“Ophthalmic examination made easy” was another incredible webinar by Ron Ofri DVM PhD DECVO. One of my favourite speakers on our website, his enthusiasm is infectious and his knowledge and experience is astounding. We’ve already written a piece on his ‘Anatomy of the Fundus’ webinar, you can see that here. For his 18th webinar on The Webinar Vet, the first-opinion practitioner is given the low-down on eye examination. What to look for, what to be aware of and what to never ever forget!
Eyes, are they the grossest organ?
The gross ocular examination
We start off the examination with a bit of a step back. Have a look at the whole animal, recognising any symmetrical anomalies or signs of pain. This is something that we do on the daily, but when we see a vague eye we like to look into it and fiddle with it for some reason. Have a look to see if there are any lid abnormalities, prolapses or congenital abnormalities. Check for secretions and think about where they could be coming from. Dr. Ofri covers some more specific things to look for in his webinar, and really brings together the whole clinical picture.
What do you see?
The visual assessment
The visual assessment and reflex assessments are the most confusing aspects of eye examination for me. Dr. Ofri covers the menace response, placement reflex, and maze test. He explains how these can have false positives and false negatives, and how patient factors can change these reflexes. There’s some cover of pupillary light reflex, anisocoria, and the dazzle reflex as well and how you can use these to evaluate retinal function and vision. Interestingly, the PLR can still be present in advanced cataracts and inherited retinal degenerations. This is because minimal stimulation is needed! Dr. Ofri, as a speaker, has a way of presenting lectures that is just so engaging and I find that information ‘sticks’ in my mind better.
Breaking eyes into pieces
The ocular anatomy assessment
The anatomic assessment of the eye is often the step that general practitioners jump to first. Using the method that’s presented – front to back – prevents any steps being missed. The technique to differentiate nuclear sclerosis and cataracts is explained, and some other tips and tricks are mentioned through this section.
I had a great time watching this webinar and it came in handy when my next consult was a sore eye complaint! One of the leaving remarks from this webinar is “you should conduct ophthalmoscopy on every patient you examine”, and I’ve started taking it to heart when I have time. Ron’s next webinar is on acute blindness in companion animals and will go live on January the 7th, 2021. You can watch the most recent webinar here.