History, Eye exam, Diagnosis and Treatment
by Doctor Asif Qureshi

Case of Insha Mushtaq Lone, age 14 years on November 30, 2016
Location: Shopian, Kashmir, Asia.

What is elaborated here? Profile of the patient. Complaint or issues relevant to patient. Eye and vision examination of the patient. Resources person is getting from state and must get from the state. Treatment options for the patient. Public health issues relevant to this case and similar cases. Case presented by: Doctor Asif Qureshi from Chicago, Illinois, North America, November 30, 2016 Name of patient: Insha Mushtaq Lone, age 14 years on November 30, 2016 Issues last updated: November 30, 2016 Location of patient: Shopian, Kashmir as of November 30, 2016 Photographs of patient and relatives: In the photograph are Insha’s mother, father, and brother. Insha's parents and her younger brother. Patient’s Medical History What are the issues? Insha lost her eyesight on July 12, 2016 after both eyes were damaged by pellets in Kashmir. She was standing by the window of her house. Which local physicians evaluated Insha Mushtaq? What are the local physician’s answers to the mentioned questions? What exactly did Insha hear, see, and feel in her eyes before the sudden vision loss? When was she last able to see with both eyes? When did Insha have normal vision appropriate for her age? Is the visual deficit in one eye or both eyes? Is there one particular area of visual loss? Is the vision loss without pain or with pain similar to that in acute glaucoma, endophthalmitis, or optic neuritis? Is there any redness and discharge? Are there any other neurologic deficits (including weakness or walking impairment due to neurological deficit)? What best describes the traumatic effects of uveitis/iritis? Does it cause decreased vision, as does ruptured globe, hyphema, traumatic cataract, or retinal detachment? What primary health center is nearest to Insha’s residence? Who is on duty at the nearest primary health center? Who is on duty at the district hospital nearest to her residence? What exact treatment was accomplished in Delhi and Mumbai Maharashtra? What are the findings of the eye and vision examination appropriate for her age? Perform a hand-motion finger counting test. Is Insha able to count the examiner's fingers in normal room lighting from a maximum distance of five feet directly in front of the examiner appropriately for her age? Are lesions in one eye or both eyes? Where are the exact locations of lesions in her eyes? Eye and vision examination of the patient. Is there a difference between a medical eye exam and a vision exam? Yes. What is the difference between an eye examination and a vision examination? Eye examination involves both anatomical examination and functional evaluation. (Vision examination). What are the findings of the eye and vision examinations of Insha Mushtaq on November 30, 2016 at 2:00 p.m. in Kashmir? What do local specific physicians have to do? Anatomical examination Lids Lacrimal system Conjunctiva Cornea Anterior chamber Pupils Lens and the red reflex Fundus Examination of function Visual acuity Snellen chart Children's visual acuity Visual fields Intraocular pressure (IOP) Pupillary reactions Optic nerve function Macular function Eyelids Extraocular muscles Eye movement Visual field assessment Ultrasound Exophthalmometer Keratometry Hess chart Fluorescein angiography Optical coherence tomography (OCT) Visually evoked potential (VEP), also called visually evoked response (VER) and visually evoked cortical potential (VECP) What resources, including food, clothing, other survival needs, does Insha and other family members get from the state or state department of human services? Once I/we get answers to these questions, we will proceed.

Last Updated: November 27, 2016