Interns orientation class - Ophthal.pptx

Best guide for interns in ophthal department

1. Interns orientation

2. What should I know???? Recording of vision : Distant and Near Recording of IOP Diagnosis and treatment Hordeolum Dacryocystitis Conjunctivitis Injuries : RTA and Chemical injury Vitamin A deficiency National programmes : NPCB and VISION 2020

3. How to place eye bandage How to instil eye drops Foreign body removal Sac syringing Cont …..

4. Vision testing Distant vision Near vision Snellen chart Jaeger chart

5. SNELLEN CHART

6. JAEGER CHART REDUCED SNELLEN CHART

7. Before performing any eye procedure: Wash your hands. Position the patient comfortably with head supported. Avoid distraction for yourself and the patient. Ensure good lighting. Always explain to the patient what you are going to do. Eye dressing

8. Reasons for applying an eye pad T o ‘rest’ the eye ( hyphaema , vitreous haemorrhage). T o aid healing following trauma ( corneal abrasion). T o protect the eye ( following surgery and procedures requiring corneal anaesthesia).

9. Method Ask the patient to close both eyes. Position the eye pad diagonally over the closed lids of the affected eye and tape firmly, but gently, to the forehead and cheek. Apply a second and third piece of tape to ensure the pad lies flat. Extra protection can be given by taping a shield over the pad in the same way.

10. Hordeolum Hordeolum externum Hordeolum internum Infection of hair follicles sebaceous glands of Zeis and glands of Moll involved infection of the meibomian glands Rx – e/d and e/o Moxifloxacin , Tab Lyser D Tab C iplox 500mg BD

11. Conjunctivitis

12. topical antibiotics e/d Moxifloxacin 4 to 6 times / day cold compress antiviral– e/o Acivir 3% 5 times / day topical anti histamine and topical steroids e/d Olopatadine twice daily e/d Fluoromethalone 4 times / day Topical anti inflammatory and analgesics BACTERIAL VIRAL ALLERGIC

13. Dacryocystitis ACUTE DACRYOCYSTITIS CHRONIC DACRYOCYSTITIS

14. Acute darcyocyctitis – Hot fomentation Tab C iplox 500mg BD for 5 days Tab Lyser D BD for 3 days e/d and e/o M oxifloxacin Never do sac syringing in a case of acute dacryocyctitis Chronic dacryocystitis - Surgery Dacryocystorhinostomy under Local anaesthesia

15. Ocular injuries

16. p Rx- e/d Predforte , e/d homide , e/d timolol , e/d moxifloxacin BLUNT INJURY

17. Rx –Lid tear repair with 5-0 ethilon and scleral tear repair with 6-0 vicryl suture Rx – Corneal tear repair using 10-0 ethilon suture

18. Chemical injuries

19. ALKALI INJURY ACID INJURY

20. Vitamin A deficiency

21. Bitots spot Stage X3A Stage X3B

22. Treatment

23. National programmes NPCB

24. VISION 2020 – The right to sight

25. Instill topical anesthetic drops . To examine the lower sac, pull the lower lid down with your finger while the patient looks up. To examine the upper sac, hold the proximal portion of the upper lid down with a cotton-tipped swab while pulling the lid out and up by its lashes, everting most of the lid, as the patient looks down. A loose foreign body usually adheres to a swab lightly touched to the surface of the conjunctiva, or will be washed out by copious irrigation with saline. Conjunctival foreign body removal