1. Ophthalmoscopy

2. Plan of action Why eyes are important in 2nd year
Hypertensive and diabetic retinopathy
Ophthalmoscopy
Possible OSCE stations
Practice

3. Eyes for second year Neuro – Diplopia, pupil constriction
GI - Jaundice
Cardio –Xanthalasma
Resp – Horner’s syndrome
Ophthalmoscopy
Hypertensive and diabetic retinopathy

4. Hypertensive retinopathy
I Tortuous arteries
“silver/copper wiring”
II Narrowing of veins due to artery compression
“A-V nipping”
III Blood leaking out of vessel and axons dying
“Flame haemorrhages and cotton wool spots”
IV ^ICP leads to optic disc swelling
“Papilloedema”
How to look for end-organ damage in HTN?

5. Diabetic retinopathy Background Pre-proliferative Proliferative
Microaneurysm, dot and blot haemorrhages
Pre-proliferative
Cotton wool spots
Proliferative
Neovascularization
+/- Macular oedema
Hard exudates
Laser photocoagulation

6. Ophthalmoscopy

7. OSCE Hello my name is X I’m a second year medical student
I’ve been asked to X before I explain to you more about that can I confirm your full name and date of birth. How old does that make you?
Explain procedure
Is that ok with you?
Wash hands (properly)

8. Ophthalmoscopy Ask patient to fix vision in distance.
Examine external eye
Dim lights
Red reflex
Lean in at 20 degrees
Try find – Disc, vessels and macula OR read words
Thank patient
?document/ present findings

10. Example stations Examine model and document findings
Examine model and tell examiner the words you can read
Cranial nerves
Don’t forget history stations!

11. Documentation

12. Practice Time

13. Presenting findings 20yo m/f
Normal lids and lashes and normal red reflex
Optic disc had a normal colour, no sign of papilloedema
Blood vessels appeared normal in all 4 quadrants
There was no sign of macular oedema
In summary this is a normal External eye

14. Thanks for listening!
Questions?
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