[VIDEO SKILL OSCE - PEMERIKSAAN VISUS NATURALIS & BCVA]

Summary

The video features Dr. Konita conducting an eye examination for a patient named Mira, who is 45 years old. The doctor performs a series of vision tests, including reading letters from a chart, counting fingers, detecting hand movements, and identifying the direction of light. The process also involves checking for refractive errors using various lenses, and ultimately determining the patient's visual acuity and diagnosing any vision issues. The video concludes with advice on maintaining eye health and a recommendation for regular eye check-ups.

Takeaways

• 🩺 The doctor, Dr. Konita, introduces herself and confirms the identity of the patient, Ibu Mira, who is 45 years old.
• 👁️ The purpose of the examination is to assess the quality of the patient's vision using various methods such as reading letters and identifying hand movements.
• 📝 The first step involves the patient covering one eye and reading letters from a chart, starting with larger letters and moving to smaller ones.
• 🔢 If the patient struggles to read the chart, the examination progresses to finger counting at varying distances.
• 👋 If the patient still cannot see, the test continues with hand-waving to determine perception of movement.
• 💡 The next step involves checking the patient's light perception by shining a light from different directions and asking the patient to identify the source.
• 🔍 The doctor interprets the patient's ability to perceive light and identifies their visual acuity based on their responses.
• 🔧 If the patient struggles with the initial tests, further examinations using lenses (spherical and cylindrical) are conducted to correct refractive errors and astigmatism.
• 📏 The doctor also checks for presbyopia by adding different diopters to the lenses based on the patient's age and evaluating near vision.
• ✔️ The examination concludes with the doctor advising the patient on maintaining eye health, including regular check-ups, proper reading conditions, and diet.

Q & A

What is the purpose of the eye examination conducted by Dr. Konita?

The purpose of the eye examination is to assess the quality of the patient's vision and determine if there are any issues, such as refractive errors, that may require corrective lenses.

How does Dr. Konita initially assess the patient's vision?

Dr. Konita initially assesses the patient's vision by asking the patient to cover one eye and read letters from a chart, starting from the largest letters. If the patient struggles to see the letters, additional tests are conducted, such as counting fingers and identifying hand movements.

What steps are taken if the patient cannot see the letters on the first line of the chart?

If the patient cannot see the letters on the first line, Dr. Konita conducts a finger-counting test at varying distances and then proceeds to check the patient's ability to perceive hand movements and light perception.

What does it mean if the patient can perceive light but cannot determine its direction?

If the patient can perceive light but cannot determine its direction, it indicates poor vision. This is part of the light perception test, which helps determine the severity of the visual impairment.

What is the significance of the pinhole test in the examination?

The pinhole test helps to determine if the patient's vision improves with the use of a pinhole device. If vision improves, it suggests that the patient has a refractive error, such as myopia or astigmatism, which can be corrected with appropriate lenses.

How does Dr. Konita test for astigmatism in the patient?

Dr. Konita tests for astigmatism by asking the patient to identify the thickest line on an astigmatism fan chart. She then adds cylindrical lenses and adjusts the axis until all lines appear equally thick to the patient.

What is the process for determining the correct lens prescription for the patient?

The correct lens prescription is determined by incrementally adjusting the lens power and asking the patient to read from the chart. Dr. Konita starts with a spherical lens and may add cylindrical lenses if astigmatism is detected. The goal is to achieve the best possible vision correction.

Why does Dr. Konita perform a final check with the pinhole after determining the lens correction?

The final check with the pinhole is done to confirm that the astigmatism correction is effective. If the patient's vision improves with the pinhole in place, it indicates that the lens prescription for astigmatism is accurate.

What age-related vision condition does Dr. Konita account for in her examination?

Dr. Konita accounts for presbyopia, an age-related condition that affects the ability to focus on close objects. She adjusts the lens power based on the patient's age to compensate for this condition.

What advice does Dr. Konita give to the patient for maintaining eye health?

Dr. Konita advises the patient to avoid reading in poor lighting or while lying down, to eat plenty of vegetables, and to have their eyes checked regularly, ideally every 12 months, to maintain good eye health.