A question -

[ArchivalUser]

ahmed

Hi guys, I have a question, as we know the limitation of time in csa, what is the best maneuver for evaluating optic nerve? "visual acuity by chart, or visual field by confrantation?
Thanks

[ArchivalUser]

DR Joe

You are testing separate things
Confrontation is for Visual Fields and Snellen chart is for Visual Acuity- macula function
If you need to to a full eye exam then you need to do both.
If you have a patient with HTN or NIDDM then you just need to do fundoscopy( this is what I did in my CSA and I passed)

JOe

[ArchivalUser]

Ahmed

thanks for your answer, but my main concern is time limitation. so if I have a patient that should be assessed for Cranial Nerves, I am wondering if I have to evaluate each nerve completely, for example, what would you do for 2nd nerve or 7th nerve assessment, is it enough to ask patient to wrinkle the forehead, or we are supposed to ask for smile, frown, puff out the cheeks, and so on? thanks a lot in advance.

[ArchivalUser]

DR Joe

I did a relatively full neuro (including all parts of Facial and Opthalmic)- but only for my neuro cases.
The problem I found was in cases where you had to examine a number of systems e.g CVS + Neuro- then I diddo a brief cursory eye exam
It depends upon how much their main complaint is one-system orientated.
The time factor is the hardest thing b'cos you need to decide early on what system is involved and therefore what you are going to do- I don't think there is any hard and fast rule- the cases are obviously easier when it is obvious what the diagnosis and dd are and they are all in one system
I found that 7-8 of my cases were like that and the other 4 (i had 12) were 'multi-system"

I don't know what else to tell you

Joe

[ArchivalUser]

Ahmed

Thanks for your reply.