Ophthalmology tests and procedures - Beckman Laser Institute

10/20/2021

OPHTHALMOLOGY TESTS AND

PROCEDURES

MANDY HELTON BAS, RVTg, VTS(ECC)

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OUTSIDE OF OPTHALMOLOGY SPECIALTY¡­¡­

? Eye trauma

? Painful eye

? Infectious disease that effect eyes

? Loss of vision

? Dilation of eyes

? Neurologic disease that effects eyes



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ACQUIRING HISTORY FOR THE EYE EXAM

? Signalment, including breed

? Where patient was acquired; how long has owner had patient?

? Previous medical history, medications

? How long has current problem been going on?

? Any other neurologic signs?

? Why does the owner perceive there is a problem (blindness)

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INITIAL STABILIZATION OF EYE TRAUMA

? Manage other injuries

? Pain management if needed

? Lube traumatized eye

? E-collar

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PREVENTING HAI FROM PATIENTS WITH URI

? Gloves when handling

? Gown

? Use separate equipment/ disinfect

? House patients away from other patients;

especially those immunocompromised

? Don¡¯t assume all infectious patients have same

disease process

? Wash hands before and after handling

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OPHTHALMOLOGICAL EXAM

? Physical examination of eye

? Cranial nerves II- VII

? Menace, PLR, dazzle, palprebral, tracking, corneal reflex, pupil symmetry

? Ophthalmological exam of retina

? Blood pressure

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EXAMINING THE PATIENT

? Watch patient¡¯s reaction to environment

? Examine face

? Symmetry

? Bulging of eye

? Paralysis of face

? Facial trauma

? Nystagmus

? strabismus

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PUPIL SYMMETRY

? Patients should have symmetrical pupils

? Anisocoria: two different sized pupils

? Miotic pupil: constricted

? Mydriotic pupil: dilated/ ¡°blown¡± pupil

? Causes for anisocoria

? Eye trauma

? Neurologic disease

? TBI



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PUPILLARY LIGHT REFLEX

? Shining of light into eyes

? Pupils should constrict from light

? Constriction is consensual

between both eyes

? Cranial nerve II and III

? Helps assess brainstem function



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LACK OF PLR

? optic nerve, oculomotor nerve injury

? Brain stem lesions

? Sedation

? Anesthesia

? Brain death



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PALPEBRAL REFLEX

? Touching of medial canthus of eye should elicit a blink

? Tests cranial nerve V

? Lack of palpebral reflex:

? Damage to sensory of cranial nerve V

? Heavy sedation



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? anesthesia

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CORNEAL REFLEX

? Touching of the corneal should elicit retraction of globe

? Tests cranial nerve V

? Dysfunction of cranial nerve V

? Heavy anesthesia

? Brain death



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MENACE REFLEX

? Learned reflex

? Movement at eye should elicit ¡°flinch¡±

or blink

? Care to not touch whiskers, create air

flow that touches face or whiskers

? Visual pathways through cranial nerve

II and VII



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LACK OF MENACE

? Blindness

? Neonatal/ pediatric patients

under 4 months

? Sedation/anesthesia

? Cats may be more difficult to

assess



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DAZZLE

? Response to intense light

? Should cause blinking, aversion, raising of third

eyelid, moving of head, globe retraction

? Retina, cranial nerve II, VII

? Lack of dazzle

? Damage to cranial nerve II, VII

? Damage to retina

? Brain death



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