By Bruce Muchnick OD
This up-to-date re-creation is a realistic advisor to the assessment, analysis, and remedy of systemic issues as they relate to fundamental eye care. It contains a multidisciplinary strategy, from the underlying pathophysiological mechanisms, to checking out and analysis tools, to clinical and surgical administration. scientific medication in Optometric perform, second version offers the reader with the data had to make proficient judgements approximately sufferer administration, reminiscent of determining indicators and their similar issues, and realizing while to refer sufferers to a clinical specialist.
- Shows how the wide variety of health conditions and their healing recommendations impression the supply of eye care.
- Familiarizes the reader with the stipulations which are encountered in perform, those who might current with ocular manifestations, and people who have major significance to medication in general.
- Organized in a pragmatic, simply available format.
- Uses case displays to illustrate scientific attempt interpretation, differential analysis, therapy, and the advance of a prognosis.
- Reflects the most up-tp-date applied sciences in exam and testing.
- Features all-new illustrations in complete colour, illustrating systemic problems, the actual examination, videotaping, dermatological stipulations, and masses more.
- Includes a brand new bankruptcy on vascular affliction, in particular very important due to the fact optometrists are often the 1st to note some of these changes.
- Contains new info on heart problems and carotid affliction, together with the consequences that stroke could have at the patient.
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Additional resources for Clinical Medicine in Optometric Practice
Repeat this several times with the patient’s eyes open and then closed (Figure 3-7). A patient with a disorder THE NEUROLOGIC EXAMINATION FIGURE 3-5 ■ Evaluation of pain sense. The procedure described in Figure 3-4 is repeated with the dull end of the pin. The examiner alternates the sharp and dull ends of the pin, and the patient is asked to compare sharp and dull sensation while the examiner moves proximally. 31 A B FIGURE 3-6 ■ Evaluation of vibration sense. A 128-Hz tuning fork is tapped to produce a vibration.
Twelfth Cranial Nerve—Hypoglossal Nerve A The twelfth cranial nerve supplies efferent motor fibers to all intrinsic and extrinsic muscles of the tongue (except the palatoglossus). Damage to the nerve results in paralysis of the tongue on the affected side. Therefore, when the patient sticks out his or her tongue, it will deviate to the side of the lesion (Figure 3-17). To test the hypoglossal nerve, the examiner should ask the patient to stick out his or her tongue and move it right and left against resistance offered by the examiner, who holds a cotton-tipped applicator to the lateral aspect of the tongue.
Pupillary constriction is tested by the light reflex, and accommodation can be tested on a near target. Loss of third-nerve function may cause diplopia and an eye that is “down-and-out” with ptosis and mydriasis. Fourth Cranial Nerve—Trochlear Nerve The trochlear nerve supplies only somatic efferent motor fibers to the superior oblique muscle of the eye. The superior oblique is tested, as previously described, by having the patient’s eyes follow a near target while the examiner traces an “H” pattern.
Clinical Medicine in Optometric Practice by Bruce Muchnick OD