Ophthalmic Checklist

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‘Few facts and much thinking leads to error whereas many facts and little thinking leads to truth.’ Author unknown.

This checklist will help GPs to remember the critical things in the ophthalmic history and examination that will enable them to reach the correct diagnosis.

History

  • Previous eye history including drops/surgery/contacts/iritis/myopia
  • Previous medical history, esp diabetes/hypertension/PMR
  • Presenting complaint
  • Duration
  • History of trauma, hammering/high speed tools
  • Examination

All patients

  • Vision
  • Pinhole vision
  • Redness including degree and whether greatest near cornea, in fornix or sectorial
  • Discharge
  • Fluorescein staining
  • Pupils size, shape and reactions
  • Red reflex
  • Ophthalmoscopy of disc/vessels/peripheral retina/macula

Selected patients, depending on possible diagnosis

  • Afferent pupillary defect (swinging light test)
  • Eye movements
  • Confrontation visual fields
  • Amsler grid (exudative macular degeneration)
  • Digital tension (acute angle closure glaucoma)
  • Relief with amethocaine (surface vs internal pain)
  • Carotid bruits (arterial occlusive disease)
  • Superficial temporal artery (arteritic occlusive disease)
  • BP/blood glucose (vascular occlusion/vitreous hemorrhage)