Clinic LogBook and Clinic Report Submission

Attention to All IIUM Optometry Students,

Kindly, please submit your all clinical logbooks and clinical reports for any clinics (OC, Jaya Gading, Ophthal Posting, Special Clinic) include two previous semester by this Monday to your respective Class Representative.  Please separate them by type of report (logbook or written report) Semester (Sem 1 & Sem 2), Batch, and Subjects (course).

After gathering all the logbooks and reports, please put in  'your basket' in front of Optometry Notice Board at IMC, Level 5. I'll collect them at 5.00 p.m on this Monday.

For those who have been submitted the logbooks and reports, please write "submitted" in comment section.

Your cooperation are highly appreciated.

Any inquiry, please call my hp.

Tq

Pediatric Optometry Case 7: 5yo/M/M

·         Referred from IIUM eye clinic with diagnose of RE constant Esotropia

·         Mother claim that her son eye is deviated suddenly since 5 month ago

·         He never had any head or eye trauma before

·         He was born through normal delivery born full term

·         Mother doesn’t notice any changes in visual or school performance after the eye deviated

Pediatric Optometry Case 6: 5yo/M/I

 Subjective

-Referred from PCO clinic. Based on PCO, vision is fluatuate, required cycloplegic refraction. 

-Parent report, patient like to watch TV very close, squinting and make pinhole effect to see small letters, like to rub, tend to have face turn (not confrm either right or left) in order to focus. Generally healthy.

Don't Stare at Me!

After  a pediatric case brainstorming session, everyone became 'haywire' for a moment. Do not believe? Let's look at these photos...all of them was staring at me..huhu..Please observe the photos carefully, who were hold the rugby ball? Do you still remember my words in class pertaining the 'ball'? Sungguh ku tak sangka,diam2 ubi berisi... Don't talk so much la..Let's see the photos & give your sporting comments

Pediatric Optometry Case 1: 2 years 6 m.o./M/F

(NEW CASE)

Hx:

·        - Suspected autism (as not confirmed by HTAA psychiatrist yet).

·        - Birth: Normal delivery.

·        -She was not feeling well during the visit.

·        - Mother reported she can suck well and eat rice as well.

·        -Good development except for speech.

TRIGGER FOR PAED & BV CLINIC WEEK 5

9 years old/Male/Malay

Observation:

- He came with LE XT.

- He keeps rubbing his eyes during the eye examination.

- He has skin problem

Subjective:

- He was referred from PCO clinic.

- No c/o blurred vision at Distance & Near.

- No c/o headache.

- No c/o double vision.

- No history of allergy, other eye disease & systemic disease reported b his guardian.

Objective:

Let's Discuss!

1) What is the exact diagnosis for this case?

2) How would you manage it?

"SELAMAT MENYAMBUT RAMADAN AL-MUBARAK" FROM GROUP 2.

TRIGGER FOR PAED & BV CLINIC WEEK 4

7 years old/Male/Malay

SUBJECTIVE:



- Diagnosed with autism since 2 years old.

- Pt is undergoing psychotherapy and is showing good progression. Pt

   also attend speech therapy.

- Father complained that child frequently look too close at near object

   since he was 2-3 years old.

- Father complained that child frequently rubbed BE.

- Eye become red especially when he's in a bad mood.

- Frequently bumped on things when walking and tend to fall down often

   since 2 years old.



- Delay development in reading, spelling, writing & calculation.

- General development history:

    1. Language - Has improved and can count simple number.


    2. Social- Not very good and prefer to be alone.



- General health & ocular history:

   1. Birth history: normal delivery.

   2. Often get high fever since 2007.

   3. Tonsilitis- On Loratadine medication and under ENT observation.

   4. Constipation problem: on medication

    * Loratadine- anti-inflammatory drug.







- Family history:

   1. The only one in family who's autistic.

   2. Unremarkable diseases in family.



OBJECTIVE:









ASSESMENT/ DIAGNOSIS:

RE: Low hyperopic astig (WTR)

LE: Low simple astig (WTR)

TRIGGER FOR PAED & BV CLINIC WEEK 3

8 years old/Female/Malay

Patient was diagnosed with alternating ET with LE as a fixating eye associated with RE hypertropia.

Patient came for follow up assesment and spectacle delivery.

This is the continuation case from week 1.

Patient came with face turn to right.

Below are the results from the examinations performed.



MANAGEMENT

-Spectacle was delivered.

Kindly refer to week 1 case for previous assesment results.

THINGS TO DISCUSS

-What is your expectation when this patient came for next follow up in 1 month time?

-How can you relate face turn to the right and the diagnosis given?

-Do you think the prognosis will be good?

-What is your next step in managing this patient when she came for next TCA?

HAPPY DISCUSSING!!!

GROUP 1 & 4 :)

TRIGGER FOR PAED & BV CLINIC WEEK 1

8/F/M

SUBJECTIVE:

1. no c/o of any symptoms from the patient but her mother noticed the deviation of the eyes since she was 5yo
2. she never wear RX before

OBJECTIVE:

	RE	LE
UNAIDED VISION	6/6 N5@40CM	6/6 N5@40CM
Refraction: Dry retinoscope wet subjective	+0.25/-0.75 X 145 +1.25/-1.00 X 150 (6/6-3 )	Pl/-0.25 X 130 +1.00/ -0.50 X 180 (6/6+3 )
Cover test w/o RX: with wet RX: (done at D only)	D: Alternate ET, RE hypertropia N: alternate ET , RE hypertropia D: intermittent RET
PCT (done at distance only) Without RX : With wet RX :	70 pd BO 32 pd BO
Other test OMT	Hess chart. Kindly refer to the attachment. -2                  +2         +2              -3 0                   +2         +2              -3 -2                  +2         0               -3

ASSESSMENT/ DIAGNOSIS:

Alternating ET with LE as a fixating eye associated with RE hypertropia

PLAN/ MX

Prescribe full wet RX with full time of wearing

TCA: 2/52

 

based on the hess chart above,

1. what is the u/a muscle?
2. what is your diagnosis based on this hess chart?

XOXO,

GROUP 3 :)

BV & Paeds Clinic Registration/ Appointment

Please refer to Flow of procedure for BV and Paeds Clinic Registration/ Appointment. Click the link below

appendix-i-flow-chart-for-registration-at-bv-paeds-clinic

If your patient needs to be referred to BV & Paeds Clinic, please leave the management part including prescibing a correction (Rx) during PCO visit.

This practice is to avoid from giving improper management to pateint.

The management part only will be determined during BV & Paeds Clinic visit.

For BV and Paeds Clinic appointment, please consult with Br Najib, do not make an appointment (give a date) by your own or without inform to Br Najib.

Now, Br Najib is on leave, please inform and advise me for any BV & Paed Clinic Appointment. For your info also, our BV & Paeds Clinic is not on every Wednesday as usual. It is alternate week. For instance, this week is BV & Paeds Clinic day, but in next week is LV day.

For 4th year student, I'm seeking your help to convey this important message for 3rd year student.

PEDIATRIC CLINIC on 17/3/2010

Please be informed that Pediatric Clinic will be running as usual. InsyaALLAH, two patients will be attending on the clinic day. Please consult Br Najib regarding pt appointment.

1) 9.00 a.m. .Please conduct test on this pt at PCO clinic room.

At 9.00p.m I've own pt at Pediatric clinic. Normally by 10 am, I can finish my case.Iif you have any query on that time, please consult me at there.

2) 11.00 am-please conduct test on this pt at PCO Clinic room.

Syah

Paed Clinic.23/12/2009-LJS-Hasbi Group

opia2612@yahoo.com
December 23rd, 2009 at 6:05 pm e

(member: hasbi, amalina, ain, shafiah)
SNM 9/F/M (file no: 5964)
-Previous visit
• Mother reported that patient needs to squint her eyes to see clearly leading to symptoms of headache
• She has high WTR astigmatism OU + meridional amblyopia
• Full prescription prescribed and vision improvement noted 2 months afterward
• Her last visit was 16th May 2008
-Today’s visit (December 23, 2009)
• Pt sits in front of the class-no problem with copying notes from blackboard. However, headache reported occasionally during writing + reading+ looking at blackboard + sometime at home; location: top of the head
• Father reported: headache in the morning and evening (1-2 times a month)
Current Rx
RE: +0.50/-4.00 X 8 (6/6-2 ; N5@ 30cm)
LE: +0.50/-4.00 X 8 (6/6-2 ; N5@ 30cm)
Subjective refraction
RE: +0.50/-4.00 X 5 (6/9 ; N5@ 30cm)
LE: +0.50/-4.00 X 5 (6/9+3 ; N5@ 30cm)
AA
RE: 10/9 11/9, 12/10D
LE: 12/9,12/9,12/9D ; BE: 11/8, 12/9,11.5/8D
NPC: TTN
Phoria assessment
Maddox rod: 2ep @distance, 2xp @near
Howell card: orthophoria @ distance and near
Acc facility
RE: 7cpm ,LE: 9cpm ,BE:8cpm
Acc response (MEM)
BE: +1.50DS
K reading (Pentacam)
RE: 7.87mm/42.90D@H ; 7.22mm/46.70D@V
LE: 7.90mm/42.70D@H ; 7.13mm/47.30D@V
Other findings
-how do I put it? Mild to severe scratches was inspected on her current lenses…hehehe
To the rest of the class (excluding me, amalina, shafiah & hasbi), what is the possible assessment of this patient? To be more specific: what is the probable causes of her headache? Selamat menjawab \(^_^)/

BV Clinic X- Files 9 Dec 2009 -- specially dedicated to Group 4 members

SNM 21/ F/ M (880416-06-5050)

This young lady came for PCO Clinic on 22 Oct 2009 with this symptom:

- Double vision after prolonged reading which is then resolved with blinking

Today morning (9 Dec 2009), she came again for BV clinic assessment. Here are
the reported symptoms:

1) Double vision seen horizontally after 5 minutes of reading (resolved with
blinking)
2) No blurring of vision at both D and N
Unaided Vision
RE: 6/6+3 (+1.00: 6/9)
LE: 6/6+1 (+1.00: 6/18+2)

Refractive error found during PCO visit
(all the tests during this visit were done using this correction)
RE: +0.50/-0.25X10 (6/6)
LE:  pl /-0.75X180 (6/6)

Refractive error found during this visit
RE: +0.50 (6/6)
LE: +0.25/-0.50X180 (6/6)

AA
RE: 13/11, 13/11, 13/11
LE: 12/10, 12/10, 12/10

MEM
RE: +0.50 D
LE: +1.00 D

NPC: 12/14, 14/16, 17/20

Phoria: 2 XP @ D, 16 XP @ N (vertical orthophoria)

NFV: 5/4 @ D, 18/17 @ N
PFV: 4/3 @ D, 5/4 @ N

AC/A ratio: kindly calculate by urself~
Zul, Muni and Amalina,
Can you state the TENTATIVE DIAGNOSES for this patient based on the symptoms?

(PLEASE post first before u take a look at the FILE ye ^^)