Ophthalmology for RVNs
Abstract
The nurse has a vital role to play in the identification of occult ocular disease, client education about the importance of preventive ocular treatment and the prevention of severe iatrogenic corneal disease in the hospital setting. Four key skills where discussed: assessing ocular pain, assessing the tear film, measuring intraocular pressure and the use of distant direct ophthalmoscopy using ophthalmoscopes and smart phones.
Ophthalmic disease is common in the veterinary patient population. Early identification can prevent life-threatening, vision-threatening and globe-threatening disease and nurses are well placed to both monitor and identify eye disease. This workshop discussed four essential clinical skills to aid in the early identification and prevention of disease:
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Demonstration of ocular pain is species and patient specific. Prey species tend to hide ophthalmic pain well as do certain dog breeds, notably many of the terriers. Of increasing importance is the reduction in corneal sensation we see associated with brachycephalic ocular syndrome (BOS). BOS affects small breed brachycephalic dogs and cats (Persians and to a lesser extent Burmese). Increased corneal exposure, poor blinking and chronic entropion leads to reduced corneal sensation which means that serious ocular surface disease (entropion, corneal ulceration and corneal sequestrum formation) may go unnoticed by owner and clinician alike. For this reason all small brachycephalic patients require good client education, life-long tear film supplementation and intensive corneal support during surgical interventions (e.g. neutering, dentistry).
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