Ophthalmology 1 Flashcards
What are the top 4 signs of eye pain?
- blepharospasm
- reduced palpebral fissure
- ocular discharge/epiphora
- hyperaemiaw
What is hyperaemia?
increased redness
What is blepharospasm/
increased blink rate
What would you see with reduced palpebral fissure?
blink/wink
What are the local signs of pain?
- photophobia
- misosis
- third eyelid protrusion
- head-shy
- self-trauma/rubbing
What is photophobia?
avoiding light
What is miosis?
small pupil
What are systemic signs of eye pain/
- reduced appetite
- quiet/subdued
- depressed
- headache?
How would you triage a patient for pain?
- systemic signs
- brief description of ocular signs
- onset
- duration
How can a pain score be difficult?
the result will be affected by blepharospasm, squinting changes the patients facial expression
What does a patient have to score for additional analgesia on an ophthalmic pain score?
3 or above
How do you manage ophthalmic pain?
- medical options - topical and systemic
- surgery
How might you treat scratchy dry lids?
lubrication with HA drops
How might you treat acutely painful indolent ulcers?
bandage contact lens
How might you treat cramping spasm uveitis?
atropine/clycopentolate drops
How might you treat chronic searing ache of intractable glaucoma?
Enucleation
How might you treat dull ache orbital swelling?
NSAIDs +/- opioids
How might you treat an eye that cannot be opened to examine?
local anaesthetic, sedation or GA
How would you handle a blind patient to make them feel comfortable?
- talk to them
- go slowly
- guide them
- avoid bumps
How would you handle a patient who is blind of visually impaired for a clincial exam?
- assess temperament
- keep steady
- keep calm
- examine at the end of the table
- reward and reassure
What types of cataract are there?
inherited or diabetic
What type of glaucoma is there?
primary inherited genetic defect or secondary to intraocular neoplasia, uveitis, lens luxation
How would you treat glaucoma?
medical management intially, surgical shunt implant, laser TSCP/EPC ultimately enucleation
What is SARDS?
sudden acquired retinal degeneration syndrome
How would you confirm SARDS?
electroretinogram
What toxins can cause vision loss?
ivermectin poisoning, enrofloxicin in cats
What is PRA?
progressive retinal atrophy
What happens with PRA?
night vision goes then day vision
What else can cause vision loss?
brain disease and trauma
How can you advise owners who have a blind dog?
- facebook forums with other owners with blind pets
- RSPCA tips
- buster collars, guide leads, bump bars to prevent injury
- doggles/rex-specs
- sound/voice commands
- behavioural modification training
- lead walks offer more support - reverse guide dog