CC/HPI
what questions would you ask an AMD patient
Amsler, Eye vitamins, smoking, retina doc, injections
Foreign body sensation x 1 month, comes and goes, and seems to feel better with AT's.
This would be considered more of a routine or next available type visit
What condition is most commonly associated with decreased/blurred vision, glare, halos, ghost images
Cataracts
What could cause elevated? IOP?
Steroid use, trauma of the eye, inflammation conditions such as iritis etc.
The difference between a phoria and a tropia?
A tropia is always present, while phorias are there some of the time
What questions would you ask a patient that is using Plaquenil (Hydroxychloroquine)?
start date, how many mg/day, weight, prescribing doctor, medical diagnosis
Flashes and floaters ongoing for 2-3 weeks and the flashes seem to be happening more often. Denies any curtain, veil, or loss of vision.
This would not necessary be a same day but we would want to get them in in the next 1-2 days to rule out retinal tear.
Name 2 conditions associated with Flashes/Floaters
PVD, Retinal Detachment, Retinal Tear
Things that can cause shifts in refractive error?
cataracts, dry eyes, macular edema
What instrument would you use if a patient is being monitored for graves disease, Thyroid disease, or has concerns with protruding eyes?
hertel also known as the exophthalmometer
What questions would you ask a patient that is here for a lid consult?
Do you have a decrease in your superior visual field due to drooping upper lids? Does your vision improve if your eyes are open wide or with raising your eyebrows up high? Do your lids feel heavy, tired. Does it feel like it is hard to keep your eyes open while reading?
Red painful eye 5/10 with light sensitivity x 2 days with worsening blurry vision
This would be a same day work. This could be something as serous as iritis, corneal abrasion, or ulcer.
Colored aura, kaleidoscope, sometimes headache, like looking through broken glass
Ophthalmic Migraine
What ADD power would you typically start at for someone who is around the age of 45?
You would want to start at a low ADD (around +1.00) if they will be new to multifocal lenses. Try not to give too much plus because they will take it even when they do not need it.
Why is it important to make sure the medication list is up to date?
Steroids can elevate eye pressure, certain medications can cause things like dry eyes, and sometimes the medications can point us in the direction of a new diagnosis that they forgot to mention.
What questions would you ask a CL wearer?
What brand do you wear? Are you wearing them now? Last fit? Mono vision, multifocal or readers over CLs? How often replaced? What solution? Ever sleep in them? Daily wear time?
Sudden double vision starting less than 48 hours ago
Same day
It could be myasthenia gravis, multiple sclerosis, a brain tumor or aneurysm, a stroke and giant cell arteritis. It is important to ask several questions such as is it monocular or with both eyes open? It is more like a shadowing or a true double etc..
Name some conditions that could cause double vision (monocular or binocular?)
Uncorrected astigmatism, cataracts, pco, palsies, dry eyes, macular edema
Causes of Amlser grid changes?
Macular degeneration, Macular edema, Wet macular degeneration, ERM, and Hydroxychloroquine retinopathy.
If someone has 3 BO prism in each len what kind of ocular muscle defect would you expect to see?
Esophoria, Esotropia, or possibly limited abduction
What questions would you ask with a New patient CHILD?
Ever worn glasses? Mom, Dad or siblings in glasses? Family history of strabismus? Premature? Any history of a lazy eye or eye patching? Any headaches? Where do you sit in class? Trouble seeing what the teacher is writing?
sudden onset of severe unilateral eye pain or a headache associated with blurred vision, rainbow-colored halos around bright lights, nausea, and vomiting.
Same day this could be acute angle closure
Blurred vision, pain in temple, jaw pain, scalp pain/tenderness, sudden onset diplopia, sudden total loss of vision in one eye
GCA--Giant Cell Arteritis
Optic neuritis, CRVO, GCA, Macular hole, Wet macular degeneration, vitreous hemorrhage, retinal detachment
What is a APD and what could cause one?
Afferent Pupillary Defect. Causes can be advance stage glaucoma, Retinal detachment, advanced macular degeneration, Central retinal artery occlusion, think of anything that can disrupt the signal to the brain.
For Glaucoma patients look at the HVF!