Ophthalmology: Liverpool Eye Examination

Question 1

When is direct opthalmoscope no use?

Answer 1

• Lid problems
• Third eyelid problems
• Dry eye
• Corneal ulceration
• Dislocated lens
• Glaucoma

Question 2

Describe direct opthalmoscope?

Answer 2

• Switch on
• Select large beam of white light
• Set lens to 0

Question 3

What is indirect ophthalmoscopy?

Answer 3

• Wide angle view
• Upside down and inverted

Question 4

What is assessed hands off lights on?

Answer 4

Signs of pain
* Squinting
* Eye fully open

Discharge- watery/mucoid/purulent

Asymmetry
* Lids/third/globes

Question 5

What is assessed hands on lights on?

Answer 5

• Menace response
• Assess lids and movement
• Proturde third eyelids

Question 6

What is assessed hands on lights off?

Answer 6

• PLR
• Examine lids, cornea and anterior chamber

Distand direct opthalmoscopy
* Room lights off
* Patients at arms length
* Look slightly upwards for tapetal reflex
* Nuclear sclerosis vs cataracts

Close direct

Question 7

What supplementary tests may be appropriate for ophthammic exam

Answer 7

• Schirmer tear test- before ant others
• Local anaesthetic- relax painful eye
• Fluroscein- corneal opacity and irregularity