VA midterm chapter 4 Flashcards
external observation:
- walking movements
- posture of body and head
head tilted?
**may indicate:
- vertical Phoria
- cyclophoria
- ocular paralysis
: explanation given by the patient as to why he is seeking visual care at this time
chief complaint
statistical analysis of chief complaint
- periodic check up
- pain
- conjunctivitis and blepharitis
- cosmetic
- glasses are uncomfortable
- disturbances of vision
types of pain
- ocular pain
- orbital pain
- headache
cosmetic:
- appearance of glasses
- broken glasses
- strabismus
glasses are uncomfortable due to:
size
fit
disturbances of vision:
- diplopia
- tearing
- poor achievement on job or at school
- blur at far or near
- asthenopia
- photophobia
- holds things close when he reads
- failed screening test
- sits too close when watches TV
: interrogation regarding previous eye care received by the patient, benefits like: care and inventory of previous visual complaints
ocular history
: apparent to the patient when the peripheral stimuli to fusion have been diminished.
diplopia
: motion sickness, accompanied by headache and nausea. peculiar to heterophorias.
vertigo
in vertigo, patient will report:
dizziness
headache
gastrointestinal disturbances
other symptoms in heterophorias:
fatigue
pain in the eyes
blurred vision
: oral infection may cause fusional and motility difficulties
dental health
severe dental and oral condition may cause
headache
diplopia
motility problem
developmental history:
_______: verbally assertive, dogmatic, shows urge to speak out, create, produce and ask why..
four years
developmental history:
_____: learning to get along well with strangers, beginning to play, can dress self up, know his name, age
five years
: eye strain due to prolonged near work. this means “weak eye”
asthenopia
symptoms of asthenopia:
ocular pain
headache
visual fatigue or discomfort
drowsiness
photophobia
congestion
puffiness
itching
irritation
: blur and HA are the most frequent complaints.
headaches
HA categories:
- ocular
- intracranial disease
- psychogenic
- migraine
- vascular
- neuralgias
- sinusitis
: no headache unless EOR between eyes is unequal or severe or eyes is abused. exposure to bright lights causes HA
nearsighted
: frontal HA moderate to severe, present daily in afternoon or evening
farsighted
: produce frontal, vertical and bi-temporal pain associated with slight dizziness, as well as nausea which is relieved after going to bed or resting or taking acetylsalicylic acid
EOR
EOR associated with muscle error is almost certain to produce:
pain
nervousness
irritability
exhaustion
nausea
loss of weight
neck pain: due to
ocular muscle imbalance
Types of ocular headaches according to Elmstrom:
- presbyopia: frontal or mid-orbital increasing in duration and severity as day goes. excessive near work may result in residual HA lasting through evening and the ff morning
- astigmatic: mid-orbital some cases frontal
- vertical phoria: HA overflow brow with a tension and pulling effect. may be unilateral radiation HA
- esophoria: HA coming on with near work similar to hyperopia. HA associated with toxemia or internal malfunction requiring medical attention
- high exophoria: HA occipital but may extend to frontal
- hyperopia: frontal and mid-orbital along with: watery and burning sensation
gradual blindness
cataract
retinal degeneration
chronic glaucoma ‘
choroiditis
presbyopia
sudden blindness
retinal detachment
hemorrhages
multiple sclerosis
trauma
embolism
case history is divided into 9 parts
external observation
age
chief complaint
ocular history
health history
education history
developmental history
occupational hx
familial hx
astigmatism also known as
astigmia
high head posture should fit with low bifocal segment
low head posture fit with high bifocal segment
patient has difficulty in seating means
poor body coordination
impairment of spatial judgment
- blood poisoning by toxins by a local bacteria
toxemia
constant, severe, deep, steady boring character. felt at the top or front of the head, occipital or cervical region
Intracranial disease headache:
: paroxymal HA suddenly appearing or disappearing with changes in the position of head
ventricle tumor
: frequent, regular and annoying but not severe enough to capacitate the patient.
ocular HA
symptoms of ocular HA
dull pain
steady
persistent
psychogenic HA
- tension anxiety
- conversion hysteria
anxiety equivalent
tension anxiety
- relieve emotional tension
conversion hysteria
: occurrence of scotoma and field defects
migraine HA
migraine HA occur in people who are:
indecisive
insecure
perfectionistic
compulsive
sensitive
anxious
easily discouraged
: typical hypertensive HA, dull or throbbing. frontal or fronto-temporal. awakes the patient in the morning from pain
vascular HA
: dull, non pulsatile in quality, felt in frontal and maxillary region, less often in occipital, severe in the morning
sinusitis
headaches accompanying changes in lens Rx or visual training: HA experience when start wearing new rx.
Check:
PD for distance
PD for near
Base curve of new lens
Absence of tint/ diff tint
Vertical centering of lens
Incorrect amount or axis of astigmia
Vertical prism if present
New rx visual discomfort -due to shif in the _______that’s occuring because of the disorganizing phases of the training routine
visual pattern
