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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