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Lec 1 opto 262 Clinical Methods 1
Transcript of Lec 1 opto 262 Clinical Methods 1
Develop a broad range of communication skills between examiner and patient, and attain skills and detailed clinical knowledge relevant to basic visual examination.
How to perform basic visual examination techniques: case history, visual acuity, pinhole, IPD (inter-pupillary distance), penlight examination of the external eye and anterior chamber, papillary function, duction, version, NPC (near point of accommodation), phoria test (e.g Maddox Rod, Red glass test), confrontation field, stereopsis, and worth-4-dot.
1) Clinical Procedures in Optometry, J. Boyd Eskridge, J.F. Amos and J.D. Bartlett.
2) Primary Care Optometry, 3rd Edition, T. Grsvenor.
The visual analysis room should be clean and tidy.
Instrument should be tested for oparation and in the ready postion.
Instrument should be placed for efficient use.
The examination chair should be lowered and locked against any sudden movement as patient is seated.
Optometrist should look for his personal hygiene, neatness and apparel.
Optometrist should be clear and audible, (faulty speech habit and mannerisms.
Avoid facial expressions (on finding that may affect pt psychologically).
Refer to the Pts by there name or my Patient.
Review of the previous visual examination record. (the visual analysis cannot be completed without considering the diagnosis, therapy and recommendations made on previous visit of the patient).
Test sequence for routine Pt
1) preliminary information. (Name,address, telephone no., date of birth, vocation (job), hobbies.
2) Case History
3) Visual acuity (VA)
4) Examine the external eye
5) Test for ocular motility
6) Test for amplitude of accommodation
7) Measure interpupillary distance
Should be determined by logic, efficiency and scientific principle.
There is no fix sequence of testing (test sequence may vary from pt to pt depend on optometrist experience)
Routine Patient (under 40yrs (non-presbyopic, who needs glasses or C.L to correct a RE, with minor pathology, not severly visually impair, or pt with general problem which does not require special technique to dignose an treat)
a) The chief complaint
b) Present visual history
c) Past visual history
d) Medical history
The case history
The Optometric Examination
The sequence of Optometric testing:
Sequence below is recommended with regards to:
1)complete the visual examination and refraction.
2)Time should not exceed 30 mins
For special patients like presbyopes strabismic patients, amblyobes and very young children. This basic routin will be adjusted by the optometric practitioner as is relevant.
10) subjective testing
11) Subjective balancing
12) Phoria tests at 6m
13) fixation disparity test
14) Prism vergence test at 6m and at 40cm
15) Binocular plus and minus lens acceptance at 40cm
16) Test for amplitude of accommodation again