Eye assessment

Vision - snellen chart, near vision chart, color vision

Visual field - confrontation test using red stimulus more acurate -as red contrast sensiivity tend to affect first e.g. Use of red cap of tropicamide bottle.

Pupil - test direct an consensual reflex an RAPD in dim light room with pt looking at distance. Peaked pupil may indicate a wound with iris being at the wound. Oval vertical pupil may indicate acute closed angle glaucoma. Small reActive pupil with ptosis , is Horner Synd assoc wih apical lung ca. Ptosis with divergent eye is 3rd CN palsy, pupil spared usually caue by medical, pupil involved (dilated) usu due to surgical, e.g ntracranial aneurysm. Argyll Robertson pupil caused by syphillis (bilateral small and irregular pupil with light-near dissociation)

Eye position and movement - corneal light reflex. EOM in all direction and convergence, ask an diplopia, look any nystagmus. Complex eye mvmt abn should lead to suspicion of dysthyroid eye dz. Look for proptosis or enophthalmus.

Eyelid - entropion/ectropion, lesions, blepharitis, trichiasis, s-shape deformity in neurofibromatosis, ptosis, evert eyelid if suspect foreign body but do not do so if suspect for ocular perforation.

Conjunctiva and sclera -red, nodule, pterygium

Cornea and ant chamber - use fluorescein, look for pus/blood/cell in chamber, look for depth.

Angle- do no forget gonioscopy

iOP - normal 10 to 21mmHg

Red reflex best assessed within 50cm

Fundus examination-will be disscuss in another entry





- Posted using BlogPress from my iPad