The Ophthalmic Minimum Data Base
Almost every type of doctor uses the term “minimum database” – the Minimum DataBase (MDB) “includes the core diagnostic tests needed to consistently achieve an accurate diagnosis...”
For most veterinarians, the minimum database in a healthy dog or cat includes bloodwork, urine analysis, and perhaps some imaging (like x-rays or ultrasound).
For Dr. Reinstein, the MDB is #focused on the eyes! The standard tests completed as part of the comprehensive ophthalmic exam include:
· A Schirmer Tear Test (STT)
· Measurement of the intraocular pressure (tonometry)
· Fluorescein staining
A STT should be performed prior to any significant manipulations of the eye, and before any drops are instilled. While dogs have a very reliable normal value of >15 mm of wetting per minute, recent studies have shown that normal cats may have STT values below 10 mm/min. Remember – not all forms of dry eye have low STT values!
Tonometry is an estimation of the intraocular pressure (IOP) usually performed using a TonoPen ® or TonoVet ®. Normal IOP is between 15-20 mmHg in dogs and cats and will lower naturally with age. This test requires proper patient restraint and technique to get accurate results.
Finally, fluorescein staining is imperative to determine if there is a corneal ulcer or abrasion on the surface of the cornea. The stain should be evaluated using a cobalt-blue filtered light after rinsing the eye surface.
With all of this in mind, do not become distracted by initial results from your ophtho MBD - perform a complete examination every time! It is not uncommon to become distracted by the large, melting ulcer, only to overlook the eyelid mass that is the cause of the ulcer.