Day 2: Male, 72. (OH)

Spent the morning learning how to do pachs and run Goldmann and Humphrey VF machines, retinal fundus cam, and taking BPs. My CCT is ~570! Good to know in case I need LASIK in the future. 11 hours in clinic. Learned a lot today in terms of equipment, but still don't know how to interpret fields.

length of exam: ~3 hours

Hx:
- risk for glaucoma
- Raynaud's
- IOPs 15 OD, 16 OS
- large disk, loss in neural rim tissue
- BCVA OD: 6/6 OS: 6/12
- history of bv problems: left hyperdeviation -> exocyclodeviation, double vision at near hence prescribed glasses with near add in OD only. Blur in OS makes him suppress and avoid double vision.


1. Predilation workup

• VA
• Angles - get slit down as thin as possible, then move in from the side until you JUST see the shadow, then grade.
  
• Pressures - repeat for repeatability
  
• Pupils
  

2. Humphrey VFs:

• 30-2 central standard
• 10 minutes per eye
• very limited in accommodation for px with posture problems
• head posture and direction of gaze affects thresholds

3. HRT

• views nerve fiber layer thinning around the disc

4. Retinal fundus camera

• move in or out until crosshairs turn yellow
• zoom in via zoom in button
• align focus bars
• make sure eyes are wide and open
• take pic
  

5. Referral letter

• SOAP format

Day 1: Female, 67. (PC)

FIRST PATIENT EVER... AND ON MY BIRTHDAY

length of exam: ~4 hours

1. case history took too long, but revealed retinal trauma OD
2. refraction revealed BCVA OD: 6/12, OS: 6/6
3. OD lens capsule contained an epicapsular star
4. OU lens contained lens vacuoles, OD contained spoke cataract
5. OD contained peripheral retinal scars from childhood trauma
6. OU floaters
7. OD glaucomatous disk with cupping of 0.85
8. Angles ~1:1/4
9. Always trial frame the px after refraction