W8 History and Symptoms

What % of diagnoses can be made with good H and S?

>70%

What do you do if px mentions any symptoms?

Follow up with LOFTSEA questions

What order do we ask questions in?

…

What do we ask when reasons for visit?

• “Are you having any problems with your eyes or vision?”

• Put px response in quotation marks

What does LOFTSEA stand for?

• Location- both eyes or just one

• Onset- when did you first notice, sudden/gradual

• Frequency- transient/intermittent

• Type- small print is blurred/unclear/double

• Self treatment

• Effect on px

• Associated symptoms

What are advantages of computer based records?

• No illegible records

• Information from previous test can be amended with new tests

What are disadvantages of computer based records?

• Hard for locums to adapt to new services

• Inability to sketch features

• Time consuming to scan in old record cards

What general observations of px can we make?

• Thin and twitchy can indicate overactive thyroid

• Obesity can indicate hypertension

• Abnormal head position can indicate ocular motility

• Eyelids: ectropion, epiphora, ptosis

• Age, gender and race (disease prevalence)