Ophthalmic examination Flashcards
Tear readings (Shrimer tear test[STT-1]) - method
Fold the strip while still packaged
Take out and hold it by the end
Retract the lateral lower eyelid with your thumb
Insert the tip up to the notch in the lower conjunctival fornix
One eye at a time usually
Wait 1 minute per eye
measure both eyes + compare
STT-1 readings - normal values
15mm/min + above = normal
10mm/min + below = low readings
Three light examination techniques
Transillumination / Slit examination
Direct ophthalmoscopy (distant and up-close)
Indirect ophthalmoscopy
Transillumination / Slit examination - 2 points of focus for the exam
anterior structures of the eye
reflexes (dazzle + PLR)
surface detail - circular beam - what should you see
conjunctiva should be smooth + shiny
melbomium glands seen as small white dots
check overall brightness and moisture
corneal thickness is..
0.5mm
possible changes in the anterior chamber (AC)
Aqueous flare: “Tyndall effect” Keratic precipitates Hyphema (blood) Hypopion (pus) Posterior synechia and anterior synechia Anterior lens luxation Anterior presentation of the vitreous
Distant direct (DDO) - method
Look directly through the ophthalmoscope into eye
have dog at arms length
Close direct (CDO) - method
Look directly through the ophthalmoscope into eye
have dog close to your face
Indirect Ophthalmoscopy
Look indirectly, at an image of the fundus
use Ophthalmoscope or 30D lens
which method to differentiate nuclear sclerosis from a cataract
DDO
which method to examine the posterior segment
CDO, IO
nuclear sclerosis vs cataracts as seen with tapetal light retroillumination
Nuclear sclerosis is transparent
Cataracts appear black
image seen through lens during IDO
L to R + upside down
Fluorescein staining - method
Strips are preferred over drops
Adheres to stroma (hydrophilic)
Repelled by epithelium
Do not touch strip to the cornea (dry or wet)
Wet strip with saline
Apply a drop onto dorsal conjunctiva
Look for ulcers or nasolacrimal duct patency
