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SOAP format-what does each letter mean
- s-subjective
- o-objective
- a-assessment
- p-plan
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subjective (s)
intangible, perceptions, history
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objective (o)
hard facts, physical exam, labs
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assessment (a)
- interpretation of s and o
- what is it pointing you to
- what are you thinking about
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plan (p)
- what are you going to do
- DX-diagnostically
- TX-therapeutically
- CE-client communication
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what are the basics of ophthalmology
- normal anatomy and physiology
- common diagnostics, medications and symptoms
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common diagnostic 1-direct ophthalmoscopy
great magnification right side up
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common diagnostic-indirect ophthalmoscopy
great magnification upside down
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common diagnostic-pan ophthalmic exam
- moderate magnification
- more than indirect
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what are other common diagnostic
- Schirmer tear test (STT)
- fluorescein stain
- culture and sensitivity (C/S)
- conjunctival scraping for cytology
- tonometry-Schiotz or Tonopen
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advanced diagnostics-split lamp
- highlight celary debris
- if normal eye should not see laser
- 3D
- can see depth of cataract and ulcers
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advanced diagnostics-ultrasound
masses or deep trauma
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advanced diagnostics-electroretinogram (ERG)
- dog asleep, eyes open
- checking to see if retina is attached
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what are the other advanced diagnostics
gonioscopy
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ophthalmic drugs-topical
retard healing
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ophthalmic drug-subconjuctival
injected on the soft tissue
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ophthalmic drug-antimicrobials
bacteria fungi and viruses
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ophthalmic drug-anti-inflammatories
steroids and NSAIDs
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ophthalmic drug-mydriatics and cycloplegics
makes pupil dilate
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ophthalmic drug-miotics
makes pupils constrict
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ophthalmic drug-lacromimetics and artificial tears
stimulates tear production
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ophthalmic drug-anesthetics
for treatment
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what is the other ophthalmic drug
systemic
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what is the ophthalmic drug order
- water soluble (drops) than oil based than ointment
- goes thinnest to thickest
- few mins in between
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what are the signs of disease for lids/adnexa
- blepharospasm
- swelling and growth
- abnormal lashes
- hair loss around the face
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what does blepharospam mean
- spastic eyelids
- symptom not a disease
- usually corneal irritation/stimulation
- squinting
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what are dogs and cats going to do after putting eye meds in eye
- squint
- if still squinting 20-30 mins after, meds are not doing anything for them
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what are the signs for disease for conjunctiva/orbit
- chemosis
- eversion of the third eyelid (cherry eye)
- vascular congestion-episcleral, scleral
- red eye-swelling of the conjunctiva
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signs of disease for nasolacrimal system
epiphora-excessive tearing
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signs of disease on cornea
- edema
- defects-ulcers, injury, FB
- neovascularization
- tissue overgrowth-pannus, keratitis
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signs of disease on uvea/anterior chamber
- hyphema-blood
- hypopyon-pus
- anisocaria-pupil size difference
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signs of disease on globe
- exophthalmos
- enophthalmos
- buphthalmos
- microphthalmos
- strabismus*
- proptosis
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prominent eyes
- buphthalmos
- exopthalmos
- proptosis
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burphthalmos
- globe enlarged
- pressure or tumor
- a lot of pressure in eye, gets bigger and stretches
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exophthalmos
- forward position of the globe
- normal, abscess, mass, other swelling
- eyeball is normal size but out towards you
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proptosis
- disruption from the orbit
- globe of eye forced ahead of the eyelid margin
- after surgery stays in the direction they were looking, centers overtime
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small eye-microphthalmos
- small globe
- congentic
- phthisis bulbi-end stage of diseased eye
- born this way
- can be functional or unfunctional
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small eye-enophthalmus
- retraction of globe into the orbit
- due to pain, reflex
- normal globe pulled back in, eye painful
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what should you worn clients about
- squinting
- red (bloody)
- cloudy or hazy
- eye bulging
- stains
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