Eyes Examination Flashcards
What cranial nerves are involved with the eyes?
optic (I) nerve
oculomotor (III) nerve
trochlear (IV) nerve
abducen (VI) nerve.
What you look for when inspecting the pupils?
Size
Shape
Symmetry
Visual acuity:
When should the previous line be recorded as the result while using the Snellen chart?
If they get more than 2 on that line wrong
Visual acuity:
What does improvement using a pinhole suggest?
What needs to be worn before using a snellen chart?
There is a refractive element to their poor vision
Glasses or visual aids and this needs to be recorded.
Visual acuity:
What if patient is unable to read the top line at 6 metres even with pinhole? - THERE ARE 5 STEPS
Reduce to 3 metres from snellen chart - acuity then recorded as 3/denominator.
THEN 1 metre - 1/denominator
Finger counting - how many fingers am i holding up
Gross hand movements - wave hand in front of face
Use pen torch to see if they can detect light
Where is the lesion if there is:
Total blindness in one eye
Bipolar hemianopia
Right nasal hemianopia
Homonymous hemianopia - 2
Homonymous inferior quadrantanopia
Homonymous superior quadrantanopia
Optic nerve
Midline of optic chiasm
Perichiasmal area
Optic tract
Occipital lobe
Lower optic radiations
Upper optic radiations
What do you look at on inspection?
Pupils Eyelids - ptosis Conjugate gaze - both eyes looking in same direction Nystagmus Double vision
Pupillary reflexes (afferent CN II, efferent CN III):
What suggests pathology?
Where could pathology be at?
Sluggish reaction
Lack of constriction
Optic nerve
Brainstem
Drugs
Pupillary reflexes (afferent CN II, efferent CN III):
What does a lack of normal consensual response suggest?
Damage to one or both optic nerves
Damage to the Edinger-Westphal nucleus
Pupillary reflexes (afferent CN II, efferent CN III):
What does the swinging light test test for?
Compares the function of the 2 optic nerves
Relative afferent pupillary defect (RAPD)
When the light is shone into the eye in which the optic nerve is functioning less well, it dilates.
What does the accommodation reflex assess?
Extraoccular muscle function
What does the H test assess
Eye movements and extra ocular muscle function
Fundoscopy:
How to assess the red reflex?
What does abscence mean>
Be about 30 cm from patients eyes
Cataracts
Neuroblastoma
Fundoscopy:
ROAM approach
Red reflex
Optic disc
Arcades
Macula
Fundoscopy:
What does a swollen optic disc mean?
Papilloedema - just say it looks swollen and it is a possible cause
Optic neuritis
Depositis
