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|Important concepts or main ideas.|
1. Ophthalmic (The Eyes)
- Ask the patient if he/she is having difficulty seeing near or far objects.
- Is there any pain in the eyes or blurring of vision?
- Does the patient experience any halos around lights?
- Halos are when a white ring is seen around a source of light.
- This is frequently seen with glaucoma (an elevation of intraocular pressure).
- Glaucoma is an eye problem associated with an increase in intraocular pressure due to the blockage of the canal of Schlemm.
- Does the patient see specks that float or move, suggesting vitreous floaters?
- Fixed defects with change of gaze suggest retinal problems.
- If the eyeballs are enlarged and the patient has been diagnosed with having hyperthyroidism, then the enlargement of the eyes is referred to as exophthalmus.
- The eyelids do not roll over the eyeball when the patient gazes down while the head is in a fixed position .
- Normally, the upper eyelid rolls over the eyeball.
- This is referred to as a positive lid lag.
- You can confirm this by holding the patient’s head steady with one hand and the patient’s gaze follows the finger of your other hand, which you move downward gradually.
- With true exophthalmus you will notice this lag and you will also see the white of the patient’s sclera.
- This is referred to as a positive lid lag test.
Enophthalmus is a sinking in of the eyeballs.
- It is often seen with sudden weight loss, as in anorexia nervosa, patients suffering from cancers, AIDS, etc.
- Patients should be treated in a semi-sitting position only.