0 - introduction to ophthalmology

8/3/2019 0 - Introduction to Ophthalmology

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Introduction to Ophthalmology


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message

Attitude Attendance

Commitment to learn2-week rotationBe prepared

PracticeEvaluationNeed to see secretary after this!!


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AnatomyPhysiology

HistoryExamination


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A dnexa


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H istory

G eneral health and systemic diseases:DM,HTN, connective tissue disease, drugs

Past ocular history: surgeries, trauma,glasses, lasers, eye dropsProfile of the patientChief complaint


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H istory

Abnormal appearance:-Lids

-Redness-Discharge


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Pain:Foreign body sensation

Itching & discomfortDeep severe painEye strainHeadache


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Disturbance of visionBlurred vision

Loss of visionDiplopiaPhotopsia and haloesFloaters

Visual field


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DischargeWatery

MucoidMucopurulentSecretion Vs drainage


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C ommon problemsSticky eye but clear vision - conjunctivitis


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P ainless progressive loss of vision in the aged - cataract


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P ain, poor vision, rainbows aroundlights - angle closure glaucoma


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B aby - one sided discharge,watery from birth NLD obst


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R ed eye, photophobia and blurred visionwith or without pain, uveitis


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No symptoms or vision of one eye found tobe poor by chance chronic simpleglaucoma


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S udden onset of horizontal diplopiaespecially in elderly - e.g. V1 cranial nervepalsy


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E pisodes of transient total visual loss inone eye - amaurosis fugax - retinal arterialemboli/carotid artery disease


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U pper half of visual field went suddenly inone eye: arterial or venous obstruction


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Dark curtain in front of one eye, coming from below; varieswith head position - upper half retinal detachment


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E xamination

Visual AcuitiyCentral vision

MaculaBest corrected


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Visual acuity tests in verbal children

Kay single picture Multiple pictures

Sheridan-Gardiner Sonksen-Silver

At age 3 years (matching tests)

At age 2 years (naming pictures)


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External examinationLids

MisalignmentRednessCorneal opacity


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P erkinje S anson images

1 st image: anterior corneal surface2nd image: posterior corneal surface

3 rd image: anterior lens surface4 th image: posterior lens surface, real, againstmovement


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stains

Fluorescein stainRose bengal


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P upils

Central, regular, reactive, roundDirect Vs indirect

Swinging light reflex, RAPD


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R ed reflex


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E ye drops

Anticholinergic: Tropicamide, cyclopentolate,atropine.

Adrenergic agonists: phenylephrine,adrenalineTopical anestheticcycloplegia


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Extraocular motilityMuscle balance


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Visual fileds

ConfrontationPerimetry


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Ophthalmoscopy

Direct ophthalmoscopeDialated pupils NB angle closure

Disc: cup/colour/contour MaculaBlood vessels

Periphery


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Invistigations

FFAPerimetry

UltrasoundCTMRI


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FFA


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CT scan


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Visual field


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U ltrasound


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M R I


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T hank you

Dr. Hasan MohidatChief resident, Ophthalmology,

KAUH

0 - introduction to ophthalmology

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