or ID (if anonymous) Name

Pediatric
Refractory errors
Adolescents
Age
Presbyopia Adults
DR PRANESH 
Cataract Old

Colour blindness Male

Autoimmune disorders Female

Sex
The Approach - LSTD Infection

Viral Keratitis
Listen See Think Do

History Examination Differential Diagnoses Investigate

STEPS TO REACH A DIAGNOSIS

Cataract Tropical
Scleritis

Infectious disorders Same eye

3. Past History Similar complaints Recurrence Inflammation
Other eye
Preliminary Data
House Fly Trachoma
Location/ Ethnicity Episcleritis

Melanoma
Temperate Anterior Uveitis

Exogenous triggers - repeated exposure

Contact Lens
Allergies - Hay Fever
Dust/ Pollen/ Foreign Body

abrupt stop in antibiotics

topical = eye drop/ ointment

Tip: Milky/ turbid colour of prednisolone

Foreign Body on Cornea tapering/ tailing doses
drops
Welders Occupation

Steroid drops - eg: 4 times/ day - 1 week -> 3

times/ day - 1 week -> 2 times/ day - 1 week

Route of Rx entry subtenon

steroid injections in uveitis/ inflammatory
peri-ocular
macular edema
subconjunctival

Welder's Keratopathy/ Photokeratitis intravitreal Anti-VEGF/ steroid/ antibiotic

intra-ocular number of injections
injections

pain killers
DV Current
Vision related oral anti-microbial
Floater/ Flashes Disturbances of vision H/o Ocular Rx Recent - not using now Consider
oral steroids tapering doses
Past
Improvement
Result of Rx
Worsening/ No improvement
Adnexal
Duration of Rx

Self
Lid swelling Discontinuation
Non-vision related by physician

Ocular Therapeutic
h/o Allergy to any eye medications
also ask for systemic rx allergy eg.
Diagnostic eg. Dilating drops: Tropicamide
Acute Red Eye Acetazolamide

Duration of wear

Acute Conjunctivitis Glaucoma

Medical Frequency of change of glasses
Myopic shift = patient reads near objects
Early Nuclear Sclerosis
better
Mention
Myope Minus glasses High myopia - risk of retinal detachment

ARE + DV Mixed

Power/ correction
Acute Angle Closure Glaucoma

Headache
Non-ocular
Hypermetrope Plus correction
Vomiting
1. Chief Complaints Aphakic glasses

Risk of angle closure glaucoma

Daily/ Extended wear

RE
h/o glasses/ contact lens wear Contact Lens Solutions
Simultaneous/ Sequential LE Laterality
3 S's Sleep with CL on?
BE
Swim with CL on?
Seconds, Minutes, Hours
Duration
Days - Weeks - Months - Years

Sudden
Onset
Insidious

</= 3 months Limited

7th Nerve Palsy = Bells' Palsy - Patch for
Duration lagophthalmos
> 3 months Persistent
Nerve Palsies

Acute

Sudden onset + Limited duration Patching

SUN Descriptors Patch the affected/ deviated eye - eg. 6th

Nerve Palsy

Chronic Course

Amblyopia = Lazy eye

Persistent + Relapse 4. Treatment History
(Ocular)
Patch the normal eye to stimulate lazy eye

HISTORY
TAKING
Cataract
Remission = Grading of activity Recurrent
Elaborate on Chief Complaints

Phacoemulsification

Cataract
HISTORY = 7 letters = 7
components of history
Increasing = insidious
Gradual

Click to watch the video on this


Mind Map
Inflammation - use of medications

Progession
Decreasing LASIK

Amblyopia

Recent
Stable
2. History of Presenting Laser treatment Lasers can imply
Mild/ Mod/ Severe Complaints Past Laser peripheral iridotomy
Severity
Scale 1-10

Other factors (SOCRATES in Pain)

Colored Haloes Yag Capsulotomy

Acute Angle Closure Glaucoma (AACG) Positive symptoms
Vomiting

-ve Discharge AACG Relevant Negative symptoms

Ask for number of 'Sittings'

Surgical

Pan retinal laser

Elaborate on Associated Symptoms Retinal laser
Uveitis Systemic

Fever/ Joint pain/ Rashes

TRAUMA Focal

Lid correction

GLAUCOMA Lacrimal drainage surgery

Adnexal
Orbital surgeries

Squint correction

Pedigree Charting Pterygium removal

Genetic Component Surgeries Ocular surface

LASIK
Corneal
Retinoblastoma
Family Screening Transplant = Keratoplasty

Cataract surgery

Intraocular Filtering/ pressure reducing sx

Pedigree Charting Post op Prone position after oil placed -

Silicone Oil
need to remove oil (2nd surgery)
7. Family History Retinal surgery = Vitrectomy +/- Tamponade
Gas
Retinitis Pigmentosa

Acute infective conjunctivitis

DM
Infection spread/ contagious Contact with family members
Tuberculosis
Hypertension
Instillation of eye drops
Vascular Hyperlipidemia
Support System
Transport - Drive
Stroke

Cardiac failure

Rheumatological Rx: Hydroxy chloroquine HCQ maculopathy

Auto-immune
Thyroid Disorder

Thyroid Eye Disease

Smoking

Viral - Herpes Zoster/ Shingles

Habits/ Addictions

Tobacco - Toxic Optic Neuropathy

Medical Infective h/o Anti-tubercular therapy Ethambutol induced optic neuropathy

Sudden BE blindness Methanol Toxicity

Alcohol
Ethanol - Toxic Optic Neuropathy
Bacterial - TB, Syphilis
Substance abuse

Fungus - Mucor (ROCM)

Infectious Uveitis - Toxoplasma

Retinochoroiditis Food/ Water intake 6. Personal 5. Systemic (with
Treatment) History Metastasis to eye

Choroidal metastases
Nutritional Optic Neuropathy - temporal Neoplastic
pallor of discs

Rx related Get a thorough Rx History!

Opportunistic Infections HIV/ Syphilis Infectious Uveitis
Intraoperative Floppy Iris Syndrome during
Tamoxifen maculopathy Tamsulosin (Flomax) in Benign Prostatic cataract surgery
Hyperplasia
Cytomegalovirus Retinitis Neurosurgical Diplopia
Surgical
ENT (post - Functional Endoscopic Sinus
Sexual History Orbital Injury
Surgery)

Chlamydia
Neonatal Conjunctivitis = Ophthalmia
Infectious Conjunctivitis
Neonatorum
Gonococcal

SUMMARY MAP:

Preliminary Data Name, Age, Sex, Ethnicity, Occupation

1. Chief Complaints Complaints + Laterality + Duration

Onset

Course
Elaborate PC
Progression
2. History of Presenting Complaints
Severity

Associated symptoms

HISTORY 3. Past History Similar complaints in the past

Medical Rx incl. glasses/ CL

4. Ocular Rx History
Surgical Rx

5. Systemic + Rx History

Smoking/ Alcohol

6. Personal History Food/ H2O

Sexual history
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Genetic MINDMAP - MINDMAP

7. Family History Contact

LINKS
Support

CLICK TO WATCH - DEFECTIVE VISION

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VIDEO