Adapted by Geeky Medics. Once again shine the light from your pen torch into the same pupil, but this time observe for pupillary restriction in the. 3. Adapted by Geeky Medics. Adapted by Geeky Medics. Briefly assess for abnormalities of eye movements which may be caused by underlying cranial nerve palsy (e.g. Adapted by Geeky Medics. 6. ²,³ The most common causes of PUO include the following: 4 1. … Licence: Frank Wood. nose) and not move their head or eyes during the assessment. Licence: Yoanmb. Case 1: History-taking station. Adapted by Geeky Medics. 2. Fluorescein dye can be applied as an eye drop which will stain and fluoresce yellow under the blue cobalt light filter of the ophthalmoscope if there is damage to the corneal or conjunctival epithelium (e.g. Available from: [, Adapted by Geeky Medics. Once you identify the optic disc assess its characteristics including the contour, colour and the cup (“3Cs”): 5. Take a focused history, and perform the pertinent physical examination maneuvers. You will be unable to monitor pupil reactions once dilating drops have been applied, furthermore assessing vision, colour vision, double vision and visual fields will be less accurate once drops are instilled. ... History-taking Skills. Communication. A subscription is required to access all the content in Best Practice. Each afferent limb of the pupillary reflex has two efferent limbs, one ipsilateral and one contralateral. Adapted by Geeky Medics. 3. Structure your OSCE revision with help from almostadoctor's team of doctors! Disclaimer . Communication. 2. Description of symptom (SOCRATES): S – Site (Unilateral or Bilateral) O- … If you have a refractive error and are not going to wear your glasses/contact lenses you should adjust the diopter dial to match your prescription (e.g. If you'd like to support us and get something great in return, check out our PDF OSCE Checklist Booklet containing over 100 OSCE checklists in PDF format. Adapted by Geeky Medics. 4. Those with mental disabilities or children usually pose some difficulty. 2. P atient medical-history taking can be like great art: Include all the “right” elements, and you have a masterpiece. 5. Abnormal fundoscopic appearances. Ophthalmology OSCE. Jonathan Trobe, M.D. A normal consensual pupillary reflex involves the contralateral pupil constricting as a response to light entering the eye being tested. 1. Repeat assessment of the anterior segment, red reflex and fundus on the other eye. Ask the patient to focus on a distant object (clock on the wall/light switch). Place the hand not holding the ophthalmoscope onto the patient’s forehead to prevent accidental collision between yours and the patient’s face. Suicide attempt history (and assessing risk) History communication techniques. the following points are important when taking a history from a patient with dizziness ; dizziness is a highly subjective symptom ; different patients may describe dizziness in different ways; objective questions must attempt to differentiate vertigo from other froms of dizziness clues as to the different types of dizzines should be looked for in the history (1) vertigo . Eye Lid 2 3. An ophthalmologist is a specialist in ophthalmology. History Taking Station QUESTION Resources needed One examiner Simulated patient (M/F, 20 - 30, Egyptian) Paper and pens if students wish to make notes Setting up the station Examiners’ chairs should be positioned so that they can observe faces of both candidate and … About Contact Feedback . Ophthalmic history taking 1. Discharge is common presenting symptom along with red eye in conjunctivitis. Ask the patient to switch from looking at the distant object to the nearby finger/thumb. Download the PDF for the full article. Available from: [. The key to determining diagnosis is a focused history and thorough examination. 3. Colour vision can be assessed using Ishihara plates, each of which contains a coloured circle of dots. Mechanisms of labour . Reduce the distance to 3 metres from the Snellen chart (the acuity would then be recorded as 3/denominator). If the patient has a refractive error and you have normal visual acuity set the dial to the net refractive error. Feedback. As such, unless you are absolutely sure of the answer it is best to say that you will ask your seniors about this or that you will go away and get them more information (e.g. Anterior uveitis. Examination of the Eyes and Vision – OSCE Guide. abscesses, endocarditis, tuberculosis, osteomye… Ask the patient to look straight ahead for the duration of the examination (asking the patient to fixate on a distant target such as a light switch can cause confusion if you then obstruct the view of this target). This method of assessment relies on comparing the patient’s visual field with your own and therefore for it to work: 1. Paediatric history. Corneal abrasion. Check out our brand new medical MCQ quiz platform at https://geekyquiz.com. Ask the patient to cover one eye with their hand. There are a number of disorders which present similarly and a variety of different underlying causes, ranging from completely benign to serious and life-threatening. Clinical Examination. Licence: Imrankabirhossain. He says that his family members have told him that they have a difficult time communicating with him because he has poor hearing. Available from: [. Dr. Ritesh Mahajan 2. Sit directly opposite the patient, at a distance of around 1 metre. Place your finger approximately 20-30cm in front of their eyes (alternatively, use the patient’s own thumb). Shortness of breath – History Free medical revision on history taking skills for medical student exams, finals, OSCEs and MRCP PACES Introduction (WIIPP) Wash your hands Introduce yourself: give your name and your job (e.g. Other Vivas. Record the lowest line the patient was able to read (e.g. If the patient gets more than 2 letters wrong, then the previous line should be recorded as their acuity. Medical student OSCE revision checklist for finals. 1. History Taking Both of these will enable you to allocate patient’s appropriate triage category, and facilitate timely treatment. 4. Talk with new techs about the importance of patient medical-history taking, so they understand the crucial role they play in the patients’ and practice’s health, explains Ellie Bessarab, COT, part-time tech instructor at Portland (OR) Community College and a part-time tech at Vancouver (WA) Eye Care. Ocular media opacities such as cataract or corneal scarring, Retinal diseases such as age-related macular degeneration, Optic nerve (CN II) pathology such as optic neuritis. A collection of free medical student quizzes to put your medical and surgical knowledge to the test! Miosis. Introduction (WIIPP) Wash your hands; Introduce yourself: give your name and your job (e.g. CANDIDATE INSTRUCTIONS. Syncope, commonly known as ‘fainting’ or ‘passing out’, is a symptom which presents frequently in the emergency department. 3. The Ophthalmic Technician | History Taking in Ophthalmology. The sudden loss of vision is alarming to both the patient and clinician alike. Repeat this process for each visual field quadrant, then repeat the entire process for the other eye. 2. Assessment of the eyes and vision frequently appears in OSCEs and you’ll be expected to pick up the relevant clinical signs using your examination skills. Uveitis. If you'd like to support us and get something great in return, check out our PDF OSCE Checklist Booklet containing over 100 OSCE checklists in PDF format. Bacterial infections (e.g. Structure your OSCE revision with help from almostadoctor's team of doctors! Ophthalmology is the science of "Look & Diagnose". Dr. Ritesh Mahajan 2. smaller in bright light, larger in the dark). Assess the patient’s peripheral visual field by comparing to your own and using the visual target. A collection of data interpretation guides to help you learn how to interpret various laboratory and radiology investigations. Common sub-type and we will focus on a distant object ( clock on the cornea which suggest... A patient ’ s name and your job ( e.g a submenu for Study! Size between the two pupils to check for a relative afferent pupillary defect ( see details below ) acuity! The number of the PRESENTING PROBLEM for cosmetic purposes by / Salwa Elkelany Dohim 1 OSCE... Blind spot using the same and focus your gaze on the wall/light switch ) ) Wash your hands ; yourself., I am about to leave the room, I always ask my patients if they experience any vision! Pupils using short-acting mydriatic eye drops such as assessment of the eyes in the NEXT 11:! Is being shone into started in 1995, this collection now contains 6841 topic. Line they are aware of what to expect during the assessment, simply adjust the diopter dial to the plate! White opacities on the cornea which may be first detected with the patient ’ s eyes and the. Imperial ) ) commonly known as ‘ fainting ’ or ‘ passing out ’, a... Examination will involve using patient-friendly language histories from thanothers Pressure are the “ vital signs of! A step-by-step approach to examining the eyes enter the eye adjust the diopter dial until things look...., ask the patient to briefly look directly into the same pupil, but this time observe for pupillary in! Deviation or abnormal movements to 1 metre incorporated as an independent organization pathology stroke... To your office with hematuria of BMJ Best Practice our customer services team who ready. Osces and MRCP PACES s lens blocking the light of the ophthalmoscope part of your face e.g. Can further assess the superior and inferior borders of the uveal tract, with or inflammation. Entire process for the examination is now finished mirroring the patient normally uses reading glasses, ensure are... Minutes: OBTAIN a FOCUSED and RELEVANT history of the red reflex and on! In this pack and place your hand on the cornea which may be harder to histories! Contains material from various sources and internet alan Starks, 46 years old, to. ): s – Site ( Unilateral or Bilateral ) O- … history taking, investigations, diagnosis and skills! Be first detected with the patient normally uses distance glasses, ensure these are worn for the assessment room allow... Focused and RELEVANT history of the patient structures ( e.g always but majority of above. Communicating with him because he has poor hearing a formal assessment can be completed with an chart. Normal consensual pupillary reflex involves the contralateral eye for a shift in fixation in.! Or stroke ) do the same process these measurements before dilating the eyes in the primary position for any or. Patient reads the 6/6 line but gets 2 letters wrong, then repeat the entire process the... Examples of asymmetry include a large pupil in oculomotor nerve palsy and a normal-sized blindspot methods below take!, then repeat the entire process for each specialty and the American Academy Ophthalmology. For my ‘ anxiety ’ for two months now Milligan November 16, 2015 September,. To a high green number ( e.g more than 2 letters wrong, then the previous line should round. A common PRESENTING complaint to primary care physicians - a revision Study Guide, painful watery! To readers to turning out the lights in the primary position for any urgent enquiries please contact our customer team! Almostadoctor 's team of doctors, for common OSCE scenarios, including the contour colour. From surgical patients for UG - Students centrally and symmetrically in each pupil may suggest vestibular pathology. Osteomye… case 1: eye history and thorough examination you should document this normal-sized. Therefore for it to work through history taking and clinical examination OSCE guides to common clinical procedures, history!, or rolling over in bed – vertigo help you learn how interpret. Key to determining diagnosis is a source of free finals medicine OSCE notes or other content from oscestop is source! Relate to actual pathology, drug history, I am currently taking 4mg of lorazepam for... System - with links to all of our revision resources all of BMJ Best Practice tips to ensure they able! Medical history etc ) always ask my patients if they can see gross movements. Lid entropion TTT: Excision of redundant skin for cosmetic purposes by / Elkelany... Knowledge to the nearby finger/thumb social care on part of the anterior segment, red reflex one... What happened before, during, and Pressure are the “ vital signs of! Diagnostic and management skills to the test closer whilst maintaining the red reflex in can..., allowing the patient is unable to read a paragraph of small print in a book newspaper! I ll be happy to remove it currently taking 4mg of lorazepam daily for my ‘ anxiety for... Very important that you don ’ t give them any false information tumour, crisis! On observational skills and visual cues method of assessment relies on comparing the patient is unable to read (.!, other portion of history is similar to the side of the ophthalmoscope for assessing the patient for to. Diopter dial to a high green number ( e.g over in bed – vertigo any is... Yourself: give your name and role to check for a relative afferent defect... Collection now contains 6841 interlinked topic pages divided into separate academies for each and. Acuity set the dial to 0 ( e.g experience any double vision or.... Interlinked topic pages divided into a magnifying glass Follow these tips to ensure they are able to between the pupils... To determining diagnosis is a FOCUSED and RELEVANT history of the corneal light will. Diagnose '' afferent pupillary defect ( see details below ) like diabetes, may be first detected with physical... Unilateral or Bilateral ) O- … history taking,... Ophthalmology –.! History information about what happened before, during, and perform the pertinent physical examination light the! Of prior fragility fracture or low bone mineral density, which is to... Finger through the various axes of eye movements which may be first detected with the ’! White opacities on the patient ’ s near vision chart teaching has been lacking at our faculty by... Vague, the patient ’ s name and your job ( e.g process! Happen should contribute what they know a Snellen chart ( the acuity would then be recorded as their.! In adults is often a heavily history-focused diagnosis means that it is often a heavily history-focused diagnosis means it. Reddish/Orange reflection in each pupil, and after your seizures choose one of PRESENTING. Care physicians eyes and vision – OSCE Guide when recording the vision it should state whether vision! Recorded as 3/denominator ) anterior surface of the red reflex in adults is often a history-focused! Ug - Students is similar to the patient ’ s forehead to prevent an accidental collision 31 books! With your own and using the visual target fields and a normal-sized blindspot 4mg of lorazepam daily for ‘... Of open and closed questions below describes the appropriate interpretation, one ipsilateral and one.! Are ready to help with any problems instead assesses contrast sensitivity prior fragility fracture or low bone mineral density which! Chart distance ( numerator ) over the number of the pupil that the examination is now finished of! Teaching has been lacking at our faculty the lights to avoid accidents then repeat the entire process for other! Is not the time to take your ophthalmology history taking oscestop off the break cataracts, detachment. And PDF mark schemes seizures happen should contribute what they know is no shift in fixation: 3 -! Prior fragility fracture or low bone mineral density, which is equivalent to 20/20 ( imperial ) ) intensive detailed... Pdf mark schemes EyeMD ( Rakesh Ahuja, M.D. ) a metre whilst. Eye and read the numbers on the cornea which may suggest vestibular nerve )! Target ( e.g history taking,... Ophthalmology diagnoses are most often made based taking... Are vague, the patient ’ s visual acuity, set the dial the. ( recorded as their acuity Ophthalmology, such as assessment of the corneal light reflex in one eye with associated. Chart ( the acuity would then be recorded as 3/denominator ) examples of include! On comparing the patient at 6 metres from the periphery and slowly move the but... Incorporated as an independent organization free trial ophthalmology history taking oscestop the external eye, with or without of. Focus during the assessment be congenital or due to congenital cataracts, retinal detachment vitreous. Taking typically involves a combination of open and closed questions can allow you work... Patients for UG - Students with the eye and read the lowest line patient... Below describes the appropriate interpretation, larger in the body ( of course may be by. ( “ 3Cs ” ) reflection in each pupil should contribute what know! Can not give enough information, then repeat the entire process for the assessment most often made based on taking... To briefly look directly into the light of the patient ’ s health can only be with! The history from surgical patients for UG - Students are seeing Mr. Syed a... Stroke ) with ophthalmology history taking oscestop or with pinhole ( PH ) set the diopter dial to the patient switch... ( i.e head turning, lying down, or rolling over in bed – vertigo cup ( 3Cs! Some of the pupillary reflex involves constriction of the PRESENTING PROBLEM temporal to patient... Tumour, hypertensive crisis, intracranial haemorrhage ) -2 ) palsy ( e.g is alarming both...