Standard Subjective Refraction I 规范化的临床主觉验光I Shihao Chen Mo.D.Ms. School of Ophthalmology Optometry 验光学课程 视光学教研室2007
Standard Subjective Refraction І 规范化的临床主觉验光 І Shihao Chen M.D., O.D. M.S., School of Ophthalmology & Optometry
Flow of Clinical Ophthalmetry Exams 临床眼视光学检查规范流程 ·Velcome patient Slit lamo:fluorescein, History taking RB,TBUT Entrance tests: Tonometry,(Gonio) cc:VAs,Amps,Cover test,NPC,Stereo, Direct ophthalmoscopy Color Vision,(Amsler) .Dilation:90D,BIO,indentation sc:Externals,Hirschberg,(Bruckner), mirrors EOM,Pupil,CVE,PD, (Special tests) (Exophthalmometry) Standard refraction AP,Contrast sensitivity,VF, /EP/ERG/EOG,Corneal Binocular function tests Topography,Orbscan,Specular accommodation,phoria,vergence fusion...... MRI,SLO,FFAICG,HRT,RTA. (Schirmer test) (Others):blood tests,ECT, 验光学课程 PET. 视光学教研室200
Flow of Clinical Ophthalmetry Exams 临床眼视光学检查规范流程 • Welcome patient • History taking • Entrance tests: cc: VAs, Amps, Cover test, NPC, Stereo, Color Vision, (Amsler) sc: Externals, Hirschberg, (Bruckner), EOM, Pupil, CVF, PD, (Exophthalmometry) • Standard refraction • Binocular function tests accommodation, phoria, vergence, fusion…… • (Schirmer test) • Slit lamp: fluorescein , RB,TBUT • Tonometry, (Gonio) • Direct ophthalmoscopy • Dilation: 90D, BIO,, indentation ,3 mirrors • (Special tests) SLAP, Contrast sensitivity, VF, VEP/ERG/EOG, Corneal Topography, Orbscan, Specular microscopy, A/B scan, UBM, Fundus photo, OCT, X-ray/ CT, MRI, SLO,FFA/ICG, HRT, RTA….. • (Others): blood tests, ECT, PET…
Nelcome patient欢迎患者 Dressing Chart review Get the patient Introduce How r u? 验光学课程 视光学教研室207 BA
Welcome patient 欢迎患者 • Dressing • Chart review • Get the patient • Introduce • How r u? BACK
History taking采集病史 ·Open questions ·Cc Present H Past H. ·Systemic H. .F.H. ·Social H. 验光学课程 视光学教研室200 BA
History taking 采集病史 • Open questions • Cc • Present H. • Past H. • Systemic H. • F.H. • Social H. • … BACK
Present H.现病史 Vision change ·When Vision Loss How fast/often of onset Pain ·Degree Photophobia 。 Double Vision ·What/When/how previous meds or Discharge treatment Tearing Glasses/Contact Lenses 验光学课程 视光学教研室200 BA
Present H. 现病史 • Vision change • Vision Loss • Pain • Photophobia • Double Vision • Discharge • Tearing • Glasses/Contact Lenses • … • When • How fast/often of onset • Degree • What / When / how previous meds or treatment • … BACK
VAs视力 OD/OS 685 山 D/N 2497 3 m 420日3 E山3 N C V K D 697502 sc/cc 573B420 7量530 PH 95 874 F NPRZ 验光学课程 视光学教研室207 BA
VAs 视力 • OD/OS • D/N • sc/cc • PH BACK
Amps调节幅度 ·Min:15-age/4 ·Ave:18.5-age/3 ·Binocular Diff:< ·Max:25-age2/5 1.0D 验光学课程 视光学教研室207 BA
Amps 调节幅度 • Min: 15 – age/4 • Ave: 18.5 – age/3 • Max: 25 – age 2/5 • Binocular Diff: < 1.0D BACK
Color Vision色觉 Ishihara: Illumination C North sky 12/13Ishihara 13/14A0 Farnsworth D-15 验光学课程 视光学教讲室200 BA
Color Vision 色觉 • Ishihara: Illumination C North sky 12/13 Ishihara 13/14 AO • Farnsworth D-15 BACK
Cover test遮盖试验 Alternating cover D:1±1AXP N:3±3AXP Cover/uncover P/T chua 验光学课程 视光学教研室207 BA
Cover test 遮盖试验 • Alternating cover D: 1 + 1∆ XP N: 3 + 3∆ XP’ • Cover/uncover P/T BACK
Stereopsis立体视 ● Stereo fly/butterfly Stereo Randot 8型型 e公公 Random dot E Normal value? 60 验光学课程 视光学教拼室207 BA
Stereopsis 立体视 • Stereo fly/butterfly • Stereo Randot • Random dot E • Normal value? • 60” BACK