PERRLA & Fundoscopy in a patient with Photophobia? - USMLE Forums
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Old 06-07-2013
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Hammer and Otoscope PERRLA & Fundoscopy in a patient with Photophobia?

Will you do PERRLA & Fundoscopy in a patient with Photophobia?
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Old 06-07-2013
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Quote:
Originally Posted by Novobiocin View Post
Will you do PERRLA & Fundoscopy in a patient with Photophobia?
Yes, you will tell them that you will perform a test with a light that will make them uncomfortable.. but that you have to do it in order to know what is going on. I did them when they were needed.
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Old 06-07-2013
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yes u need to do both. i had this pt . don't forget to turn the room light off when u enter
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Old 06-07-2013
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That's what I find very ironic (and difficult to digest)-- the patient can't tolerate the room light but will let you shine bright light into their eyes!
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i would not do fundoscopy in this pt.

it is clearly stated not to do test to elicit pain in patient which will have the pain

i would say ""i need to do this test, but since I do not want to hurt you with the light, I will not do it""

is like asking some one to lie down when they have pericarditis

or shaking some ones hand who is in severe pain.

http://www.slredultrasound.com/Files...res/Optic4.pdf
this is about the fundoscopy and photophobia




BUT YOU NEED TO WRITE IN THE EXAM PAPER YOU DID NOT DO IT< SINCE PT WAS PHOTOPHOBIC

http://www.google.ca/#q=photophobia+...w=1366&bih=639

the above explains more
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Old 06-09-2013
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just take it easy.
Don't go deep in thinking.
in FA there is a case of headache and one of the exacerbating factor was light but they mention funduscopic exam and also light reflex exam to examine the pupil and exclude papilledema. don't loss point from deep thinking.
the most important to dim the light when you enter the room.
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Quote:
Originally Posted by usramt View Post
just take it easy.
Don't go deep in thinking.
in FA there is a case of headache and one of the exacerbating factor was light but they mention funduscopic exam and also light reflex exam to examine the pupil and exclude papilledema. don't loss point from deep thinking.
the most important to dim the light when you enter the room.

i think i should ask if the light bothers them, offer to dim the light, if they like than yes, if not than no. RIGHT ??
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Quote:
Originally Posted by shima View Post
i think i should ask if the light bothers them, offer to dim the light, if they like than yes, if not than no. RIGHT ??
the rule is not to repeat harm procedure and we need to do light reflex and fundoscopy in such case.
but we should explain to patient

I know this light can be bright, and this exam is uncomfortable because of that. Please bear with me, though, because it is really important that I see your eye clearly.
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Quote:
Originally Posted by usramt View Post
the rule is not to repeat harm procedure and we need to do light reflex and fundoscopy in such case.
but we should explain to patient

I know this light can be bright, and this exam is uncomfortable because of that. Please bear with me, though, because it is really important that I see your eye clearly.

I know this,

you said in the above post, for me to enter the room and turn of the light. I was confused dude.
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Originally Posted by usramt View Post
the most important to dim the light when you enter the room.

Last edited by shima; 06-09-2013 at 01:56 AM. Reason: lights
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Quote:
Originally Posted by shima View Post
I know this,

you said in the above post, for me to enter the room and turn of the light. I was confused dude.
oh yes for sure..
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