CLINICAL SKILLS OSCE S5 - VISION AND EYE MOVEMENTS

Question 1

Inspection

Answer 1

• ptosis
• strabismus
• pupil sizes

Question 2

Visual acuity

Answer 2

• cover eye, count fingers
• wave hands, shine light
• Sensory information carried by CN II

Question 3

Visual fields

Answer 3

• cover eye, say when you see my finger (peripheral vision)
• CN II transmits afferent peripheral vision

Question 4

Pupillary reflex

Answer 4

• look in distance, now look at my finger (accommodation)
• look straight ahead, shine light from lateral (first do direct pupil response, then consensual pupil constriction)
• Swinging flashlight (afferent pupillary defect)
  *CN II afferent, CN III controls efferent pupillary muscles responsible for constriction and dilation

Question 5

Eye movement

Answer 5

• Follow finger with your eyes, don’t move head (H)
• Tell me if you see double
• Observe for nystagmus
• CN 6 - lateral rectus (abduction)
• CN 4 - superior oblique (inferomedial)
• CN 3 - all other rectus muscles and inferior oblique