Eye exam

Question 1

Observation

Answer 1

• Sclera (white part) and conjunctiva (behind eyelids)
  o Pull eyelid down and get pt to look opposite direction
  o Get pt to look at each side and down
  o Look for nodules, swelling, colour and vascular pattern
• Cornea and lens
  o Use penlight and shine from side towards the eye
  o Check for opacities
  o Crescentic shadow on iris suggests glaucoma
• Pupil size
  o Use pupil size indicator on penlight
  o Check for symmetry of size

Question 2

Palpation

Answer 2

• Place finger on closed eye and compare tautness of each eyeball

Question 3

Visual Functions

Answer 3

Assess eye function:
* Visual acuity
o Snellen chart
o Cover one eye and read down until error, repeat for other eye

• Visual fields
  o Ask patient to look into your eyes
  o Have both hands equal distance apart around pt’s head
  o Move one hand close to visual field and wiggle fingers
• Light reflex: direct, consensual (pupil constriction)
  o Tell pt to look into the distance
  o Shine light from the side and observe direct reaction in first pupil
  o Swing light to other side and observe consensual reaction in other pupil
• Accommodation
  o Ask pt to look at your finger
  o Move finger towards bridge of nose
• Extraocular movements
  o Ask patient to follow finger
  o Make a large H

Question 4

Ophthalmoscopy

Answer 4

• Red reflex
• Optic disc
  o Size, shape and colour
  o Physiologic cup
  o Clarity of disc margin
  o Vessels
• Retina: colour
• Macula and fovea
  o Temporal to the optic disc
  o shape and colour