hello welcome to the clinic, get my hands clean here for you. I'm going to introduce some tests
that you may not have had before and incorporating some new equipment.
okay don't worry if you have had some of these I'm guessing the majority you haven't
okay so we're going to do an ocular staining. I'm sure many of you have had ocular staining
with the fluorescein dye vital satin there, it is most commonly used today, but how about we do
a turbo to do an ocular staining using another vital stain, Lissamine green staining
in the sterile
packaging there, sterile strip. If I pop a bit of Lissamine green into the eyes
to check for any devitalized or dead cells with the staining
Lets just wet the tip
okay looking up for me it doesn't sting slightest bit of lissamine green
dye there thank you
let me just dispose of this now single use
okay and to check for the staining, the conjunctival and corneal staining, I'm
going to have a look at your eye with the green light. Please look straight ahead to begin with
now look to the left please to check the conjunctiva. Now look right
Look up to the ceiling now
just look down as I lift the top lid please
okay we might avert the lid a little bit later for a closer inspection.
Look straight down and blink for me excellent that's the right eye with
the lissamine green staining check. Look straight head again for your left eye review
now blink please
look to the right. Look left
Look
up now
look down as I lift the top lid
on the left side
Straight ahead again thank you, that's probably your first vital stain check with the listsamine
green, excellent so let's record those results down and then move on to the second test
We may have another vital stain
to show you afterwards which you've probably never had before
okay let's move on to a small hearing test
have you ever had audiometry performed with the handheld device here? It presents some sounds
which you have to say whether you hear. You get some nice clicking sounds from the buttons here.
We've got 500 Hertz at 60 decibels. And as we go along I'm going to be plotting your results
on the audio graph there. I'll place your details there and record
there for you. So let's place this over the right ear tell me whether you hear the sound
nice and simple test
thank you let's decrease
the volume there to 50 decibels
Just about, excellent. I'm going to increase the frequency
to a thousand hertz, can you hear this sound?
marvellous and here please
brilliant that's two different frequencies so we had 500. 60 1000
60 and 50.
let's move on to your left side now please, just say whether you hear this sound
marvellous
and
the second
good
up to a thousand Hertz now
good and just reducing down a little bit here, can you hear this?
excellent so that's the audiometry hearing test handheld device many of you have used the
earphones before. Hopefully that's a new one for you left results 500 Hertz
decibels 60 50.
and that's audiometry thank you
Okay so
I'm aware that you've had convergence and ocular motility performed in the clinic before but
I'm going to introduce a new piece of equipment to perform those tests,
have a look at these beautiful
pieces of equipment, beautiful flowers, Floral Design here at the back and a scale there
for performing some precise ocular measurements, let's get started with
convergence using this beautiful flower here, eyes on the flower, following
let me know if you see double vision at all
is that single
okay and any double vision there
okay let's use the second trigger for ocular movements follow this
just with your eyes please the beautiful flower
observing the movement
looking for any anomalies
you should report any double vision
or discomfort please
and up and down, up and down, lovely convergence and motility
its only right that we incorporate the measuring scale here
to check your vertical apertures the palpebral apertures look straight
and for the left please
seven millimetres lovely. Just from the side here
maximum eyelash length
each side there, lovely thank you, and maybe just your iris diameter
okay just look into my open eye please
and the other eye
12 millimetres there, so that's using the new ocular trigger
that's your convergence, ocular motility
and we took some ocular measurements there, lovely, progressing well
okay I'm going to show you a new trigger that will be used in The Eye Hospital
for chalazion surgery potentially and it's housed in this protective case here.
this is the chalazion clamp here. So by just rotating the dial there we
increase the distance between these two surfaces there, this is hollowed out so
that the chalazion can come into the space there, ready for surgery
and this will go inside the lid
and then can be brought into a secure but comfortable
distance and then the surgeon can perform the surgery
this part here, the hollowed out part where the chalazion protrudes through, comes
in different diameters and different shapes depending on the size of the chalazion
those are the Surgical chalazion clamp there, thank you
okay the next trigger is a dental one, something I've been recommended, but
i may not have shown you in the clinic previously
we have these little inter Dental flossing sticks, so we hold it like this and you can bend
the tip there to fit between the spaces of the teeth and then you just want some little back and
forward movements to clean between the teeth. Good to do before brushing and mouth washing,
so let me just demonstrate the interdental brushing between your teeth
okay so just open wide please
we will
try the lower rows there just so you can experience
see how it feels
how does that feel between the teeth?
thank you
that was the interdental flossing brushes there
okay I'm going to check your tear production performing the phenol
red thread test, let me just take this thread here
okay I'm just going to bend the sterile strip and place it over the lower lid
thank you and I'm going to give that 15 seconds just look straight ahead and blink normally
okay now I have the strip let's measure the
tear production there
okay 35 millimetres
fresh one for the left
just going to place this on the lower lid here
okay give that 15 seconds
look straight ahead and blink
okay let's remove that for you
and we measure the red part there
tells me that we have about 37 mL of tear production there,
its positive results thank you doesn't appear to be any deficiencies to your tear production
okay we did say we was going to do another final vital stain for the eyes now that the
lissamine green has drained out we're going to do the rose touch Rose Bengal ocular staining
okay there in the package there the sterile strip
I feel a little bit more uncomfortable than the lissamine green, let me know how it
feels, looking up
some rose bengal in that one
and for the other one there marvellous. Take a few blinks please
and to have another look at the ocular surface
with the ophthalmoscope
okay just look straight ahead again please
blink
Look up
look left
look to the right
looking down again please
straight ahead now. Excellent thats the right eye rose bengal
staining check. for the left look straight
okay take a fast blink. Look down for me please
okay looking right, left
and up. Good that's the rose Bengal staining completed thank you
all right
now we're on to our vision test using an app this time so cover your left eye I'm going to show you
some single letters, Just say the letters you can see there from top to bottom please
good and I'll change them for you try those excellent and let's try some shapes here
tell me the shapes please top to bottom now excellent and let's try these shapes
okay and those please lovely cover the other eye now
starting from the top say these shapes and the rows there please
excellent just attempt the bottom row when you're ready thankyou
some tumbling E's just tell me which way there tumbling please top to bottom
try those letters please
and these letters and both eyes are open now
try these letters with both eyes open, top to bottom there
and for the bottom
let's finish off with some numbers there, say the numbers you see please
that concludes all the tests today. Just record the results,
so we've done lissamine green Oculus staining, some handheld audiometry, we've done some
convergence motility and ocular measurements with the new device, so I've showed you the chalazion
clips, inter Dental brushing with demonstration, phenol red thread for tear production,
Rose Bengal staining and the Vision phone app thank you that's everything today