Preclin: Disease specific questions and a bit more history

Question 1

Px has red eyes. What can you ask?

Answer 1

• Location?
  
  • When 1st notice? Happened before?
  • How often?
  • How long last?
  • When worse? Getting worse?
  • Treatment?
  • Affect on vision?
  • Associated symptoms?

Question 2

Px has contacts. What can you ask?

Answer 2

• How is your vision with contacts? Any problems? TYPE?
  
  • How often do you wear? How many hours/ days per week?
  • When you start wearing
  • Brand?
  • How do you clean contacts? What solution’

Question 3

Px has hypertension. What can you ask?

Answer 3

• Medication- name, dosage, frequency,
  
  • When 1st diagnosed
  • Do you take your own BP measurements or do you rely on GP. Has progressed or worse.
  • was your last visit to the GP?
  • When was last BP measurement. What was it?
  • FOH? Do you have any CVD

Question 4

Px has AMD. What can you ask?

Answer 4

• Location?
  
  • Type wet or dry
  • Do you take medication
    ○ Name, dosage and frequency
  • Do you continuously use amsler grid at home to self monitor? How often you do it?Worse vision since 1st diagnosis. Is disease controlled or progressive?
  • When 1st diagnosis? Regular checks up with opthal/optom for co-management of the disease? Surgery?
  • How is your central vision? Have there been any significant impacts on your vision (e.g. can no longer recognise faces anymore)? Do you experience any flashes or floaters as well
  • Any history of blindness or other conditions in family? Is it controlled
  • If you drive, how do you cope?

Question 5

Px has glaucoma. What can you ask?

Answer 5

• Location: 1 eye or both
  
  • Type? Congenital, open, closed, primary or secondary
  • Medication? Form? Name, dose, frequency. When last reviewed? When first given?
  • When 1st diagnosed? Are you under care by an opthalmologist or optometrist? When was last visit? Next visit?
  • What was your last IOP reading
  • Do you have diabetes
    ○ Any FOH of diabetes
    ○ Any FOH of glaucoma
    ○ Any FOH of HBP.
  • Do you drive? How’s vision while driving?
  • On any other medication? For BP, high cholest/ heart disease.

Question 6

Px has diabetes. What can you ask?

Answer 6

• What type
  
  • Do you take medication? What form of medication? Oral or injections Is your medication controlling your diabetes? Name, dosage, frequency. When medication last reviewed? When first given?
  • When 1st diagnosed? When last GP, endocrinologist visit? Doctors name and contact details.
  • Do you self-monitor
    ○ What was your last reading of your blood sugar levels? Are your blood sugar levels relatively stable?
  • Do you have FOH of diabetes? If yes, was their diabetes well managed?
    ○ Any FOH of glaucoma, hypertension, high cholest/ heart disease
  • Do you have: glaucoma, hypertension, high cholest/ heart disease
  • Associated symptoms.

Question 7

Px has floaters. What can you ask?

Answer 7

• Location. 1 or both. Where in visual field
  
  • When did you first notice them? Happened before
  • How often
  • How long do they last?
  • When worse? Getting worse? Number and size?
  • HOW DO THEY AFFECT YOUR VISON.
  • Associated symptoms

Red eye

- Location?
- When 1st notice? Happened before?
- How often?
- How long last?
- When worse? Getting worse?
- Treatment?
- Affect on vision?
- Associated symptoms?

Question 8

Px has photopsia/flashes. What can you ask?

Answer 8

• Location. 1 eye or both. Where in visual field. What colour
  
  • When you first notice? Happened before
  • How often
  • How long they last
  • Severity. Getting worse i.e. more numbers.
  • When is worse.
  • Associated symptoms

Question 9

Px has double vision. What can you ask?

Answer 9

• Asks them what DV is.
  
  • Are you experiencing now can you show me; horizontal or vertical. 2 separate images?
  • WITH OR WITHOUT GLASSES
  • 1 eye or both
  • How long have they had it for.
  • Frequency
  • Duration- intermittent or constant?
  • When is it worse
  • Anything help relieve it?
  • Associated symptoms

Question 10

Px has headaches. What can you ask?

Answer 10

• WITH OR WITHOUT GLASSES
  
  • Location
  • When did you first notice them.
  • Frequency
  • Duration
  • Severity? 1-10. pain or throbbing. Getting worse
  • When is it worse e.g. end of day?
  • Treatment: name, dose, frequency. Does it help?
  • How does it effect you
  • Associated symptoms.

Question 11

What do you ask for visual tasks?

Answer 11

• What do you do for living?
  
  • How many hours infront of screen and how many days per week.
  • Do you drive?

Question 12

What do you ask for General Health?

Answer 12

• How is your general health?
  
  • History of diabetes, high blood pressure, heart disease, cholesterol?
  • Medications?- list of current medications
  • Allergies- ocular and systemic
  • GPs name and address, how often to they see.

Question 13

What do you ask for family ocular history?

Answer 13

Glaucoma,

- AMD
- Turned/ lazy/ patched eye (when child)
- Systemic- diabetes, hypertension, heart disease, high cholesterol
- High Rx or blindness

Question 14

What do you ask for patient ocular history?

Answer 14

• Last eye examination
  
  • When did you first get glasses?
  • Eye operations
  • Eye injuries
  • Eye infections
  • Previous practitioners
  • Turned lazy eye
  • Were you patched