眼科英语口语

ENGLISH GUIDE TO COMMON EXAMINATION PHRASES

OCULAR DISEASE

POSTERIOR SEGMENT EXAMINATION

RETINA

ARTERIES/VEINS

CRVO(CENTRAL RETINAL ARTERY OCCLUSION)

“Everything suddenly went dark in my right eye. It wasn't painful. But I can see anything through that eye. All I can make out are your fingers”

1 You had a stroke in your eye due to blocked arteries. This is probably a result, of an underlying systemic condition. I need you to close your eyes and I will touch your eyelids in order to massage them. Now hold this paper bag, take a deep breath and hold then breath into the bag.

ANTERIOR CHAMBER PARACENTESIS

2 We need to drain a little bit of fluid from your eyes. This procedure may improve your present visual acuity. Are you allergic to numbing drops? Please relax your eyes.

I need to numb one of your eye muscles. You will feel a pressure sensation. Just keep your eyes turned towards the side. Look at where my fingers are.

3 Now I need you to take this pill. It helps reduce your eye pressure to prevent further damage.

WORK-UP

4 I need to find the underlying cause of your condition. Your vision will not improve. But we need to preserve what remains. Follow-up is important. I also need to refer you to an internist for a complete workup. They will need to run blood tests (FBS, CBC, PT/PTT, ANA, FTA-ABS) and so fourth (Carotid Doppler, ultrasound, ECG). I need to see you back in 3-4 weeks to make sure there are no signs of oxygen deprivation damage.

I will have my staff make that appointment for you.

BRVO(BRABCH RETINAL ARTERY OCCLUSION)

5 You have a partial stroke to your eye due to blocked artery. This is probably due to an underlying systemic condition. I need to see you back in 3-

6 months to monitor

your condition. Follow-up is important so please don't forget.

CRVO(CENTRAL RETINAL ARTERY OCCLUSION)

You have a blockage in the drainage system of blood in your eye. It is causing blood to leak out of vessels, which is the cause of your visual problems. We need to find out the underlying cause. Are you on any. medications such as oral contraceptives? Do you remember the name of your blood pressure pill? I need to discuss with your doctor and see if it's advisable to change your medication. I also need to refer you to an internist for a blood work-up. I recommend we do a fluorescein angiography. It's a special test that will give me better information as to the extent of vessel blockage. I will need to inject this yellow dye into your system. We will then take photos of the back part of your eyes. When you go outside, it is important that you have sun protection and cover your skin because this dye makes your skin more sensitive to the sun. Some patients have even told me when they go to the bathroom, their urine turns yellow. But this won't be permanent. I need to see you back every 4 weeks for these first six months to closely monitor for signs of oxygen deprivation.

BRVO(BRABCH RETINAL ARTERY OCCLUSION)

7 You have a partial blockage of the drainage system of blood in your eye. It is causing blood to leak out of vessels, which is causing your visual problems. We need to find out the underlying cause. This is usually related to hypertension (HTN) or diabetes. I need to refer you to an internist for blood testing. I need you to come back every 1-2 months to monitor the blood leakage and for initial signs of oxygen deprivation so we can treat you right away.

DIABETIC RETINOPATHY

8 You have a condition called Diabetes (DM), which is increased blood sugar, and this is affecting your vision. We need to refer you to an intemist to control the underlying cause with medications. Regular eye exams are important to monitor for progression.

9 What's your fasting blood sugar level? Do you remember your glycosylated hemoglobin #? It is important to try to keep that number ＜6.5-7.0%.

DIABETES WITHOUT RETINOPATHY

10 Your eyes look great. I don't see any signs of diabetes. Keep up the good job in controlling your blood sugar level. I want to see you back every year looking this way.

11 Since you are just in your first trimester and knowing that you are diabetic, I want to monitor your eyes closely. Everything today looks perfect. Please come back in 6 months so I can check up of things again.

DIABETES WITH MILD NPDR

12 I see early signs of diabetes affecting your eyes. If you've had diabetes for over 15 years, it's expected. I need you to come back for a dilated exam in 6 months to monitor your condition.

13 You are just in your first trimester. I do see very mild, trace signs of blood leakage. It is of no major concern at this time. I need to monitor its progression closely. Many 'have shown regression soon alter birth. So I will just need to follow up again when you've reached your second and third trimester.

DIABETES WITH MODERATE TO SEVERE NPDR

14 I see early signs of oxygen deprivation at the back of your eyes due to your diabetes. I need to see you back in 3 months to monitor your condition. No treatment is necessary at this time.

HIGH RISK NPDR(PREGNANT)

15 I see signs of oxygen deprivation at the back of your eyes. There is a 50/50 chance it will progress. But I?ve seen regression after birth. Please come back next month so I can monitor for any changes.

PDR

16 We need to work on how to better control your diabetes. It is affecting your eyes in a way that can result in vision loss. I need to see you back in one month.

HIGH RISK PDR/CLINICALLY SIGNIFICANT EDEMA(CSME)

17 You need laser beatment to prevent further vision loss. We call it Panretinal Laser Photocoagulation (Focal laser treatment). I am seeing new blood vessels growth at the optic disc (around your retina/iris) which shouldn't be there. It tells me that your eyes are not getting oxygen and your system is creating new vessels in response to that.

You are now at very high risk for visual loss. In order to preserve what you have, the laser will kill unnecessary retinal cells to decrease the oxygen demand. To put this another way, picture your retina as a forest. But it's suffering from a draught. There is a special tree inside the center of the forest that you must save. In order to do that, you need to kill rest of the trees around so they won't compete for water. Initially for the first week right after the treatment, you will think things looks worst (dimness of vision). But your eyes will adapt to this change.

18 I need to beat you. but it does not indicate you need to terminate your pregnancy. I need to examine you every month. At around the time of labor, it's Important to monitor your condition. If I continue to see active PDR, I will need to communicate with your doctor. We should discuss about he need for cesarean section because the energy exerted during natural birth may cause hemorrhage inside your eyes which will result in complications of your vision and treatment regimen. HYPERTENSIVE RETINOPATHY

19 Hypertension is usually asymptomatic, so it is important to check your blood pressure daily. We are finding changes related to HTN in your eye. Come back in 2 months for a follow-up so I can see if it resolves or not.

ARTERIOSCLEROTIC RETINOPHY

20 You have a condition from long-standing hypertension. You need to be referred to an internist to treat the underlying cause.

TEMPORAL ARTERITIS(AION)

21 You have an inflammation of the large and medium sized arteries. The cause is unknown. Medications must be taken to prevent involvement of the ether eye. MACULA

CELLOPHANE MACULOPATHY

22 A membrane has grown in the back of your eye. This is not an urgent condition,

but it needs to be monitored. Yearly follow-up examinations are a must to monitor the progression of your condition.

CSC(CENTRAL SEROUS CHOROIDOPATHY)

23There is fluid similar to a blister, in the central vision part of the back of your eye.

It will go away, but it may take some time (1-6 months). Do your home amsler grid one eye at a time and RTC if you rtotice any changes. There is a very good chance of complete recovery.

CME(CYSTOID MACULAR EDEMA)

24You have a condition in which there is fluid going into the back of the eye, under the retina. When this condition resolves, your vision will improve. You need to be seen by an internist to rule out any underlying cause, usually related to Htn, DM, cataract surgery.

AGE RELATED MACULAR DEGENERATION(ARMD)

NON-EXUDATIVE

25There are signs of aging in the central part of the back of your eye. I need to monitor this condition for any changes. I recommend you take these vitamin supplements, 4 tablets per day. I need to know if you are still smoking or if you've smoked before. If that is the case, I won't prescribe Vitamin A for you because I don't want to create a new problem (enhance your lung cancer rate).

These vitamins will not affect your cataracts. So far there are no cure for this, but we can try to slow down its rate of progression.

EXUDATIVE

26There is a possibility of bleeding in the back of your eye. Your vision will net improve. I want to help you. There are very good Iow vision aids that can help maximize the use of your remaining vision.

27Your visual loss is Irreversible. But we still need to monitor for retinal detachment. If there is a sudden onset of flashes and: floaters, come into our office ASAP.

PERIPHERAL RETINA

28I see a small area of weakness at the back of your eyes. A very small piece of tissue has been tom away. Usually the treatment for this is to leave it alone. But you must pay careful attention for signs of retinal detachment. If you see flashes and floaters or a curtain in anywhere in your flashes and floaters or a curtain in anywhere in your field of view, RTC immediately.

RETINOSCHISIS

29You have a separation of the layers in the back of your eye. Follow-up is necessary to monitor the progression and prevent permanent vision loss. RTC ASAP if you noticed flashes and floaters.

LATTICE DEGENERATION

30You have thinning of the tissue in the peripheral part of your eye. We need to monitor for retinal detachment. If flashes and floaters are noticed, you need to RTC ASAP.

RETINAL DETACHMENT

31You have a separation in the back part of your eye. The layers have to be reattached to prevent further detachment. Do not do any strenuous activity in the mean time like golfing, weight lifting.

CHOROIDAL DETACHMENT

32You have a separation of the back part of your eye which needs to be monitored, so that further decrease in vision does not occur.

TOXOPLASMOSIS

33There is an infection inside your eye which is usually transferred by cat feces in the liter box or undercooked meat. You need to take your medications to calm the inflammation otherwise, permanent decrease in vision will occur, I also need to refer you to a specialist to start oral medication treatment. It's not possible to kill the parasite but we need to suppress its activation because reoccurrence is possible.

TOXOCARIASIS

34Round worms in the back of your eye are causing this condition. The roundworms may have come from exposure to pets or eating dirt. Medications must be taken to get rid of the inflammation.

HISTOPLASMOSIS

35There is a fungal infection active in the back of your eye from chicken or bird droppings. The condition should remain good provided you have good compliance with the daily home amsler grid monitoring. If you see sudden

changes with your vision, you must retum immediately so we can start laser treatment right away.

UNKNOWNS

CHOROIDITIS

36there are signs of inflammation at the back of your eyes. I haven't been able to identify its cause. So I am going to refer you to a very good specialist in this field for consultation.

GLAUCOMAS

ACUTE ANGLE CLOSURE GLAUCOMAS

“I feel pain around my eyes, vision is a bit hazy. When I look at light, I see colored halo around lights. At Times, I feel a bit nauseated, and have been vomiting. I am also getting a headache at the front.”

37The drainage structure of your. eye has been blocked. This is due to the anatomy of your eyes with a narrow chamber compared to normal. We often see this in Asians and hyperopes. Being both, you are at higher risk. You really need to be extra careful and monitor for signs when you go to the movie theaters going to dim illumination. Because your vision have been severely affected to hand motion only I need to lower your pressure immediately. The oral medication

I prescribe will help. I will prescribe these drops to lower your pressure. Please

stay here because I need to check your eye pressure and vision again in one hour.

If it does not decrease after the second course, we need to proceed with laser peripheral iridectomy to correct this condition.

38The drops worked well, and we see your pressure decreased. But your cornea is still swollen. I need to see you back tomorrow and daily (1-5 days) to monitor the inflammation. I will need to prescribe several medications. Then we can do the laser procedure to create more drainage holes to prevent another attack in the future. I want to treat the other eye too because Ithere is a 40-80% chance it will be blocked 5- 10 years down the road. I will do that firs[ ain-dthenonce your cornea has resolved, we will laser this eye. You should tell your relatives about your condition. There is a 33-50% chance your first degree relatives inherit this

condition.

CHRONIC OPEN-ANGLE GLAUCOMA

39Take your medications! The medications will slow the progression of glauco(na but there is no cure.

40The drainage structure of your eyes is not working optimally. We measure your pressure and it is too high. You won't feel the early stages damage but we do see it in our exam findings today. That is why I need to start you on the medications to control your pressure. What is damaged is irreversible and fortunately, you came in early enough. If it progresses, it will cause your side vision to constrict.

Normal pressures are less than 20. Yours is above 30. We will start treatment on one eye first to check its affects. Every patient responds differently to these eye drops. Our target (I would be very happy) if we get a 30% reduction. So come back in (3 weeks/3 days/tomorrow) and we will check pressures both eyes. if we are getting effective results then we will proceed with this therapy and keep your pressures under control. Exercise, especially walking is good too. So I strongly encourage you to start this habit.

ANGLE RECESSION GLAUCOMA

41Your condition is due to prior trauma to the eye. There is scarring-to the trabecular meshwork, which, is blocking drainage from your eye. Compliance with your medication is essential.

PIGMENTARY GLAUCOMA

42The type of glaucoma you have is caused by pigment coming off the colored part of your eye. This pigment is causing a blockage in the drainage system of your eye. Compliance with your medication is very important. PSEUDOEXFOLIATIVE GLAUCOMA

43You have a condition in which the colored part of your eye is rubbing up against the lens inside your eye. This is causing white flaky material into the drainage system of your eye. !t is hard to control IOP spikes due to the small pigment blocking the drainage.

NORMAL TENSION GLAUCOMA

44You have a condition in which the pressures in your eyes are about average. But your eye is more sensitive than the average individual and it is damaging sensitive tissues even with these pressures.

45It is difficult to decrease your eye pressure further since the pressures are already low. I will prescribe this eye drop that I want you to place one drop, four times a day. Come back in a week and we'll see how your pressures are.

PVD(POSTERIOR VITREOUS DETACHMENT)

46It is a normal age-related change occurring at this time. But we need to monitor for higher risk of retinal problems. RTC if you noticed sudden flashes of light, and sudden burst of floaters.

ENGLISH GUIDE TO COMMON EXAMINATION GREETINGS

1 Good morning/aftemoon/evening. Welcome Mrs . How are you today? Sit down please. I am Dr .

2 I am sorry you had to wait. We are very busy today.

3 How did you hear about us?

CASE HISTORY

PATIENT PROFILE

4 How old are you? When is your birth date?

CHIEF COMPLAINT (FOLDARS)

5 How can I help you? What is the reason for your visit?

6 Who referred you to me? For what reason?

7 Have you noticed any changes in your vision? Do you have any problems with your vision or your eyes? Can you see things well at near?. What about things which are far away? / Do you see well far away and up close?

8 Which eye or both? (Do you have questions? )

9 Can you show me? (Did you understand everything that I told you? )

10 When did this happen? /When did it start? / Since when have you had this problem? (Don't mention it. )

11 Was the change sudden or gradual? ( Same to you. )

12 How long have you had it? (You are very kind. )

13 When was the last time it happened?

14 How often have you had this problem? Do you have it all the time/always/once in

a while/almost never?

15 Was the change sudden or gradual?

16 How long does it last?

17 Tell me, where does it hurt?

18 Excuse me? Can you please repeat what you told me? I didn't understand you completely. You told me that, correct?

VOCATION

19 What type of work/do you do?

20 Are you working? Do you work on a computer?

A VOCATION

21 What sports or hobbies do you do?

PEH

22 Is this your first eye exam?

23 When was your last eye exam?

24 Do you wear glasses or have you worn them in the past? For distance? For reading?

25 Have you had any injuries to your eyes or surgery performed on your eyes?

26 Have your eyes been dilated before?

27 Did the doctors ever tell you that you have an eye disease?

28 What did the doctors tell you?

29 How long are your glasses?

30 How are you doing with your glasses?

31 Do they still work well?

32 Did you bring your glasses?

33 Have you used contact lenses before?

34 What care system do you use for the lenses; OptiFree Express, Renu?

35 Are they hard or soft?.

36 Are they disposables?

37 Why did you stop using them?

38 Do you know the brand of contact lens

39 Ho long are the lenses that you are using now?

40 How is your vision with your lenses?

41 Normally, what time do you put them in and take them out?

42 Approximately how long do you use your contact lenses everyday?

43 Do you know if you have any eye disease such as glaucoma?

44 Have you had infections of the eyes?

45 How did you lose this eye? What happened?

46 Do you feel something in your eye?

47 Do your eyes get red?

48 Do you wake up with discharge in your eyes?

49 Do vou have difficulty seeing at night?

50 Does the sun bother you a lot?

51 Are you very sensitive to light?

52 Do you see cobwebs/spots in your vision?

53 Do you see flashes of light like lightning/little lights?

.54 Did a stick penetrate your eye?

55 Do you think it is a small piece of wood or metal?

56 Do your eyes feel very dry?

57 Do your eyes bum or hurt?

58 Do your eyes itch?

59 What are you doing when it hurts?

60 When you read a lot does it hurt?

61 Have you ever seen double?

62 Are you seeing things double right now?

63 Do you drink much alcohol?

64 Do you smoke?

65 I need to perform some tests to make sure this is the reason

FEH(family eye history)

66 is there anyone in your family who has glaucoma, cataracts, any eye turn(strabismus) or is blind?

PMH(patient medical history)

67 When was your physical exam?

68 How is your general health?

69 Do you have any problems with high blood pressure, diabetes?

70 Who is your primary care doctor?

71 Do you know if your diabetes is type I or II

72 How was your blood sugar level?

73 What was your Hba1c level?

74 How long have you had diabetes?

75 Any fluctuation in vision?

FMH(family medical history)

76 Does anyone in your family have Htn(hypertension), Cancer, Dm?

78 Are you taking any medications, vitamins or eyedrops?

79 For what reason do you take the medicines?

ALLERGIES

80 Are you allergic to any medications?

81Can you put these glasses on? Can you take them off ?

ENTRANCE TESTING

VISUAL ACUITIES

82 Cover your right/left eye.

83 Without squinting, please read the smallest letters you are able to read on the chart (here / there) It's OK to guess.

84 Can you see the last line?

85 Read me this line and the next and the one below?

86 These letters are extra. Most people can't read those.

87 Those letters are very small. Few can read them.

88 Can you make them out?

89 Look through these holes. Pick one to look through. Do they help you?

COVER TESTNERSIONS/NPC

90 We are checking to see if you have any problems with your eye muscles.

91 Please keep your eyes focused on this letter while I cover your eyes.

92 I am checking how well your eye muscles work as a team.

93 Without moving your head, please follow this target by moving your eyes only.

94 I am checking how well your eyes can sustain focus.

95 I am going to bring this close to you. Keep looking at it and let me know if it splits into two. CONFRONTATIONS

96 I am Checking how well your side vision is.

97 Cover this eye and look at my right eye. Without looking off to the side, let me know how many fingers I am holding_up altogether

STEREO

98 I am checking how good your depth perception is. Tell me which of the circle in box #1 seem to come off the page.

REFRACTION

99 I am getting an estimation of your prescription. Don't look at my light, but look at the letter far away.

100 I am going to cover one eye.

101 I am going to have you make several choices between two lens. There are no right / wrong answers, just tell me what you prefer.

102 Looking at the chart far away, let me know as soon as you can start to read the letters on the second last row.

103 Comparing this lens #1 and this second lens #2 which one looks clearer and sharper.

104 Whenever they look the same, just let me know.

105 Things may look blurry with this lens.

106 Try to read these Blurry letters.

107 Close your eyes while I set some special lenses in place.

108 Are you able to see two rows of letters: one above and the other below.

109 Comparing the top and bottom row, which row looks sharper / clearer? The top one or the bottom one?

110 I am going to dim the lights. Comparing the red side and green side, the letters on which side looks darker / more black.

111 Now we are checking a prescription for reading glasses. I am going to put lenses in front of you to see how well you can focus. Try your best to keep the letters focused but let me know when it becomes too blurry to read.

112 Do you see two boxes of letters? I am going to use special lenses to move the letters. Let me know when the box once top is lined up directly with the one below it

like one ice-cream scoop on top of another.

113 Let me know when the letters are blurry, when you see double and when they appear one again.

114 I am going to check the health of the front part of your eyes to look for signs of infection, cataracts.

115 Please rest your chin here and forehead here and close your eyes. I am going to move your chair.

116 I am looking at a magnified view of your lashes. Open your eyes and then look up. I am going to touch your lids.

117 Look right, look left, look straight ahead and look down, blink, try to keep your eyes open, look over here / there.

118 I am going to place drops in your eyes. It will sting. But try not to rub your eyes.

119 Look at direction of my ear over here. Pick a point far away to look at. I am checking your eye pressure. It is one of the way we check for signs of glaucoma. You will see a blue light and this is going to come close and touch your tears. Remember to breath .

120 I am using this to check the health of the back area of your eyes to look at your blood vessels and check for signs of high blood pressure, diabetes in your eyes. The light will be bright.

121 I am going to shine a light at your eyes to see how well your pupils, the black part of your eyes respond to light. It lets me know how well the connection from your eyes are to the brain.

Cataracts

122 You have the beginnings of cataracts.

123 Right now they are not affecting your vision, but in the future it is possible they will.

124 Cataracts are very common. This is a normal age related change or it could be from medications. The cataract will continue to progress. You will eventually need surgery and replace new lens in your eye.

125 Your crystalline lens inside your becomes cloudy. Many older people have cataracts. Like how our hair color changes with age; with our lens, the same thing happens. It begins to get more yellow with age.

126 The cataracts aren?t mature yet. They are not ready for surgery. Perhaps in five years they will be.

127 Just return each year for an eye check-up.

128 We are going to observe them

129 The operation for removing the lens is very easy nowadays. Usually the operation lasts no more than 20 minutes. The anesthetic doesn't hurt, and is stitchless . 130 You will be able to return home the same day. Don't worry.

131 Let's make an appointment.

132 Complications are rare.

133 In the majority of cases, much vision is regained.

PCO/Nd-YAG Cap.

134 You have a film behind the lens implant.

135 This is a common change one sees following cataract surgery.

136 The treatment is easy with a laser that cleans the film away.

GOODBYE

137 I want to see you again in two weeks.

138 Don's skip the next visit. It is very important.

139 I wiil see you again in one year. But if you think or suspect there is a problem with your eyes, certainly retum at once.

140 Here is my card with the telephone numbers where you can call me.

141 The main reason you have……is because……

142 Everything inside your eye is healthy-the retina, the blood vessels, and the optic nerves.

143 The condition of your eyes is stable.

144 Your condition is in an advanced state.

145 Fortunately, you don't have any eye disease.

146 Your eye is damaged. Unfortunately, there is no treatment to restore your

vision.

147 Make sure you protect your other eye .

Post-Operative Care

148 Everything appears fine.

149 The wound is not healing as I would have expected.

150 Have patience, your vision will improve little by little.

151 You need to avoid swimming and direct water contact with water until the next visit.

Medications

152 Use these drops four times a day in both eyes until you finish the bottle .

153 Shake the drops before applying to the eye.

154 Shake well and keep refrigerated.

155 This prescription can be refilled two times.

156 Don't stop taking this medication suddenly.

157 Don't use it more than four times a day until the next visit.

158 These drops will help stop the inflammation.

159 Remember to shake the bottle before use.

160 When you finish them according to instructions, don't use them again without my direction.

161 This medication is for relieving your pain.

162 Put a bit of ointment on the edge of your eyelids at night.

Artificial Tears

163 I recommend that you use artificial tears to reduce the irritation and dryness.

164 These drops are for lubrication and to wash your eyes.

165 They will not stop the redness completely because they contain no medicine.

166 One brand of artificial tears is called Systane / Genteal.

167 This brand is unique because it does not contain any preservative and therefore it is possible to use them as frequently as you like.

168 You can buy them in any pharmacy without a prescription.

Sun Protection

169 It is important to protect your eyes from Ultraviolet (UV) rays. Wrth too much exposure to UV, the skin can bum.

170 UV rays can damage the eyes just as they do the skin.

171 For example, there is a relation between these rays and tumors of the eyelids, cataracts, and problem of the cornea and retina.

172 Your eyes are very sensitive.

173 When you are outside, wear a hat and put on sunglasses.

Gonioscopy

174 I am going to put a special contact lens on your eye to examine the drainage structures of your eye better.

175 It may feel strange but it won't hurt you. It feels a bit cold.

176 Dilation Eye Drops.

177 These drops are for dilating the pupils of the eyes.

178 The drops make the pupils large and relax the ability to focus.

179 It is important since without the drops, it is hard to determine if there are problems inside.

180 It is very important that you have the dilation to determine the health of your eyes.

ENGLISH GUIDE TO COMMON EXAMINATION PHRASES

OCULAR DISEASE

ANTERIOR SEGME~NT

LIDS

PTHIRIASIS PALPEBRUM (PEDICULOSIS)

1You have lice infestation on your eyelids and lashes. This is controlled with the ointment that may cause temporary blurry vision. The ointment acts as a blanket to suffocate the lice. Then, I will remove them. Also, use Kwell shampoo to get rid of lice on your hair. I will write down the name for you and you can usually buy that kind of shampoo from any pharmacy or Walmart. Inform your sexual partner of this situation so they can get checked. You also need to wash all your bedding and clothes in hot water. I want to see you back in a week for your follow-up.

DEMODEX

“My eyelids feel so itchy. I have been loosing a lot of eyelashes.”

2Demodex are mites which all people carry in their eyelash follicles. If they increase in number, this may cause irritation. You need to do lid hygiene QID to reduce the number of mites. I will also prescribe an antibiotic ointment to suffocate the mites. Apply it to the base of your lashes BID (am/pm) for 2 weeks.

I want to see you back in 1 week for your follow-up.

ENTROPION

“I feel as though there is something (foreign body) in my eyes. I tear a lot to o.”

3Your lower lid has turned inward and the lashes are touching your eye, therefore, you feel the irritation. This is due to age related changes or previous trauma.

What I am most concerned about is that your lashes rub against your cornea constantly. Luckily your cornea looks healthy. (If there is SPK) I will prescribe an antibiotic ointment that you need to apply TID. This is not a permanent treatment, but I will tape your eyelid so that its not tumed inward.

(Symptomatic) Since you feel so uncomfortable, what I can do today is pluck out your lashes. But they will grow back so I need to see you back in a week for

follow-up. We will discuss about the need for surgery if necessary, during your next visit. I the mean time, I want you to use this Ab. Opthal. gtt. QID for 10 days.

ECTROPION

“My eye feels irritated and watery all the time.”

4Your lower lid has turned outward. This could be due to the aging process, 7th nerve palsy, scaring contraction or muscular weakness. I will prescribe artificial tears for you to use QID. Your eyes are dry all the time so it's susceptible to infection. I need to prescribe an antibiotic ung and gtt to use QID for a week.

Please come back in a week for follow-up. If necessary, I will refer you for surgery.

TRICHIASIS

“1 get this foreign body sensation and my eye team all the time.”

5The irritation is due to some eyelashes that?s been grown Inward instead of curling out There's just a few, so I can remove them for you. But I see the your lashes had been rubbing against your cornea for some time and I need to prescribe an antibiotic ung for you to use for 7 days to relieve the irritation it caused on your cornea.

BLEPHAROSPASM

“My friends tell me to get some help because at times, I can't control the way blink. My eyelids suddenly closes involuntarily.”

6Do you notice if it happens while you are sleeping too? If so, there is damage to your 7th nerve. I need to refer you for an MR I. Can you associate other symptoms along with this lid twitch such as pain, uttering bizarre sounds? Have you been on any medications lately? Do you drink a lot of caffeine? Have you been very stressful lately? On a scale of 1 - 10 with 10 being the most severe, how would you rate your problem: very bothersome, so so or not too bad. If it bothers you too much, I recommend injection of Botox around this part of your lid. What it will do is relax your eye muscles around that area. This treatment is good for 3 months.