Download presentation
Presentation is loading. Please wait.
Published byMagdalen Glenn Modified over 9 years ago
1
EYE EXAM
2
How to approach the eye..
3
What do we need? Snellen chart Magnifier - preferably X8 Torch with a blue filter Fluoroscine drops or paper Topical anaesthesia Topical short acting mydriatic preferably tropicamide Hand held ophthalmoscope A Systematic approach
4
Two types Medical - red eye (infection, inflammation) - loss of vision Trauma - penetrating - blunt - chemical - thermal
5
History Main symptom(s) Pain Discharge Vision Any trauma PMH, PSH Medication
6
Examination Anatomical Lymphnodes Eye movements Lids and lashes Conjunctiva Cornea Anterior chamber Iris, Pupil & Lens Fundoscopy
7
Eye Movements
8
Ophthalmoscopy Dim room Approach from 15cm, “O” magnification Right to Right, Left to Left Red reflex Aim nasally, small aperture, low light Cornea Lens
9
Red Reflex
10
Fundoscopy 1 Optic disk Swelling, cupping Colour Vessels, bleeds Macula Colour Exudates, abnormalities
11
Papilloedema
12
Fundoscopy 2 Vessels New vessels Tortuousity, segmentation Colour Rest of retina Pallor Bleeds Pigmentation Retinopathy
13
Fundoscopy 3 Tips Both eyes open – yours and theirs! Stand to side Peripheral retina Dilate pupils - if safe, after RAPD test and VA test Polarised filter
14
Rest of exam Visual acuity Visual fields RAPD “Digital” tonometry
15
VA – Pinhole
16
Rest of exam
17
Lids and Lashes
18
Lacrimal System
19
Dacryocystitis Treatment Acute - antibiotics - I & D Chronic - DCR
20
Lids and lashes
21
Viral
22
Viral treatment Check Cornea! Symptomatic, supportive Chloramphenicol Refer if in doubt
23
Bacterial
24
Bacterial Treatment Simple - chloramphenicol - drops day, ointment nocte’ Gonococcal - admit - swabs - IV cefoxitin 1g QID - Topical Gentamycin Neonatal - IV and topical Pen Chlamydia - occ. Tetracycline QID four weeks - Oral doxycycline or erythromycin for six weeks
25
PKC HS reaction Self resolving ?Steroids
26
Allergic, Vernal, GPC
27
Treatment Topical Antihistamines Spersallerge ® Topical Mast cell stabilisers Optichrom ® Topical Steroids Refer
28
Conjunctiva - other
29
Cornea
30
HZO Refer Check immunity Treat Systemic antivirals Topical antivirals Analgesia
31
Glaucoma
32
Acute Angle Closure
33
Glaucoma Post - Surgery
34
Chronic OAG Cup/disk ratio
35
Acute Angle Closure Mx Recognise Risk or reality Meds - diamox 500mg stat, 250mg QID - glycerine/mannitol 1-2g/kg - pilocarpine 1-2% QID - B-blockers BD Referral for Laser or Surgery
36
Diabetic retinopathy Background - dot and blot - hard exudates Pre-proliferative - cotton wool spots - IRMA - venous segmentation - large dark blots Proliferative - NVD or NVE - vitreous bleeds - fibrous proliferation and retinal detachment - neovascular glaucoma
37
Non Proliferative Background - dot and blot - hard exudates -micro aneurysms - macular oedema Pre-proliferative - cotton wool spots (soft) - IRMA - venous segmentation - large dark blots
38
Proliferative NVD NVE Fibrovascular proliferation Vitreous bleeds
39
Proliferative 2
40
FB, Blunt and Perforating Trauma
41
Blunt Trauma
42
Corneal Injury
43
Lens Injury
44
Other trauma Traumatic mydriasis Traumatic iritis Vitreous bleed Retinal detachment Macula oedema Optic neuropathy
45
Trauma management Analgesia Low light Gentle Same as all eyes X rays Topical antibiotics Tet Tox
46
References UCT Ophthalmology Lecture Notes www.trauma.org www.medicine.ucsd.edu/clinicalmed/eyes. htmwww.medicine.ucsd.edu/clinicalmed/eyes. htm www.atlasophthalmology.com www.eyecasualty.co.uk www.webeye.ophth.uiowa.edu/eyeforum
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.