Eagleview Eye Clinic

Tag eye Examination

LOCAL ANAESTHESIA

πŸ‘¨β€βš•οΈ Local anesthesia numbs a specific area, blocking pain signals to the brain. In eye care, it’s used for procedures like cataract surgery, corneal scraping, or injections.

Common agents:

  1. Lidocaine: Fast-acting, short duration
  2. Bupivacaine: Longer-lasting
  3. Proparacaine: Topical anesthetic for surface procedures

Administration:

  1. Topical drops: Surface anesthesia
  2. Injections: Subconjunctival or periocular blocks
  3. Gel or ointment: Prolonged effect

Effects:

  1. Numbness: Reduced pain sensation
  2. Muscle relaxation: Reduced eye movement
  3. Variable duration: Depends on agent and dose
CASE HISTORY

A case history is a detailed record of a patient’s medical history, symptoms, and treatment plan. For eye care, it includes:

Key components:

  1. Chief complaint: Patient’s main issue (e.g., blurred vision)
  2. History of present illness: Symptoms, duration, severity
  3. Medical history: Systemic conditions, medications
  4. Ocular history: Previous eye issues, surgeries
  5. Family history: Relevant eye conditions
  6. Social history: Lifestyle, occupation, habits
  7. Medications: Current medications, allergies

Purpose:

  1. Accurate diagnosis
  2. Personalized treatment plan
  3. Monitoring progress
REFRACTION

πŸ” Refraction is the bending of light as it passes through different mediums (e.g., air, lens, cornea). In the eye, it focuses light onto the retina.

Types:

  1. Emmetropia: Normal vision.
  2. Myopia (nearsightedness): Blurred distance vision.
  3. Hyperopia (farsightedness): Blurred near vision.
  4. Astigmatism: Distorted vision.
  5. Presbyopia: Age-related near vision loss.

Tests:

  • Visual acuity: Snellen chart.
  • Autorefraction: Objective measurement.
  • Subjective tests: Lens power adjustment.

Corrections:

  • Glasses/contact lenses: Adjust refractive power.
  • Surgery: LASIK, PRK, etc.

MIOTIC DRUGS

πŸ‘¨β€βš•οΈ Miotic drugs constrict the pupil (miosis) and reduce intraocular pressure (IOP). Used for glaucoma, post-surgery, or counteracting mydriasis.

Common examples:

  1. Pilocarpine (cholinergic)
    • Effect: 1–2 hours, lasts 4–8h.
    • Use: Open-angle glaucoma, miosis.
    • Side effects: Headache, dim vision, brow ache.
  2. Carbachol (cholinergic)
    • Effect: Strong, longer-lasting.
    • Use: Glaucoma, post-op care.
    • Risk: Retinal detachment risk.
  3. Acetylcholine (direct-acting)
    • Use: Intraocular surgery (short-acting).
  4. Echothiophate (anticholinesterase)
    • Use: Chronic glaucoma.
    • Risk: Cysts, systemic toxicity.

Precautions:

  • Night vision issues: Avoid driving in low light.
  • Retinal risk: Check for detachment symptoms.
  • Asthma/COPD: Caution (bronchospasm).
  • Tapering: Avoid sudden stop.

MYDRIATIC DRUGS

πŸ‘οΈ Mydriatic drugs dilate the pupil (mydriasis) by relaxing the iris sphincter muscle. Used for exams, surgery, or treating inflammation.

Common examples:

  1. Phenylephrine (Ξ±-1 agonist)
    • Effect: Fast (30–60 min), short (3–6h).
    • Use: Diagnostic exams.
    • Risk: Hypertension, arrhythmia.
  2. Tropicamide (anticholinergic)
    • Effect: 30–45 min, lasts 4–6h.
    • Use: Routine dilation.
    • Risk: Blurred vision, photophobia.
  3. Atropine (strong, long-acting)
    • Effect: 1–2 weeks.
    • Use: Uveitis, amblyopia.
    • Risk: Prolonged blur, dry mouth.
  4. Cyclopentolate
    • Effect: 24–48h.
    • Use: Pediatric exams.
    • Risk: Behavioral changes in kids.

Precautions:

  • Avoid driving until pupils return to normal.
  • Glaucoma risk: Check IOP.
  • Monitor elderly/kids.
  • Side effects: Headache, stinging, dry eyes.

CYCLOPLEGIC DRUGS

πŸ‘¨β€βš•οΈ Cycloplegic drugs paralyze the ciliary muscle, blocking accommodation (focusing) and dilating the pupil. Used in eye exams, treating uveitis, or managing amblyopia.

Common examples:

  1. Atropine (long-acting, 1–2 weeks)
    • Use: Amblyopia, uveitis.
    • Side effect: Dry mouth, blurred vision.
  2. Cyclopentolate (shorter, 24–48h)
    • Use: Pediatric exams, refraction.
    • Risk: Hallucinations in kids.
  3. Tropicamide (fast, 4–6h)
    • Use: Routine dilation.
    • Mildest side effects.
  4. Homatropine (moderate duration)
    • Use: Uveitis, post-surgery.

Precautions:

  • Avoid driving post-use.
  • Monitor IOP (glaucoma risk).
  • Children/elderly: Adjust doses.
  • Contraindicated: Narrow-angle glaucoma.

CYCLOPLEGIA

πŸ” Cycloplegia is the temporary paralysis of the ciliary muscle, which controls the eye’s focusing (accommodation).

Key effects:

  1. Blurry near vision
  2. Difficulty focusing on close objects
  3. Pupil dilation (mydriasis)
  4. No pain, but uncomfortable for reading/near work

Common causes:

  1. Medications: Cyclopentolate, atropine (used in eye exams)
  2. Infections: Viral (e.g., herpes zoster)
  3. Trauma
  4. Toxins (e.g., botulinum)
  5. Conditions: Adie’s tonic pupil

Management:

  • Reversible (lasts hours–days, depending on cause)
  • Use glasses for near tasks
  • Avoid driving until resolved
  • Consult an eye doctor if persistent 😎.
MIOSIS

Miosis is the constriction of the pupil. It’s the opposite of mydriasis 😊.

Common causes:

  1. Bright light
  2. Medications: Opioids (e.g., morphine), eye drops (e.g., pilocarpine)
  3. Conditions: Horner’s syndrome, iritis, or neurological disorders
  4. Aging
  5. Substance use: Certain drugs (e.g., heroin)

Effects:

  1. Reduced light entry β†’ dim vision in low light
  2. Increased depth of field (improved near vision)
  3. Headache or eye strain
MYDRIASIS

Mydriasis is the dilation of the pupil, often caused by:

  • Low light conditions
  • Certain medications (e.g., atropine)
  • Medical conditions (e.g., Adie’s pupil)
  • Substance use (e.g., stimulants)
  • Trauma or injury

Effects:

  1. Increased light sensitivity
  2. Blurred vision
  3. Difficulty focusing
DECENTRED PUPIL

A decentred pupil refers to a pupil that is not centered in the iris, often due to trauma, surgery, or certain eye conditions.

Possible causes:

  1. Trauma or injury
  2. Surgical complications
  3. Congenital conditions
  4. Uveitis or inflammation
  5. Synechiae (adhesions)

Effects:

  1. Vision disturbances
  2. Increased sensitivity to light
  3. Cosmetic concerns