Eye emergencies may present in the GP surgery, A&E or an outpatient clinic, but few people outside of ophthalmology are confident about the management of eye problems. This book will give you the essential skills to: perform an initial assessment understand what you can manage yourself and how to do the basics decide when you need to refer to ophthalmology. In addition, the book provides: a glossary of common ophthalmic terminology and medications which will be invaluable when reviewing ophthalmology letters a triage ready reckoner to help you sort the symptoms and decide how quickly you need to refer a systems-based approach to highlight common conditions and then describes how to assess, investigate and manage each of them a guide to the most common investigations and how to interpret the results. At all stages, symbols are used to highlight what can safely be undertaken in general practice and A&E, and when ophthalmologists should take over. Red flag boxes highlight important clinical concepts that should never be missed, and red text is used to indicate sight- or life-threatening conditions. This is a book to help anyone looking to refresh their knowledge of diagnosis, management and referral to ophthalmology: medical students, foundation doctors, GPs, A&E doctors, junior ophthalmology specialty trainees, ophthalmic nurses and nurse practitioners.
1 Basic ophthalmic history 1.1 Introduction 1.2 History of presenting complaint 1.3 Systems review 1.4 Background history 2 Basic ophthalmic anatomy and examination 2.1 Introduction 2.2 Assessment of visual function 2.3 Orbit 2.4 Adnexal structures 2.5 Conjunctiva and cornea 2.6 Sclera 2.7 Anterior chamber and iridocorneal angle 2.8 Iris and pupil 2.9 Lens 2.10 Posterior segment 3 Common terminology and abbreviations used in an ophthalmological report 3.1 Introduction 3.2 Common terms 4 Common ophthalmic medications 4.1 Introduction 4.2 Key medications and their indications 4.3 Combination glaucoma drops 4.4 Dry eyes drops/lubricating eye drops 4.5 Other combination ocular medications 5 Focusing your history: sorting the symptoms 5.1 Introduction 5.2 Red eye 5.3 Acute loss of vision 5.4 Flashes and floaters 5.5 Swollen lids 5.6 Headaches with ringing in the ears (tinnitus) and visual obscuration 5.7 Transient monocular vision loss 6 Triage ready reckoner 7 The orbit 7.1 Introduction 7.2 What might an orbital condition look like? 7.3 What are the causes of an orbital presentation? 7.4 Orbital presentations you need to understand 8 Lashes, lids and lacrimal apparatus LASHES 8.1 Lash malposition 8.2 Blepharitis LIDS 8.3 Lid malposition 8.4 Lid lumps 8.5 Lid lesions & malignant 8.6 Lid lesions & benign LACRIMAL APPARATUS 8.7 Epiphora 9 Conjunctiva, cornea and sclera 9.1 Introduction 9.2 Dry eye disease 9.3 Conjunctiva 9.4 Corneal ulcers 9.5 Peripheral corneal disease 9.6 Corneal graft 9.7 Corneal dystrophies 9.8 Scleritis 10 Anterior chamber and iridocorneal angle 10.1 Introduction 10.2 Uveitis 11 Lens 11.1 Introduction 11.2 Cataract 11.3 Pre-operative checks for the ophthalmologist 11.4 Post-operative checks for the ophthalmologist 11.5 Post-operative endophthalmitis 11.6 Post-operative considerations for the non-ophthalmologist 12 Medical retina 12.1 Introduction 12.2 Investigation of retinal disease: electrodiagnostic testing 12.3 Age-related macular degeneration 12.4 Retinopathy associated with systemic disease 12.5 Vascular occlusion 12.6 Inherited retinal dystrophies 12.7 Ocular oncology 13 Vitreoretinal 13.1 Introduction 13.2 Acute presentations 13.3 Chronic presentations 14 Neuro-ophthalmology 14.1 Introduction 14.2 Basic visual pathway anatomy 14.3 Neuro-ophthalmology examination 14.4 Headache 14.5 Blurred vision 14.6 Diplopia 14.7 Anisocoria 14.8 Visual field defects 15 Paediatric ophthalmology 15.1 Introduction 15.2 Paediatric history and examination 15.3 Common paediatric conditions 16 Trauma 16.1 Introduction 16.2 Trauma history and examination 16.3 Lid laceration 16.4 Chemical injury 16.5 Thermal injury 16.6 Orbital fractures 16.7 Globe injuries 16.8 Non-accidental injury in children 17 Visual fields 17.1 What is a visual field test and why do we use it? 17.2 The visual field 17.3 Types of visual field test 17.4 Common terms in visual field testing 17.5 Interpreting visual field tests 18 Ocular coherence tomography 18.1 What is ocular coherence tomography and why do we use it? 18.2 What types of OCT are there? 18.3 Macular OCT 19 Ocular ultrasound 19.1 What is an ocular ultrasound and why do we use it? 19.2 Performing an ocular ultrasound 19.3 Interpreting an ocular ultrasound 20 Fundus fluorescein angiography 20.1 What is fundus fluorescein angiography and why do we use it? 20.2 Performing an FFA 20.3 Phases of FFA 20.4 Interpretation of FFA 21 Systemic inflammation 21.1 Introduction 22 Systemic infection 22.1 Introduction 22.2 Conjunctivitis 22.3 Keratitis 22.4 Scleritis 22.5 Uveitis 22.6 Endophthalmitis 22.7 Retinal signs of systemic infection Appendix 1: Snellen chart Appendix 2: Jaeger near vision chart
