1st Optometry Lab Practical

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IBalla26

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I am a 1st year student at ICO and our first optometry lab practical is approaching...I was just wondering if anyone had any tips to perform efficiently. We have to complete case history, VA, Direct, Lensometry and entrance tests in 22 min. I'm mostly concerned about doing direct on an undilated eye efficiently enough to leave time to work my way through the entrance tests that shouldn't be a problem. Any advice? Thanks
 
Practice!!! Direct is usually done on undilated eyes.. this should not be a problem.

The only way to perform direct efficiently is to get comfortable with it and practice it! I know it is nerve-racking because this is your first practical, but as with all practicals we need to practice hours upon end.

Good luck!
 
Doing well on the direct ophthalmoscope (DO) definitely requires many hours of practice. Here are some useful tips that I learned as I became more proficient with the procedure.

1. Make sure to perform the procedure in dim room illumination.
2. Provide a fixation target: slightly up and out
3. Tell the patient to keep both eyes open and try to hold the fixation even when the examiner head is in the way.
4. Your direction of observation should be about 15 degrees temporal to the patient’s line of sight.
5. Reduce the lens power of the DO slowly (move toward the red) to focus sharply on optic nerve and/or fundus (it depends on which comes into view first).
6a) If vessels first, then follow vessels toward the disc (towards the larger branches)
6b) If disc first, then examine the optic nerve head (ONH) and then follow the vessels away from the disc.

7. Examine disc --> determine color, margins, C/D ratio

8. Examine vessels --> determine spontaneous venous pulsation, A/V ratio, ALR ratio, and vessel crossings (normal, abnormal – nicking & deflections)

9. Examine macula LAST
- Instruct the patient to NOT follow the DO’s light.
- Follow the vessels superiorly & then drop down to the macula to determine foveal light reflex (FLR)
- Record pigmentation (uniform, dark, grainy, mottled, drusen)

Good luck on your 1st proficiency!
 
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