Ophthalmology topics of interest to primary care residents

[nafraguoc]

Hey everyone! I am in the middle of a family medicine rotation where I was asked to prepare a short 10 minute teaching session for the inpatient team I am working with. Since I recently matched in ophtho they suggested I prepare something within ophthalmology that would be applicable to primary care as well. Does anyone have any suggestions on what to teach? I was thinking maybe a little more in depth pupillary exam with common pitfalls to avoid etc.? What do you think? Any other suggestions out there? Thanks in advance

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[DrZeke]

Creating a differential for the red eye and going through common diagnoses.
You can also do common diagnoses based on appearance with a penlight.

 

[ophthope]

Besides what Zeke said:
Teach them that they can just write "PERRL" since if the pupils react they most certainly will accommodate and we all know they didn't actually check accommodation anyway.
Then get a Will's Eye Manual and show them that nowhere in there does anyone recommend gentamicin drops for pink eye. Then teach them what drops are recommended for bacterial conjunctivitis. Never seen a PCP give a fluoroquinolone drop. Blows my mind.
Make sure they know that if someone gets Zoster in V1, they can still give acyclovir. Sometimes this freaks them out and they end up seeing us the next day and have lost a day of antivirals.
Show them how to check acuity on a near card with details like allowing the patient to use readers, pushing them to guess the next line down, and that getting half the line correct means you "passed" basically. This may seem trivial but often on consults this has not been done correctly and it's probably because nobody ever took the time to train them.

 

[DrZeke]

Besides what Zeke said:
Teach them that they can just write "PERRL" since if the pupils react they most certainly will accommodate and we all know they didn't actually check accommodation anyway.
Then get a Will's Eye Manual and show them that nowhere in there does anyone recommend gentamicin drops for pink eye. Then teach them what drops are recommended for bacterial conjunctivitis. Never seen a PCP give a fluoroquinolone drop. Blows my mind.
Make sure they know that if someone gets Zoster in V1, they can still give acyclovir. Sometimes this freaks them out and they end up seeing us the next day and have lost a day of antivirals.
Show them how to check acuity on a near card with details like allowing the patient to use readers, pushing them to guess the next line down, and that getting half the line correct means you "passed" basically. This may seem trivial but often on consults this has not been done correctly and it's probably because nobody ever took the time to train them.

Tell them that gentamicin is the worst and to stop prescribing it

 

[Eyeball Tickler]

Also ophtho emergencies like acute angle closure!