hello there i have a few questions to run through today that are listed on my pad here,
so first up have you ever had your vision tested with a single letter that varies in orientation?
i'll arrange that for you, cover your left eye, tell me which way the letter is facing please
okay just uncover, cover the other eye now please
so
okay uncover and relax
have you ever needed to use a cleaning product for blepharitis, to clean your lids of any debris?
well you're in luck
have a fresh Blephaclean clean wipe for your eye
okay just close your eyes, i'm going to gently
clean the lids for you
i'm going to focus on the upper and lower margins
okay and a fresh wipe for the other eye now
keep them closed please
just very gentle pressure
and you can relax now
okay moving on, has anybody ever discussed age-related cataracts with you?
i can do that now. it so happens that i have a
lens grading system here this is the
lens opacity classification system number three, abbreviated to LOCS
okay so essentially we have three types of age-related cataract. you have your
hazy nuclear type here, cortical type here, which we can describe as spokes coming across
like on a wheel and the cataract that develops, the posterior part of the lens the posterior
subcapsular,, as you can see as you move along the scale the increasing severity is cataracts
there's the cortical this is encroaching on the vision, the nuclear very hazy crystalline lens
there and a very large posterior subcapsular cataract there. okay so that is the grading
system, one of the grading systems that can be used to assess cataracts age-related type
okay moving on have you ever seen the city rule before?
this is a city rule
you can take various measurements of your face, of your spectacles
okay so you've never had any measurements taken with the city rule.
all right looking into this eye please
this eye,, this one back to this one
this one
coming across, back to this one please. okay have you ever had your iris diameter measured?
i'll arrange that for you. this eye and this eye, this one,
this one it. stands at 12 millimeters there, pupillary distance 65 millimeters
all right have you ever had the Hirschberg light test performed on you before?
okay it's very simple
you keep the head still, look into the light
and i'm going to observe the corneal reflexes there, the corneal reflexes
okay so i'm just looking for that slight
nasal displacement that tells me the eyes are straight left and right
keep looking. that's completed thank you
okay and just to back this test up, I have a related test.
when was your last ocular cover test?
with something like this? have you had one before? the cover test? okay we're checking for any eye
deviations, any tropias or any drifts such as phorias .so keep looking into this eye please
I'm going to cover one eye at a time
now just observe this side
okay just looking at the tip of my nose now
this is the phoria check, looking for esophoria
or exophoria, if there's an absence of tropia. A little bit quicker now
finally complete
all right next question, when was your last temperature check?
very simple and straightforward here is the thermometer, it's a handheld,
contactless device
and that's all we need there, all we need
okay so keep steady i'm going to point it at the forehead
okay we have a reading of 36.7
so it's rather accurate let's just take a second reading
okay and we're in the normal still, 36.6 degrees celsius
okay have you ever had your head measured before? the dimensions of the head?
let's just start with a simple tape measure
keep the head steady
okay and we're going to be a little bit more specific
with the device here
okay head width first and foremost
and now for the temple width
i have those readings there
what about your apical radius measurement, has that been performed before?
it's using this scale here
looking for a snug fit
on the bridge of the nose, not too loose,
not too tight. it's great for when you need bespoke spectacles. relax
that's an eight, seven getting there, six looks good. five a little tight
excellent thank you
and what about a front angle measurement? has that been performed on you previously? relax again then
lining this up with the centre of the nose
bringing the cursor in until we have slight contact or first contact gently here
and here, and then we'll use the scale here in terms of degrees as our units
start off with the right front angle
25 degrees. for the left
just over 20. we'll call that 22 degrees there
that concludes the measurement questions and tests
right when was your heart last listened to? have you seen a doctor recently?
okay let me get the stethoscope ready, just breathe naturally
okay we'll tie this in with a pulse reading, just roll up your left sleeve, let me have your hand
and to give it a few moments, just breathe naturally
okay sounds good
okay when was your last amplitude of accommodation test?
i'll perform it for you now then. i'm going to use the replica RAF rule here. i'm going
to rest this gently on the bridge there, contact on the cheeks, i'm going to find the correct scale
i want you to tell me when the print on the drum wheel first goes blurry please. go here
focus on the second block of print down there please, the second row
and again just tell me if it goes blurry
okay you have a good amplitude of accommodation looks as though we have 12 dioptres there,
12 dioptres. okay and final set of questions,
have you ever had a burton lamp assessment with the blue light?
right that involves popping some yellow dye into the eyes
certainly doesn't sting or affect your vision. have you had the die before?
all right one drop in each eye, look up
take a few blinks and now for the left, look up again
let's take a few blinks again
i'm going to set up that burton lamp now
i'm going to look at your eyes through the window here, try and look through the window
yourself back at me, blink naturally. let's start with the right eye please
right blink again
and look up
look to the right
to the left
looking down
straight ahead
it's a very simple test looking at the cornea and the conjunctiva. let's line this up, look straight
and look up
look down
to the left, and to the right, straight ahead, blink a couple of times
and it's that simple, that's all the tests and questions covered today
let me just take the final few notes and i'll let you escape
okay thanks for stopping by. bye for now