EYE EXAM

Question 1

GENERAL APPROACH:

Answer 1

1. PATIENT POSITION: Patient seated on exam table

2. EXAMINER POSITION: Stand in front of patient

Question 2

VISION TESTING: **Note if glasses or contacts were used

3. VISUAL ACUITY:

Answer 2

A. Distance Vision: Snellen chart-Test each eye separately, then together
B. Near Vision: Rosenbaum near-vision-Test each eye separately, then together
C. Peripheral Vision: Visual Fields-Confrontation Test

Question 3

EYEBROW/ORBITAL EXAMINATION:

4. EYEBROW INSPECTION:

Answer 3

A. Hair Texture
B. Size
C. Extension To Temporal Canthus

Question 4

5. ORBITAL AREA INSPECTION:

Answer 4

A. Edema
B. Redundant Tissues
C. Lesions

Question 5

EYELID EXAMINATION:

6. EYELID INSPECTION:

Answer 5

A.   Ability To Open & Close 
B.    Eyelash Position
C.    Ptosis
D.   Fasciculations/Tremors
E.    Flakiness
F.    Redness
G.   Swelling

Question 6

EYELID PALPATION:

Answer 6

A. Nodules

Question 7

CONJUNCTIVA & SCLERA EXAMINATION:

8. CONJUNCTIVAE & SCLERA INSPECTION:

Answer 7

A.   Color & Condition
B.    Discharge
C.    Lacrimal Gland Punctum
D.   Pterygium:  Abnormal growth of conjunctiva that extends over the cornea from the limbus
E.    Foreign Bodies

Question 8

LACRIMAL GLAND EXAMINATION:

9. LACRIMAL GLAND INSPECTION & PALPATION

Answer 8

Palpate lower orbital rim near inner canthus. If temporal aspect of upper lid feels full, evert lid and inspect gland.

EXPECTED:Slight elevations with central depression on both upper and lower lid margins.

UNEXPECTED:Enlarged glands. Dry eyes.

Question 9

EXTERNAL EYE EXAMINATION:

10. EXTERNAL EYE INSPECTION:

Answer 9

A. Corneal Clarity-shine light targentially on cornea (UNEXPECTED=blood vessels present)
B. Corneal Sensitivity-CHECK BY COTTON WISP TEST (WOULD EXPECT A BLINK REFLEX). Skip if wearing contacts.
C. Corneal Arcus-an age-related condition that creates a deposit of cholesterol, phospholipids, and triglycerides in an “arc” on either the top or bottom side of the iris, inside the cornea. Over time, the arc can grow to encircle the entire iris, creating a white, gray, blue, or yellowish “outline.”
D. Color Of Iris
E. Pupillary Size & Shape
F. Pupillary Response To Light & Accommodation
G. Afferent Pupillary Defect: Health of optic nerve-Swinging flashlight test
H. Nystagmus-Nystagmus is a vision condition in which the eyes make repetitive, uncontrolled movements. These movements often result in reduced vision and depth perception and can affect balance and coordination. These involuntary eye movements can occur from side to side, up and down, or in a circular pattern.

Question 10

EXTRAOCULAR MUSCLE EXAMINATION:

11. EYE MUSCLE BALANCE & EYE MOVEMENT EVALUATION:

Answer 10

A. Corneal Light Reflex
B. Cover-Uncover Test
C. Six Cardinal Fields Of Gaze

Question 11

INTERNAL EYE/OPHTHALMOSCOPIC EXAMINATION: **Hold ophthalmoscope in hand (& against same eye) that corresponds to examining eye; Tell patient you will be turning lights off in room & slightly opening clinic room door
12. OPHTHALMOSCOPIC INSPECTION:

Answer 11

A.   Lens Clarity
B.    Red Reflex
C.    Retinal Colors & Lesions
D.   Characteristics Of Blood Vessels
E.    Disc Characteristics
F.    Macula Characteristics:  Ask patient to look directly into light