4cm
Stereopsis tests
-ability to distinguish objects from background
Contrast sensitivity
1)Pelli Robson (20/60 VA chart)
-2.0 score = normal
-below 1.5 = impairment
2) Vistech
-6000 (near/reading 16in/40cm)
-6500 (distance 3m-10ft)
Contrast tests
-cataracts
-small pupil size
-improper px position
-instrument myopia (aware of near even with optical inifinity)
Autorefraction errors
-measures 3mm area of cornea
-length of the radius of curvature in mm
- dioptic power of the cornea
- “k-readings”
- high reading 46.00D = Steep curve
-lower reading 42.25 = flatter curve
-used in CL fittings
- managaing keratoconus
Keratometry
-age = higher when older
-forced lid closure/rubbing
-low blood pressure = low IOP
-corneal thickness (thicker)=overestimated
-time of day (low at night, high in morning)
Factors affecting IOP
1) systolic pressure (top #)= constricting
2)diastolic= at rest
-2mm from elbow
-pump until 20mm, palpate, 20mm more
-onset beats = systolic
-cessation sounds = diastolic
Blood pressure testing
Review testing instructions
