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Description: Great for medical students in ophthalmology posting. Complete, precise and short notes to approach short case examinations.
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Short case Ophthalmology
1
...
Do not press palm against eye
...
- 6/6…6/60, 5/60, 4/60…1/60, CF-3 (counting finger at 3m), CF-2, CF-1, CF close to
face, HM +ve, PL +ve, PL –ve
- Charts for illiterate: E chart/Landolt’s C chart/simple picture chart
- Pinhole: removes need for focus
...
- Near vision: Jaeger’s chart, Roman test types, Snellen’s near vision
...
3
...
5
...
7
...
9
...
Look at reflection on both pupils
...
- Lacrimal puncta- eversion, discharge, stenosis, absence
- Lacrimal sac area – redness, swelling
Conjunctiva
- Palprebal conjunctiva – anemia
- Bulbar conjunctiva
o Use torch
...
Ask patient to look up: Check congestion, chemosis
...
Ask patient to look down: Check congestion, chemosis,
conjunctival bleb
...
Check for pterygium, pinguecula
Pterygium:degenerative conjuctival fold
...
Slightly vascular
Pinguecula: degenerative condition
...
10
...
Anterior chamber
- Depth
- Contents: hyphaema, hypopyon, ACIOL
12
...
Pupil
- Location, shape, size, symmetry, colour
o E
...
centrally placed, round, normal size, symmetrical, blacl
o Vertically oval pupil – acute congestive glaucoma
o Festooned pupil on dilation – uveitis
o Mention if pharmacologically dilated
- Reflex – DIM LIGHTS
o Direct light reflex
o Consensual light reflex – shine on other pupil
...
o Swinging light reflex (Marcus Gunn pupil) – to check for relative afferent
pupillary reflex (RAPD) – Positive in optic neuritis, optic atrophy, CRVO,
CRAO, RD
o Accomodation reflex – focus on pen, bring close to eyes
14
...
Status
4th Image
Phakic
Dull
Aphakic
Absent
Pseudophakic
Bright
Transparent/ opaque – In pseudophakia: posterior capsular opacification
Color of opacity
Iris shadow test – shine at 45degree
o Mature cataract: no shadow
o Immature cataract: shadow at the pupillary margin in the direction of
light
Red reflex
o Red globe bright and uniform – no opacities
o Location of opacities if seen
Periphery – cuneiform
Central – polar/ nuclear
o To confirm lens/ corneal opacity
Ask patient to move eyes
Opacity moves in same direction – cornea
Opacity moves in opposite direction – lenticular
o Also check for patency of iridectomy/iridotomy
Reflex present from scar : patent
Posterior segment
1
...
Red reflex: round and uniform
b
...
Direct ophthalmoscopy
a
...
b
...
c
...
Colour: pinkish yellow
ii
...
Cup:disc ratio: 0
...
Shape? Size?
v
...
Neovascularisation
d
...
Hypertensive changes
ii
...
Neovascularisations
iv
...
Ask patient to look at light
i
...
Foveal reflex
f
...
g
Description: Great for medical students in ophthalmology posting. Complete, precise and short notes to approach short case examinations.