Patient history Flashcards
If a patient has visual disturbance, how urgently do they need to see a doctor?
Urgent assessment by GP and referral to Ophthalmologist depending on assessment
What things would you ask to check for foreign body sensation?
Strongly suggests active corneal process if have foreign body sensation.
Does it feel like there is something in the eye?
Objective evidence
- visible foreign body
- Unable to spontaneously open eye or keep eye open ie in metal particles.
What is meant by an objective foreign body sensation?
Objective evidence
- visible foreign body
- Unable to spontaneously open eye or keep eye open ie in metal particles.
What is meant by a subjective foreign body sensation?
Scratchy, gritty eyes, like sand in eyes
May suggest allergic, viral conjunctivitis or dry eyes.
Patients with an active corneal process present with what 2 cardinal features?
Photophobia, sensitive to bright light
Objective foreign body sensation.
Patients with iritis, present with what features on history and exam?
Photophobia without objective foreign body sensation.
Why is a history of contact wearing important in eye history?
Risk of keratitis.
What features would you look for in pupil examination?
Mid dilated pupils 4-5mm suggestive of acute angle closure glaucoma.
Constricted pupils without CN deficit suggests plus photophobia without objective foreign body sensation suggest iritis.
In what eye conditions would you see a pinpoint pupil?
Iritis, corneal abrasion, infectious keratotis
Iritis, there is no objective foreign body sensation, but there is photophobia.
Corneal abrasion there is fluoroscein staining.
Describe what is meant by palpebral and bulbar conjunctiva?
Palpabral - inside eye lid
Bulbar - over globe
Describe the relevance between a ciliary flush and diffuse conjunctival injections?
Diffuse conjunctival injections are more indicative of conjunctivitis.
Ciliary injections seen in more serious eye conditions ie keratitis, iritis, acute angle close glaucoma.
What is meant by diffuse injection?
Dilated blood vessels.
Outline the corneal findings seen in keratitis?
White spots of corneal opacity. Picks up stains.
Why do we use flouroscein staining?
To detect the presence or absence of corneal process.
Define hypopyon?
Layer of white cells in anterior chamber.
