Principals

Question 1

Discuss anatomy of the eye

Answer 1

Look at an atlas fool

Question 2

Discuss Examination of the eye

Answer 2

VA
-Corrected using glasses or pinhole

Occular inspection

• Pupillary response, RAPD
• EOM
• Inspect lids (evert), conjuncitiva and cornea
• Blood vessels (conjunctival vessels are supericical and move with the eyelid, episclearal vessels do not move)

Slit lamp

• Lid eversion
• Examine cornea with thin beam rotated to one side (allows viewing of both anterior and posterior surfaces)
• Fluoresceien examation with cobalt blue lite

Fundal insepction
Optic disc
-Normal optic disc is comprised of the retinal ganglion cells that exit the retina to form the optic nerve
-Contains the optic cup which is pale central depression in the disk
-Has a cup diameter : disk diameter ratio of 0.3
–Ratio >0.5 may indicate gluacoma
Retina
Foveal

Fields

IOP

• normal < 25 mmHg
• diurnal variation
• –usually 3 - 5 mmHg
• –highest readings at 6:00 a.m
• Contraindications (suspected globe rupture or penetrating injury, history of recurrent corneal erosions, severe bullous keratopathy, corneal abrasions or oedema)

Question 3

Discuss common othalamic mediacations and dose

Answer 3

LA

• Oxybuprocaine (amide LA, 0.5%)
• single dose only (corneal toxicity with repeated doses)

Cycloplegics

• cyclopentolate (muscarinic antagonist) 1% TDS
• homatropine 2% (paeds) or 5% drops - last 36-48 hours

Mydriatics

• topicamide 0.5% - last 2-6 hours
• Atropine last 7 days

Miotics

• Pilocarpine (cholinergic) 2%
• used to reverse mydriatics
• used in the treatment of acute glaucoma - stimulates cilary muscle to open trabecular meshwork

NSAIDS

• diclofenac 1mg/ml
• ketoralac trometamol 1mg/ml
• fubiprofen 300 mic/ml

Steroids
•fluoromethalone acetate 0.1%
•dexamethasone 0.1%
•prednisolone 0.5%, 1%
•hydrocortisone ointment 0.5%,1%
Adverse effects
•may exacerbate infectious keratitis
-occasionally used to treat severe herpes keratitis (only after ophthalmologic review)
•induces glaucoma if used > 1 week
•induces cataracts if used in long term
•slightly slows corneal healing

ABs
-Chloramphenical 
-Ciprogloxacin 0.3%
gentamicin 03%
tobra 0.3%

Anti virals
-aciclovir 3%