ophthalmic exam Flashcards
instruments
basic
- magnification
- light source
- opthalmoscope
light source
finoff transilluminator
- bright, focal light source
- superior to pen-light
what do we evaluate
- pain
- symmetry
- eye size and position
- periocular region
eye size
problems
- bupthalmos
- microphthalmos
- phthisis bulbi
eye position
problems
- exophthalmos
- enophthalmos
- strabismus
examination
- neuro-opthalmic examination (assess CN, reflexes, and vision)
- perform diagnostic tests (STT, Fluorescein dye, IOP)
- systematic exam (right then left, “outside to in”, “front to back”
cranial nerves that are examined
II, III, IV, V, VI, VII
ocular reflexes that are examined
- PLR
- menance
- palpebral
- dazzle
what do we assess first
pupil
which CNs does PLR assess
CN II and III
which CNs does the palpebral reflex assess
CN V, VII
which CNs does the menance response assess
CN II, VII, visual cortex
which CNs does the dazzle reflex assess
CN II and VII
assessment of vision
menance and dazzle
- not strictly tests of vision
relies on
- observation
- response to visual stimuli
tonometry
measurement of intraocular pressure
anterior chamber assess
- clarity
- depth
posterior segment assess
- dilate pupil
- tropicamide 1% (parasympathomimetic, time of onset, duration, varies with species)
examin lens
- stand back, examine at arm’s length
- find fundic (tapetal) reflex
a normal lense should be
optically clear
a cloudy lens (opaque) =
cataract
lens assessment
- direct and retro-illumination
- pupil dilation is critical
- note position, amount of opacity
what is the fundus
enormus variation in the dog
- number of retinal vessels
- appearance of tapetum (color, size)
- optic nerve (shape, size)
less so in the cat
direct ophthalmoscopy
- small, magnified view
- held between your face and patient’s mouth
- easy to use
lens in indirect ophthalmoscopy
- hand-held, convex
- large field of view
- most useful in vet species
- image is inverted and reversed
- challenging to learn
