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PVM Exam I > Practical opthalmology lecture > Flashcards

Practical opthalmology lecture Flashcards

1
Q

Patients may present WITHOUT an ocular complaint but…

A 
STILL need their eyes examined!
-new patient visits
-wellness exam
-pre-op exam
-health certificate exam
-non-ocular sick exam
OR
-with a primary ocular complaint
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2
Q

Ocular discharge normal but excessive..

A

Epiphora

Noted brown staining near the corners of the eye

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3
Q

How do you describe ocular discharge?

A

Abnormal color, consistency, translucency… unilateral or bilateral.

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4
Q

ID red eye

A

Slide 6

Could be allergic, infectious, or secondary to an underlying disease process (glaucoma)

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5
Q

ID conjunctivitis

A

Chemosis

Edema

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6
Q

Blepharospasm..

A

?

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7
Q

Photophobia..

A

?

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8
Q

ID change in corneal pigmentation..

A

slide 9

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9
Q

Change in pigmentation of the Iris..

A

Iris nevus (singular)
Iris nevi (plural)
Iris melanoma?
Slide 10

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10
Q

Change in pigmentation of the sclera…

A

icterus

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11
Q

Prominent nictitans..

A

slide 12

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12
Q

Third eye lid mass…

A

Cherry eye!

Slide 13

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13
Q

Entropion

A

Eyelids roll IN

*slide 14

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14
Q

Ectopion

A

Eyelids roll OUT

*slide 15

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15
Q

Abnormal eyelids

A

Agenesis (lid is absent)

*slide 16

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16
Q

Change in the shape of the globe.

A

Buphthalmos

*slide 17

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17
Q

Change in the size/shape of the pupils…

A

Anisocoria

*slide 18

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18
Q

Proptosis

A

*slide 19

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19
Q

Acute blindness

A

Slide 20

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20
Q

When patients present for a primary ocular complaint.. what do we need to know?

A 
Clients perspective.. what have they noticed? what is there concern?
Which eye? Both? 
How long?
Has the condition progressed?
Does the patient seem bothered?
Blepharospasm? pawing at the eye? Third eyelid prominent? Rubbing? Change in behavior or activity?
Known incident?
Underlying medical conditions?
21
Q

Hyperthyroidism (renal disease) can cause…

A

Hypertension > retinal detachment

22
Q

Nutritional issues affecting the eye?

A 
Taurine deficiency
(cats and vegetarian diets)
23
Q

Facial symmetry and/or distortion?

A

Ears, eyes, lips, nose..

24
Q

Globe position..

A

Enphtalmos (eye sunken in)

25
Q

Exophtalmos..

A

Globe is pushed out.

Decreased retropulsion as from space occupying mass or carnassial tooth root abscess.

26
Q

Ptosis

A

Droopy lid

27
Q

ID..

A

strabismus

28
Q

Look for evidence of corneal trauma..

A

loss of translucency

loss of transparency

29
Q

Trichiasis

A

Hair in normal site but misdirected towards the cornea..

slide 36

30
Q

Distichiasis

A

extra eyelashes along the eyelid margin where they should not grow
*slide 37

31
Q

Ectopic cilia

A

Eyelash emerges from the underside of the lid

*slide 38

32
Q

Ocular exam..

Retropulsation

A

retropulse both of the globes (press with thumbs)

33
Q

Menace response

A

Cranial nerves II and VII

*Wave hand in front of the eye, cover the other.

34
Q

Palpebral reflex

A

CN V and VII

35
Q

Pupillary light reflex

A 
CN II and III
Direct 100% pupillary constriction
Consensual 50% pupillary constriction
Pupillary constriction (parasympathetic pathway)
36
Q

Advantages of direct opthalmosopy..

A

Greater magnification (greater detail)
Options (grid, slit, altering the dioptic power)
The fundus image is real, upright and 14x magnified in emmetropia (in the canine)

37
Q

Disadvantages of ophthalmoscopy..

A

Small field of view
Short working distance
Lack of steroposis- monocular exam
Difficult to see through cloudy media (limited light source)
Difficult examining the peripheral fundus
Greater distortion when the visual axis is not completely transparent
Your face is very close to the patients muzzle!

38
Q

ID the parts of the ophthalmic scope..

A

slide 45

39
Q

Direct ophthalmoscopy..

To examine the right eye..

A

Stand or sit at the patients right side…
Hold the opthalmoscope with your right hand vertically infront of your right eye
Keep your index finger on the edge of the lens dial.

0 to -1 diopters focus on the fundus for most examiners

Keep both eyes open and look as though you are looking past the patient to block your own accomidation

40
Q

Slide 49

A

Opthalmalogy lecture

41
Q

Indirect ophthalmoscopy

A

Image is virtual and inverted.
The magnification depends on the focal length of the lens.
20 D lens: 4-5x mag less field of view
30 D lens: 2-3x mag but greater field of view
An important point to consider is that the axial magnification of the image varies with the species examined. For this reason a very mild elevation of the optic disc seen in a horse should be given much more significance than a disc of similar appearance in a dog as a horse optic nerve would be minifed a the lens strength.
Consider 14 D lens for horse exam.

42
Q

Indirect ophthalmoscopy

Advantages

A 
Larger field of view for fundic image
Larger and safer working distance
Stereopsis
Ability to use both hands for patient examination
Ability to see through cloudy media.
43
Q

Indirect ophthalmoscopy

Disadvantages

A

Larger learning curve

Less magnification of structures, less detail

44
Q

ID indirect opthalmascope..

A

slide 52

45
Q

ID optic nerve

A

slide 53

46
Q

Schirmer tear test

A

diagnose keratoconjuctivitis sicca (KCS, dry eye)

47
Q

Fluorescein stain

A

Diagnose corneal ulceration

48
Q

Tonometry

A

Diagnose glaucoma, high intraocular pressure

Uveitis = low intraocular pressure.

PVM Exam I (9 decks)

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