Ocular diagnostic testing: what, when, how? (Proceedings)

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Ocular diagnostic testing: what, when, how? (Proceedings)

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Aug 01, 2011

The basics

Signalment

     • Glaucoma in Cockers, Bassets
     • KCS in Cockers, Bulldogs, Pugs, Lhasas, Shih Tzu
     • Retinal degeneration in Poodles, Labs
     • Indolent corneal ulcerations in Boxers, Retrievers

History

     • When did the problem start?
     • Can the patient see?
     • Do they bump into things? If so, when?
     • Current medications? When they were started?
     • Environment?
     • What did the owner notice first?
     • Past illnesses, injuries, medications, etc.

Examination

     • Set yourself up for success, Have a quiet dark room, a comfortable exam space, a stool, and an assistant. If presenting for other problems as well, do the eye exam first.Have a systematic plan and stick to it.
     • Gather equipment and proceed to a low lit area. Bright light source, Schirmer tear strips, Fluorescein stain, Proparacaine, Tono-Pen/Tono-Vet/Schiotz, Head loops, Direct ophthalmoscope or lens

Basic eye exam

     • This exam should be the same in every eye case that walks in. Assess symmetry, Menace response, Test dazzle and PLR (direct AND consensual), Palpebral reflex, Tear Test, Fluorescein stain, Proparacaine, Examine the eye with a bright light source and head loop.

Basic eye exam

     • Lids: Lacerated? Inflamed? Alopecia?
     • Conjunctiva, Sclera, Third eyelid: Is it red? Is there hemorrhage? Is the TEL elevated?
     • Cornea: Hazy? Taking up stain? Divot? Laceration? Vessels? Melting?
     • Anterior chamber: Can you see the pupil or is it obstructed by hyphema/lens
     • Lens: Is it in position, is it clear?
     • Examine the posterior segment: Use the direct ophthalmoscope OR Use transilluminator and lens
     • Can you see the optic nerve and retina? Is the retina detached? Bleeding in the posterior segment?