Neuro Test 2

• MEASURES DISTANCE AT WHICH LETTERS ARE SEEN
• -20/70 MEANS ONE SEES AT 20 FEET, WHAT SOMEONE WITH 20/20 SEES AT 70 FEET

• PTOSIS-DROOPING OF UPPER LID
• ENTROPIN-
• EXTROPIN-
• LID MARGINS-NO EDEMA, ERYTHEMA, LESIONS, SCALES, OR CRUSTS
• CONJUCTIVIA-NO LESIONS OR DISCHARGE
• SCLERA-OPAQUE & WHITE

• DARK ROOM; PT FOCUSES ON DISTANCE OBJECTS
• VEINS-LARGER THAN ARTERIES
• -FOLLOW TOWARD MIDLINE
• CUP 1/3 SIZE DISC (SHARP MARGINS)
• MACULA-MOST LIGHT SENSITIVE
• RETINA-GLISTENING, FREE OF LESIONS

• INTRARETINAL HEMORRHAGES-RED SMUDGES
• FLAME SHAPED LESIONS-HTN
• LIPID DEPOSITS-YELLOW
• COTTON WOOL SPOTS-FUZZY WHITE APPEARANCE
• MICROANEURYSMS-RED DOTS
• DRUSENS-MACULAR DEGENERATION

• MAGNIFIES 10-40 TIMES
• FOR EXAMINATION OF ANTERIOR CHAMBER
• FOR EVALUATION OF CATARACTS

• *A TEST FOR MACULAR DEGENERATION
• *CENTRAL FIXATION
• * TEST EACH EYE WITH GLASSES
• *FOCUS ON CENTRAL POINT
• *IN MACULAR DEGENERATION SOME
• -SQUARES FADED OR WAVY LINES
• *USED FOR DETECTION OF EARLY S/S OF MACULAR DEGENERATION

• *USED TO EVALUATE MACULAR EDEMA
• -TO IDENTIFY NEOVASCULARIAZTION
• -GROWTH OF ABNORMAL BLOOD VESSELS
• *DYE GIVEN IV
• *PHOTOGRAPHS TAKEN OF RETINAL VESSELS
• *SE: GOLD TONES TO SKIN OR URINE

• *TO MEASURE IOP BY DETERMINING AMT OF PRESSURES TO FLATTEN A SMALL PORTION OF GLOBE
• -LOCAL BEFORE
• *NORMAL 10-21 MM/HG
• *3 TYPES
• -INDENTATION
• -APPLANATION
• -NON-CONTACT

• *TO EVALUATE FIELDS OF VISION
• *2 METHODS OF TESTING
• -MANUAL-USE OF MOVING OR STATIONARY TARGETS
• -AUTOMATED-USES STATIONARY TARGETS

• *REQUIRES EMOTIONAL, SOCIAL, & PHYSICAL ADAPTATION
• *REQUIRE ACCEPTANCE OF CONDITION & RECOGNITION OF PERMANENCE
• *STEPS OF GRIEVING PROCESS, FAMILY ALSO GRIEVES
• POSITIVE AND NEGATIVE ATTITUDES AFFECT REHABILITATION

• REFRACTIVE ERRORS-
• -MYOPIA-NEARSIGHTEDNESS
• -HYPEROPIA-FARSIGHTEDNESS
• -ASTIGMATISM-REFRACTION OF A RAY OF LIGHT IS SPREAD OVER A DIFFUSE AREA RATHER THAN SHARPLY FOCUSED ON THE RETINA
• -PRESBYOPIA-OCCURS IN THE 40'S, INABILITY TO MAINTAIN FOCUS ON OBJECTS HELD NEAR TO THE EYE
• -EMMETROPIA-NORMAL, EYE IS AT REST

• -USUALLY ASSOCIATED WITH HEAD INJURIES.
• -STABILIZE BEFORE CONDUCTING OCULAR EXAM
• -INSPECT FOR POSSIBLE FRACTURES ESP. WITH BLUNT TRAUMA
• -DETERMINE EXTENT OF INJURY, VISUAL ACUITY ASAP
• -MAJOR INJURIES: SOFT GLOBE, PROLAPSING TISSUE, HEMORRHAGE OR LOSS OF RED REFLEX

S/S: REDNESS, ECCHYMOSIS, LID SWELLING, PROTOSIS, CONTUSIONS, SUBCONJUCTIVAL HEMORRHAGE

TX: CLEANSE AND REPAIR OF WOUNDS; COLD COMPRESSES FOLLOWED BY WARM; I & D OF HEMATOMAS

PENETRATING INJURIES-OPTIC NERVE DAMAGE

VISUAL LOSS AFTER INJURY OFTEN IRREVERSIBLE

• *CT SCAN TO IDENTIFY OBJECT
• *METAL OBJECT-NO MRI
• CULTURES AND ANTIBIOTICS AS INDICATED

• -LEADING C/O BLINDNESS IN CHILDREN, TEENS, & YOUNG ADULTS
• -CAUSES-OCCUPATIONAL INJURIES, SPORTS, BOXING, ASSAULT, MVAS, AND WAR
• -INTERVENTIONS- (NON-OPHTHAMOLOGIST)
• -CHEMICAL BURNS-IRRIGATE WITH NS OR H20
• - FOREIGN BODY- DONT ATTEMPT TO REMOVE
• - APPLY PATCH AND METAL SHIELD OR STIFF PAPER CUP

• -CHEMICAL-IRRIGATON WITH NS OR TAP WATER
• -RUPTURERED GLOBE-NO EYE OR GTTS OR OINTMENTS
• -AVOID FURTHER MANIPULATION
• - IV ANTIBIOTICS & TETANUS TOXOID, ANALGESICS, AND ANTIEMETICS

• -REMOVE FOREIGN BODY; ANTIBIOTIC OINTMENT; PATCH EYE; AVOID ANESTHETIC DROPS-MASKS FURTHER DAMAGE
• -CHECK FOR S/S OF INECTION UNTIL HEALED
• -CONTACT LENS CAN CAUSE SEVERE PAIN, PHOTOPHOBIA
• -CORNEAL EPITHELIAL DEFECTS-ANTIBIOTIC OINTMENT; NO STEROIDS