This includes the variety of examinations Animal Eye Care performs depending on the individual case
- History: discharge, squinting, redness, cloudiness, vision loss, medications.
- Breed Predisposition.
- Observe from a distance: squinting, cloudiness, redness, symmetry.
- Close-up: – menace response (cover each eye in turn), retropulsion of the globes.
- If mucky discharge present, or corneal or conjunctival disease suspected, a Schirmer Tear Test should then be performed before touching/stimulating the eye much. Similarly perform early in the examination for rechecks of dry eye. Place the bent paper strip 2/3 to ¾ way along eyelid towards the lateral canthus for 1 minute. Normal is 15mm/min.
- (Darkened room) Focal light examination: PLR (direct and consensual), eyelids, conjunctiva, cornea, lens/tapetal reflection. At this point you are trying to localise the lesion. A slit beam can help to locate the depth/position of a lesion (present on many ophthalmoscopes).
- Magnification e.g. slit lamp, Lumiview (Welch Allyn), head loupe, head torch and 20D lens works well for magnification. Check eyelids (distichia, entropion, tumours), conjunctiva, cornea, iris, lens.
- Fundus examination: indirect ophthalmoscopy (head torch or focal light, 20D lens), direct ophthalmoscopy (less useful – ophthalmoscope), panoptic.
- Fluorescein staining: apply with dye impregnated strip – just touch onto conjunctiva once then flush with a few drops of artificial tears. Do not leave excess stain on the cornea.
- Fluorescein passage through the tear duct. Apply slightly more stain than for corneal staining then a few drops of tears. Stain should be visible at the nostril within 5-10 mins.
- Tonometry: applanation (Tonopen), Schiotz. For Schiotz tonometry have 3 people. Apply topical anaesthetic to the eye. One holding the animal, second holding the head – nose up. Vet lowers the footplate onto the cornea momentarily 4-5 times with the reading scale pointing to the nurse holding the head. Each time the needle flicks across the person reading the scale reads out the reading. Once 3-4 similar readings are called out, use these to read of the scale on the table to get IOP.
- Looking behind the third eyelid: apply topical anaesthetic then grasp the third eyelid with a fine pair of mosquito forceps or move with smooth cilia forceps.