2nd OSCE Flashcards
(5 cards)
Gonio script:
Hi Im dyllan, this test will assess the hidden angle in your eye
* You’ll need anaethetic, and this lens on your eye, do you consent?
Let me clean the rest and wash my hands
Fist we’ll check your cornea with this sye
* Have you had any allergies
* Looking up while i put it in
Using wratten filter everything looks clear
Are you pregnant or breast feeding
* Looking up
* Dont rub your eyes for 30mins
○ LET ME RECORD THE DROPS
While that settles, ill explain how this lens has been cleaned
* Surfactant
* Saline rinse 1min
* Soaked in 1:10 bleach 5min
* Rinsed with saline
The coupling fluid may be cold and fall
* Hold onto these tissues in case
* Looking down, up, straight ahead
Iris is healthy, looking at the angles
* Superior lens showing inferior angle
* NAD, can see schwalbe’s line, trabecular meshwork, pigmented and non, most anterior structure is the ciliary body band seen
Im going to rotate the lens
* Will feel strance, just look straigyht
* Same as above
In a moment I’ll get you to look up
* Removeing the lens with a gentle rock
Now checking your cornea again
* NAD with white light
* Looking up
And NAD with the wratten filter
Subjective refraction process:
Explain test
PD’s
* Use ret light
Ret: Green 120/6
* Against is minus
* Try find most plus > cyl change
* BVS cyl change
Refract
* First letter of each line
* Focus on threshold
* Add 0.25
* Minus 0.25 (improvement)
Blur check
* Add 1.00
* Ensure Px cant read 4 lines above
JCC:
* Axis: chase red
* Power: White means add minus
○ BVS
* Axis refinement
VA
Blur check
Binocular balance
* Add 0.75 to one eye
* Push 0.25 in other eye till worsens
* Repeat
Contact lens procedure:
Explain test
Wash hands
Insert RGP
* Anaesthetic
* Conditioner on lens
* Px looks up > straight
Remove RGP
* Press lid margin onto lens
○ Or pull lateral lids and blink
SCL assessment:
Centration:
* Diffuse view of CL
* 1/1 view of edge
○ Measure lateral and superior (note inferior)
○ Check movement on blink (at 4’)
Coverage:
* 1/1 of cardinal limbus
* Px looks away from light
* Measure lens coverage in gazes
Movement:
* Lag on lateral and up gaze
○ 1/1 measure how much lens moves after looking straight
* Push up test
Toric assessment:
* 2/4 align with toric marker
○ Using lamp rotator
Left Add, Right Subtract
Subjective refraction script:
Hi my name is Dyllan, this test will check your refractive error
* You’ll need to read some letters, do you consent
First I’ll measure your PD’s
* Look at my right eye, now my left
Looking at the green side of the big E
* I’ll shine a light
* LMK if I get in the way
Reading the first letter of each line
Focus on last line read
* Better with 1 or 2
* Can you read this line while blurred
Focus on the dots
* Better with 1 or 2
Reading the first letter of each line
* Can you read this line while blurred
What is the script in your other eye
* Better with 1 or 2
* Now the other eye
Better with 1 or 2
CL script:
Hi im Dyllan, this test will check the fit of your contact lens
* Will need to shine a light and have you look around, do you consent
While I wash y hands, would you like to do the RGP now or after?
Using global illumination the lens is well situated
* No damage, tear film is intact
* Otherwise NAD
Using a 1/1 the lens is over the limbus by 1mm
* Temporal, nasal and superiorly
* Please blink
○ Lens moves 0.2mm on blink
Please look left, right, up, down
* Lens displaces a couple mm, still on cornea
Please look left/right/up > Straight
* Lens lags only a little bit 0.2mm
* Smooth lens recentering
Look straight, im going to push on your eyelid
* Smooth, easy motion, and fast recovery
Checking the toric alignment
* Marking is 5’ right, so we need a lens axis 5 less
To place in the RGP you need some anaesthetic
* Are you allergic, breast feeding
* Looking up
* You cant rub your eyes for 30 mins
Im placing some conditioner in the lens and will place it on your eye
* Look down, ill hold your lower lid
* Look up, in a moment ill get you to look straight, try to keep upper lid open
* Look straight
To remove the lens just look straight and ill push your eyelids
