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ophthamology > ophthamic examination > Flashcards

ophthamic examination Flashcards

1
Q

components

A

signalment
chief complaint
hx
visual exam of ocular and periocular structures
diagnostic testing

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2
Q

signalment

A

age

sex

species

breed

coat color

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3
Q

hx

A

chief complaint: symptoms, duration, ophthalmic meds-response to tx, onset
concurrent systemic dz and tx
previous ocular dz
environment in which the problem is more apparent
housing
family hx
travel hx
diet
visioin status
behavior change
changes in gait or posture
ocular d/c
eye color change
signs of pain

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4
Q

vision status

A

light vs dark
familiar vs new environments
laterality
distance
gradual or acute
progressive vs static

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5
Q

equine equipment

A

sedation

auriculopalbral block

very strong eyelids

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6
Q

examination

A

be systematic
both eyes!
disance examination
navigation and tracking

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7
Q

distance examination

A

globe positino
globe size
pupil size
presence of d/c
facial symmetry
head tilt

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8
Q

neuro-ophthalmic examination

A

menace response
palpebral reflex
dazzle
pupillary light reflex
vestibulo-ocular reflex

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9
Q

meance response

A

menace responselearned
blink in response to menacing gesture
CN II & VII, cerebral cortex, cerebellum
cover other eye
avoid generating air currents or stimulating vibrissae

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10
Q

palpebral reflex

A

diagnostic test in which the eye should blink in response to touch to the medial & lateral canthus of the eye
CN V & VII

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11
Q

dazzle

A

blink in response to light stimulus
CN II & VII, subcortical visual pathways
positive dazzle does not equal vision–>pathways are intact

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12
Q

pupillary light reflex

A

The pupillary light reflex is the normal constriction of the pupils when bright light shines on the retina.
CN II & III
positive PLR does not equal vision

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13
Q

direct PLR

A

stimulus and response in same eye

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14
Q

indirect PLR

A

response in eye not receiving stimulus

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15
Q

vestibulo-ocular reflex

A

involuntary ocular movements induced by moving head slowly from side to side
fast phase in direction of head movement
CN III, IV, VI

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16
Q

retroillumination

A

use of light reflected from a deeper structure to examine a more anterior structure
to ID opacities within the visual axis
very useful

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17
Q

orbit exam

A

palpation of orbital bones and periocular tissue
retropulsion

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18
Q

transillumination

A

observing light as it passes through transparent and translucent ocular structures

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19
Q

diffuse illumination

A

A type of Direct Focal. Used for gross examination of lid, lashes, lacrimal, conjunctiva illuminatin as much area as we can.

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20
Q

structures that can be examined with diffuse illumination

A

eyelids-skin, margins, grey line, palpebral conjunctiva
conjunctiva-palpebral, bulbar
third eyelid-elevate-bulbar surface
cornea & sclera-can also use slit beam

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21
Q

eyelid exam

A

abn hairs, masses, eyelid position
evert eyelids!

22
Q

conjunctiva, third eyelid

A

vascular congestion
edema (chemosis)
masses
pigmentary changes
third eyelid position

23
Q

Cornea

A

surface hydration, texture and defects
reflections

24
Q

color changes: red

A

blood vessels

25
color change: brown
melanin
26
color changes: yellow/creamy white
WBC
27
color changes: sparkly white
lipid or mineral
28
color changes: bluish white +/- cobblestone appearance
corneal edema
29
color changes: wispy grey white
fibrosis
30
sclera
masses color change
31
slit beam
use of narrow beam of light to create an optical cross section visualizes depth, spatial relationships and lesion localization
32
purkinje 1
corneal layer can be visualizedwhen using a slit beam should be parallel to purkinje 2
33
purkinje 2
anterior lens capsule can be visualized when using a slit beam should be parallel to purkinje 1
34
purkinje 3
posterior lens capsule can be visualized when using a slit beam
35
normal aqueous humor
does not reflect light because it lacks proteins and cells
36
flare in aqueous humor
beam of light is visible in anterior chamber connects purkinje 1 &2, cannot see purkinje 3 suspended particles
37
iris
use slit beam evulate anterior iris face before dilation color change texture change mass development pupil shape & movement
38
lens
use slit beam full dilation required opacity position anterior capsule texture changes
39
vitreous
use slit beam any opacities
40
fundic examination
examination of a composite created by super imposition of retina on choroid & sclera
41
indirect ophthalmoscopy
mirror image & inverted good magnification & field of view dilated pupil arm's length away from eye light source held at eye elicit tapetal reflection light beam is a straight line from examiner's eye, through indirect lens, into patients eye scan central & peripheral fundus
42
direct funduscopy
high magnification, limited field of view direct image uses-magnified view of lesions detect via indirect, lesion localization, fluroscent set wheel to 0 D in focus with + lens-raised lesions (anterior to retina) in focus with - lens-depressed lsions (posterior to retina)
43
optic nerve changes
color borders size & shape vascular: toruosity, engorgement, bleeding, vessel attentuation
44
tapetum changes
hypereflectivity-thin retina hypoflectivity-thick retina
45
non-tapetal fundus changes
thinner retina-more red/see vessels clearer thicker retina-change in color
46
schirmer tear test
meausrement of tear production per minute-basal and reflex perform before administering any eye drops do not touch strip with fingers bend at notch place strip into ventrolateral conjunctival fornix normal \>15 mm/min
47
tonometry
measurement of intraocular pressure perform prior to dilation in horses-have head above heart have head in same position for each reading
48
fluorsecein stain
for detection of corneal ulceration dye retained by hydrophilic corneal stroma NOT retained by hydrophobic epithelium or Descemet's membrane do not apply directly to cornea rinse excess dye-to see if ulcer is down to Descemet's membrane
49
jones test
assessment of patency of nasolacrimal ducts dyes should appear at nasal puncta within 2 minutes of placement into conjunctival sac (or oropharnyx)
50
cytology, culture and sensitivity
hard to culture eye bugs to aid in IDing an underlying etiology for surface ocular dz aerobic, anaerobic & fungal
51
nasolacrimal flush
establish/assess patency of the nasolacrimal ducts after a negative jones test do retrograde for horses
52
assessment of vision

ophthamology (3 decks)

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