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This document provides an overview of procedures for conducting an eye examination. It discusses examining the anatomy of the eye, taking a patient's medical history and family history. Common causes of visual loss like cataracts, retinal detachment and optic neuritis are explained. The examination components covered include visual acuity testing, visual fields testing, external examination of the eyes, motility testing, pupillary examination, ophthalmoscopy and additional tests like tonometry and visual field testing. Common examination findings and conditions like cataracts, glaucoma and optic disc abnormalities are illustrated.

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55 views41 pages

Pemmataccm PDF

This document provides an overview of procedures for conducting an eye examination. It discusses examining the anatomy of the eye, taking a patient's medical history and family history. Common causes of visual loss like cataracts, retinal detachment and optic neuritis are explained. The examination components covered include visual acuity testing, visual fields testing, external examination of the eyes, motility testing, pupillary examination, ophthalmoscopy and additional tests like tonometry and visual field testing. Common examination findings and conditions like cataracts, glaucoma and optic disc abnormalities are illustrated.

Uploaded by

Jimmy
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 41

E YE E X AM INATIO N

Gitalisa Andayani
Nila F M oeloek
S etiowati S uhardjono

D ept of O phthalmology,
Faculty of M edicine, University of Indonesia

1
ANATOMY OF THE EYE

2
Anamnesis
1. Chief complaint:
- acute persistent visual loss
- chronic progressive visual loss
- flashes, photopsia
- red eye
- proptosis
- tearing, etc
2. History taking
3. Family history
4. Systemic diseases

3
Visual loss
Abnormalities in media of refraction
 cornea, anterior chamber, lens,
vitreous body

Abnormalities in neural tissue


 retina, optic nerve

4
Common causes of visual loss
Acute visual loss:
- Retinal detachment
- Optic neuritis
- Retinal vascular occlusion

Chronic visual loss


- Cataract
- Progressive myopia

5
Ophthalmology examination

COMPONENTS:
Visual acuity
Confrontation visual fields
External examination
Pupillary examination
Motility and alignment examination
Ophthalmoscopic examination

6
Ophthalmology examination
Visual acuity

• Determine the smallest object


clearly seen in a certain distance
• Distinguishing 2 separate points
• Visual angle of 5 minutes to see
a letter, but to analyze the form
completely, require resolution of
1 minute arc
7
Visual acuity testing
Snellen Chart
• Snellen’s notation:

testing distance
____________________

distance of the line of


smallest letters readable

• Notation
- Fraction of 6/50 - 6/6 (6/5)
- Decimal

8
PINHOLE TEST
• If visual acuity is not
normal
• Determine if it is:
- optical (refractive error
or media opacity)
- neural (retinal or optic
nerve lesion) Pinhole: eye shield with a small hole allowing
light rays to reach retina without interference
• Improved: optical of optical problems

• Not improved: - neural


- poor compliance 9
Low vision

Counting fingers (1/60 - 5/60)


Hand movement (1/300): vertical and
horizontal
Light perception (1/~)
No light perception

10
Refraction
Refraction Near vision/reading

Picture chart 11
CONFRONTATION TEST

Distance of 1 m
Examiner considered normal 12
External examination
1. Anterior segment:
– Eyebrows, eyelids, tarsal conjunctiva, bulbar
conjunctiva, cornea, anterior chamber, iris,
pupil, and lens
(at least, use a penlight; if available:
loupe)

1. Posterior segment:
– Vitreous, retina, optic disc
13
Ciliary injection

Conjunctival injection

Red eyes Scleral injection


14
ANTERIOR CHAMBER

HYPOPION

15
FLUORESCEIN TEST

16
CORNEAL SENSITIVITY TEST

17
IRIS

• Crypti

• Color

Synechia

Iridodialisis
18
LENS

Katarak
Shadow test

19
Immature Mature

CATARACT

Morgagnian Hypermature 20
Senile cataract

21
Pupillary examination

Pupil size (in dim and light)


Swinging light test (if dilated: Marcus Gunn
pupil or relative afferent pupillary defect)
 optic neuritis, retinal detachment,
vein/artery occlusion
Anisocoria

22
Motility and Alignment
Examination

Extraocular muscles
23
Ocular alignment
ESOTROPIA

EXOTROPIA

HYPERTROPIA

HYPOTROPIA
24
Corneal light reflection test

Normal (ortho)

15 * ET (esotropia)

30* ET

≥45 *ET

25
OCULAR MOVEMENTS

Cardinal Gaze
Fields
Convergence
Diplopia
Nystagmus

26
CARDINAL GAZE FIELD

27
OPHTHALMOSCOPY

28
FUNDUS EXAMINATION
Reflex

Optic disc

Arteries & Veins

Macula

Retina

29
Syatematic fundus examination

30
Optic disc

Normal

Large cupping

Glaucomatuos
cupping

31
Other examinations
PERIMETRY/CAMPIMETRY

TONOMETRY

EXOPHTHALMOMETRY

ANEL TEST

SCHIRMER TEST

COLOR VISION
32
GOLDMANN CAMPIMETRY

33
Digital Palpation

2 hands

1 hand

34
SCHIOTZ TONOMETER

Callibration 35
VARIOUS TONOMETERS

36
ANEL TEST
37
HERTEL EXOPHTHALMOLMETER

38
SCHIRMER TEST

39
Color vision tests:
ISHIHARA PLATES

40
THANK YOU

41

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