2 Eye Examination Slides

Advanced keratoconus.

The condition affecting the conjunctiva.

From anterior to posterior.

Light flashes.

Put fluorescein in the inferior fornix and examine the eye with a cobalt blue light.

Uveitis or keratitis.

A hole.

As dark areas in the red reflex.

A condition where the iris protrudes through a wound or incision in the cornea.

Hobbies and sports can indicate activities that might affect eye health, such as exposure to sunlight or risk of injury.

Less than 12.5mm.

Move the target slowly, equidistant between the two eyes.

Diffuse bright redness.

Surgical, medical, and trauma history.

Ask the patient to look at your nose with both eyes open.

Snellen chart.

Compare your field with the patient's field.

The patient can see at 6 meters what a person with normal vision can see at 60 meters.

A systematic approach.

Red reflex.

Name, age, occupation, hobbies, and sports.

Retinal detachment.

To detect quadrantanopias, altitudinal defects, and even paracentral scotomas.

The conjunctiva and the cornea.

Epithelial defects colored by fluorescein strips are seen with a blue light as green.

Determine the visual acuity of separate eyes without applying pressure on the occluded eye.

Amsler chart.

With what were they busy with when it happened?

White.

It is used for imaging and measuring the topography of the retina and optic nerve head.

Corneal oedema.

The iris is evenly illuminated.

The cornea normally has a convex anterior curvature.

Fluorescence is when light of one wavelength is shined in and is reflected as light of a different wavelength.

Abnormal shadows may be noted on the iris.

The fornix is the loose, flexible fold of the conjunctiva where the palpebral conjunctiva meets the bulbar conjunctiva.

One eye or both eyes?

Hypopyon.

Systemic history.

The green light filters other colors and causes red to be seen as black, helping to see blood vessels better.

D-shaped.

To detect significant macular disease.

Snellen or E-chart.

E - chart.

Benign.

The biggest spot size.

1 drop every 5-10 minutes for 2-3 times.

Is the cornea smooth?

The patient can see at 6 meters what a person with normal vision can see at 36 meters.

It is used for testing inherited defects and can also be used for acquired defects in color vision.

Size and eccentric fixation.

Occupation can provide insights into potential eye strain or exposure to harmful conditions.

Presence and distribution of any inflammation and discharge.

Front to back, outside to inside.

For different pupil sizes.

Conjunctivitis is the inflammation or infection of the conjunctiva, the membrane that lines the eyelids and covers the white part of the eyeball.

Is the cornea clear?

Refraction is crucial for focusing light onto the retina, enabling clear vision.

A white pupil.

Is the shape normal?

Hyphaema.

It provides high-resolution, three-dimensional images that allow for precise measurement and monitoring of changes in the retina and optic nerve head.

The cornea normally has a smooth appearance.

Sit at the same level as the patient, 1 meter apart.

Drooping of the upper eyelid.

Visual field defects.

The target should be brought in from the periphery.

To identify any asymmetries or differences that could indicate a problem.

Cornea.

Current eye history (Main complaint).

A cataract is a clouding of the lens in the eye, leading to a decrease in vision.

The cornea and lens refract light to focus it on the retina.

The Farnsworth-Munsell 100 Hue test.

Compare the two eyes.

A posterior chamber intraocular lens (IOL) is an artificial lens implanted in the eye's posterior chamber, typically after cataract removal.

Ask the patient, 'Is any part of my face missing?'

Fluorescein strips color epithelial defects on the cornea.

Conjunctiva, cornea, anterior chamber, iris, and lens.

Hemianopias and quadrantanopias.

A non-invasive imaging technique used to map the surface curvature of the cornea.

To allow a better view of the internal structures of the eye.

The bottom line the patient is able to read.

The optic disc appears as a round or slightly oval, well-defined structure with a pinkish color.

Whether there is any redness of the conjunctiva.

To determine if a lesion is elevated or excavated.

Light flashes, floaters, and visual field defects.

Defects of the cornea appear as rough and uneven reflections.

It is typically implanted after cataract removal.

Shallow anterior chamber.

Refraction occurs because light travels at different speeds in different media.

Each eye is tested in turn.

Exophthalmos or proptosis, often associated with thyroid eye disease.

Anterior chamber.

It provides detailed maps of the cornea's surface, helping surgeons to customize procedures for better outcomes.

Fluorescein is used to highlight abnormalities in the cornea and conjunctiva.

Orbscan provides both anterior and posterior corneal surface imaging.

Normal vision, where the patient can see at 6 meters what a person with normal vision can see at 6 meters.

Move a penlight to and fro to determine corneal clarity.

Ophthalmoscope on +10.

Partial dislocation of the lens from its normal position.

Pen torch or direct ophthalmoscope.

Ptosis and retraction.

Eyelids, orbit, and eye position.

With a ruler.

Refraction is the bending of light as it passes from one medium to another with a different density.

Testing each eye in turn by finger counting in quadrants and asking 'How many fingers do you see?'

An eclipse is an astronomical event where one celestial body moves into the shadow of another celestial body.

Urgent referral to an ophthalmologist.

A V-shaped indentation observed in the lower eyelid when the patient looks downward, indicative of advanced keratoconus.

In the inferior fornix.

Common symptoms include blurry vision, difficulty with bright lights, and seeing halos around lights.

Lens.

Night vision?

It uses a laser to scan the retina and optic nerve head, creating a detailed topographic map.

Conditions such as glaucoma, macular degeneration, and other retinal diseases.

Subluxation of the lens.

To note the size and eccentric fixation.

Diabetes mellitus, hypertension, thyroid disease, infections, HIV, TB, and syphilis.

The temporal iris will be illuminated, but a shadow will be visible on the nasal iris.

Marfan syndrome.

Keratoconus.

A pterygium is a benign growth of the conjunctiva that extends onto the cornea.

A V-shaped (conical) indentation observed in the lower eyelid when the patient's gaze is directed downward.

On the medial aspect of the eyeball.

Distortion or a missing area (scotoma).

Abnormal elevation of the upper eyelid.

It is placed in the posterior chamber of the eye.

To inspect the inner surface of the eyelid for abnormalities.

Congenital glaucoma (buphthalmos).

Pinhole.

Sudden or gradual?

To measure the degree of forward displacement (proptosis) of the eye.

Iris.

The same size as the optic disc.

During a solar eclipse, the Moon passes between the Earth and the Sun, blocking all or part of the Sun's light.

Optical Coherence Tomography.

When they first took notice of it?

Because dilatation can temporarily impair vision, affecting activities like driving and reading.

Keep the eye closed or press on the tear duct for 3 minutes.

The patient should cover their eye with their own hand of the same side.

A condition where the two irises of an individual are different colors.

Central scotomas or hemianopia.

Eclipse test.

Good light and magnification.

Without glasses, with glasses, and with a pinhole.

Ishihara chart.

Penlight, Direct ophthalmoscope, Fluorescein, Blue light, Slitlamp.

Systemic history.

The retinal vessels are clearly visible, with arteries appearing brighter and narrower than veins.

To save time.

The macula appears as a darker, avascular area located temporally to the optic disc.

The posterior segment of the eye includes the vitreous humor, retina, choroid, and optic nerve.

Is the epithelial layer intact?

No, it is a non-invasive imaging test.

Retinoblastoma.

It can indicate underlying eye conditions that need to be addressed.

Strabismus is a condition where the eyes do not properly align with each other when looking at an object.

A technique used to examine the interior structures of the eye, including the retina, optic disc, and blood vessels, using a light source and a condensing lens.

Double vision is seeing two images of a single object and is a significant eye complaint.

By allowing the visualization of retinal blood vessels, which can show signs of damage or leakage due to diabetes.

Redness is a common eye complaint that can indicate inflammation or other issues.

The optic disc is the point where the optic nerve enters the retina, and its appearance can provide important information about the health of the optic nerve and retina.

6 meters.

The patient is instructed to 'point when you see the target.'

Because it can complicate the procedure and affect the lens.

The ophthalmoscope.

Previous eye history.

By comparing the position of the corneal apex relative to the lateral orbital rim.

A visual defect that causes linear objects to look curvy or rounded.

To understand the patient's vision correction needs and history of refractive errors.

Abnormalities in the optic disc can indicate conditions such as glaucoma, optic neuritis, or increased intracranial pressure.

Assessing ocular position is important for diagnosing and managing conditions like strabismus and other alignment disorders.

Retinopathy of prematurity (ROP).

Up to 7 days.

Small shapes or specks that drift through the field of vision.

A visual acuity of 20/40 indicates that a person sees at 20 feet what a person with normal vision sees at 40 feet.

Retinal detachment.

Sclera

20/20 vision is considered normal visual acuity.

It typically provides a magnification of about 15 times.

Retina

Funduscopy is a technique used to examine the interior surface of the eye, including the retina, optic disc, macula, and posterior pole.

Solar eclipse and lunar eclipse.

Because it can exacerbate the injury or complicate the assessment.

The retina, optic disc, macula, and posterior pole.

During a lunar eclipse, the Earth passes between the Sun and the Moon, casting a shadow on the Moon.

Gonioscopy is performed to evaluate the drainage angle of the eye, which is crucial for diagnosing and managing glaucoma.

Current eye complaints.

To diagnose and monitor conditions like thyroid eye disease, tumors, and orbital inflammation.

Conditions such as macular degeneration, diabetic retinopathy, and glaucoma.

Visual acuity is commonly tested using a Snellen chart, where the patient reads letters from a distance of 20 feet.

Gonioscopy helps in glaucoma management by allowing the clinician to assess the angle structure and determine the type of glaucoma, which guides treatment decisions.

In early childhood, usually before the age of 5.

Toxocara or toxoplasmosis.

Conjunctiva

The vitreous humor helps maintain the eye's shape and provides a clear medium for light to reach the retina.

Treatment options include chemotherapy, radiation therapy, laser therapy, cryotherapy, and surgery.

Headache.

A person's ability to distinguish between different colours.

The refractive index is a measure of how much light bends when it enters a material.

By holding up one finger and asking 'Which finger is most clear?'

To detect and diagnose corneal conditions such as keratoconus and to plan refractive surgery.

Gonioscopy is a diagnostic procedure used to examine the anterior chamber angle of the eye.

To obtain detailed images of the retina and other structures within the eye.

Is the diameter normal?

Cataract.

Because it does not require any contact with the eye or the use of any instruments that penetrate the cornea.

Funduscopy is an examination of the interior surface of the eye, including the retina, optic disc, macula, and posterior pole.

Brief bursts of light in the field of vision.

Common conditions include retinal detachment, diabetic retinopathy, macular degeneration, and optic neuritis.

The Sheridan-Gardener test.

External inspection, Anterior segment examination, Posterior segment examination.

Tonometer (iCare, Schiötz).

It is a current eye complaint that may suggest infection or other eye conditions.

Penlight.

A B-scan ultrasound can diagnose conditions like retinal detachment, vitreous hemorrhage, and intraocular tumors.

It assesses the ability to perceive light and determine the direction from which it is coming, used in cases of severe visual impairment.

Less dense hemianopias.

Glasses or contact lenses, diseases of the eye, ophthalmic operations, and injuries of the eye or orbit.

Slitlamp examination.

Family history.

A gonioscope, which is a special type of contact lens, is used in gonioscopy.

Decrease in vision, pain or discomfort, change in appearance, double vision, discharge, and redness.

Gonioscopy can help diagnose conditions such as glaucoma, angle-closure, and other abnormalities of the anterior chamber angle.

The retina.

It allows detailed examination of the eye's structures to diagnose and monitor various eye conditions.

Jaundice.

Dilatation drops.

The numerator indicates the test distance (20 feet), and the denominator indicates the distance at which a person with normal vision can read the same line of letters.

An ERG measures the electrical responses of various cell types in the retina, including the photoreceptors, to diagnose retinal diseases.

Distance visual acuity measures the clarity of vision at a distance, typically using a Snellen chart, while near visual acuity measures the clarity of vision at a close range, often using a reading card.

It is the point where the optic nerve enters the retina and can indicate signs of diseases like glaucoma.

Yes, retinoblastoma can be hereditary, caused by a mutation in the RB1 gene.

Paperclips.

The movement of the eyes and the function of the eye muscles.

The outer structures of the eye, including the eyelids, conjunctiva, and sclera.

Orbscan is used for corneal topography and pachymetry, providing detailed maps of the cornea's surface and thickness.

Colour vision?

It uses light waves to take cross-section pictures of the retina.

Are the corneas’ sensation normal, diminished, or the same on both sides?

Cyclopentolate, tropicamide, phenylephrine.

It is a common current eye complaint that needs to be assessed.

CT uses X-rays to create images, while MRI uses magnetic fields and radio waves.

Orbscan is important for refractive surgery planning because it provides detailed corneal maps that help in assessing the suitability of the cornea for surgery and in customizing the surgical approach.

Visual acuity (VA), Confrontation field testing, Amsler grid testing, Colour vision testing, Ocular motility.

Fluorescein strips.

They can indicate conditions such as glaucoma or optic neuritis.

UBM is used to visualize the anterior segment of the eye, including the cornea, iris, and ciliary body, providing detailed images for diagnosing and managing anterior segment diseases.

The person is legally blind in the United States, as they can read at 20 feet what a person with normal vision can read at 200 feet.

By observing changes in the retinal blood vessels, such as narrowing or hemorrhages.

The patient should be seated comfortably, with their eyes level with the examiner's eyes, and the room should be dimly lit.

Cataract (congenital or acquired), Retinopathy of prematurity (ROP), Retinoblastoma, Parasitic infections of the eye (e.g., Toxocara or toxoplasmosis), Retinal detachment.

A laceration with uveal tissue protruding or melanosis in darker races.

Conjunctiva.

Scleritis, which can be associated with arthritis.

'B scan' ultrasonography works by emitting sound waves that bounce off the internal structures of the eye, creating a two-dimensional cross-sectional image.

Previous surgeries can impact current eye health and influence treatment decisions.

The direct ophthalmoscope is commonly used for examining the posterior segment of the eye.

Any trauma or injuries that could have long-term effects on eye health, such as blunt force trauma, chemical injuries, or foreign bodies.

Cornea

Fluorescein Angiography helps diagnose retinal conditions by highlighting blood flow in the retina and choroid.

It is used for examining the interior structures of the eye, including the retina, optic disc, and blood vessels.

CT.

Magnifier.

A direct ophthalmoscope provides a magnified, upright image of the retina, while an indirect ophthalmoscope provides a wider field of view but with an inverted image.

Iris

Corneal Topography maps the surface curvature of the cornea, aiding in the diagnosis and management of corneal diseases and fitting contact lenses.

It requires more skill and practice to master compared to direct ophthalmoscopy.

The back part of the eye, including the retina and optic nerve.

It helps in diagnosing and monitoring various eye conditions such as diabetic retinopathy, glaucoma, and macular degeneration.

A total eclipse occurs when the celestial body is completely covered by the shadow, while a partial eclipse occurs when only part of the celestial body is covered.

Blue light causes fluorescein to fluoresce, making it easier to detect corneal abrasions and other abnormalities.

Retinoblastoma is a rare type of eye cancer that typically develops in early childhood.

Magnetic Resonance Imaging.

Conditions such as strabismus, nystagmus, and cranial nerve palsies can be diagnosed by examining ocular position.

A direct ophthalmoscope.

The foveal reflex is a small, bright reflection seen at the center of the macula, indicating a healthy fovea.

The patient reads letters from a Snellen chart at a standard distance, usually 20 feet or 6 meters.

It is important for diagnosing and managing diseases that can lead to vision loss or other serious eye conditions.

They represent normal visual acuity, where the first number is the distance at which the test is performed and the second number is the distance at which a person with normal vision can read the same line.

The optic disc, macula, retina, and blood vessels.

The peripheral vision of a patient.

It indicates profound visual impairment, where the person can see at 3 meters what a person with normal vision can see at 60 meters.

To detect visual disturbances caused by changes in the retina, particularly the macula.

It assesses the ability to see and count fingers at specified distances, used when standard visual acuity tests are not possible.

Because it provides a wider field of view compared to direct ophthalmoscopy.

Pachymetry measures the thickness of the cornea, which is important for assessing conditions like glaucoma and for pre-surgical evaluations.

By having the patient look downward, causing a V-shaped indentation in the lower eyelid.

Conditions like keratoconus, corneal ectasia, and irregular astigmatism.

A slit lamp.

Medication and allergies.

The anterior segment of the eye, including the cornea, iris, lens, and anterior chamber.

The primary treatment for cataracts is surgical removal of the cloudy lens, often replaced with an artificial intraocular lens.

'B scan' ultrasonography can help diagnose conditions such as retinal detachment, vitreous hemorrhage, intraocular tumors, and foreign bodies.

Tools such as the Hirschberg test, cover test, and prism cover test are commonly used to assess ocular position.

A narrow beam of light.

Temporary loss of vision in one eye due to lack of blood flow to the retina.

Retinoblastoma is often detected through a routine eye examination or when parents notice unusual signs such as a white reflection in the pupil.

It provides a magnified, detailed view of the retina and other internal structures of the eye.

Conditions involving soft tissues, such as brain and spinal cord abnormalities.

A Visual Field Test assesses the range and sensitivity of a person's peripheral vision, which is crucial for diagnosing conditions like glaucoma.

To assess orbital fractures and other bony abnormalities.

A wide field of view, allowing for better examination of the peripheral retina.

Lens

Vitreous

The lateral orbital rim and the corneal apex.

Sensitivity to light.

Any past diagnoses such as glaucoma, cataracts, macular degeneration, or other eye conditions.

Rings or circles of light seen around a light source.

Visual fields?

Orbscan can measure corneal curvature, elevation, and thickness.

A direct ophthalmoscope allows for close-up examination of the eye's anterior structures, such as the cornea and lens.

OCT is used to capture detailed images of the retina and optic nerve, aiding in the diagnosis and management of conditions like macular degeneration and glaucoma.

A technique used to examine the interior surface of the eye, including the retina, optic disc, macula, and blood vessels.

CT.

The patient can read at 20 feet what a person with normal vision can read at 40 feet.

Vision that appears foggy or blurry.

A condensing lens, often with a power of +20 diopters.

It tests the ability to detect hand movements when the person cannot see well enough to count fingers.

The red-free filter enhances the visibility of blood vessels and hemorrhages by filtering out red light.

The front part of the eye, including the cornea, iris, and lens.

Ocular position refers to the alignment and orientation of the eyes in relation to each other and to the head.

'B scan' ultrasonography is used to visualize the internal structures of the eye, especially when the view is obstructed by opacities like cataracts or vitreous hemorrhage.

A cataract is diagnosed through a comprehensive eye examination, including a visual acuity test and a slit-lamp examination.

Funduscopy allows visualization of retinal blood vessels, helping to identify signs of diabetic retinopathy such as microaneurysms, hemorrhages, and exudates.

The retina generally appears as an orange-red color due to the reflection of light from the underlying choroid.

To measure a person's visual acuity, or the clarity and sharpness of their vision.

The retina, optic disc, macula, and posterior pole.

Common symptoms include a white color in the pupil when light is shone in the eye, eye redness, and vision problems.

The retina.

A light source and a condensing lens.

It provides a wider field of view and better visualization of the peripheral retina.

Factors that can affect visual acuity include refractive errors (such as myopia, hyperopia, and astigmatism), eye diseases, age, and overall health.

The key components include a light source, a series of lenses, and a viewing aperture.

Risk factors include aging, diabetes, smoking, prolonged exposure to sunlight, and certain medications.

Computed Tomography.

Visual acuity is the clarity or sharpness of vision, which is measured by the ability to discern letters or numbers at a standardized distance.

Direct ophthalmoscope.

Osteogenesis imperfecta.

Eyelids

To measure visual acuity using a chart with letters or symbols.

'B scan' ultrasonography is particularly useful when the view of the retina is obscured by media opacities like dense cataracts or vitreous hemorrhage.

It helps in diagnosing and monitoring various eye conditions such as glaucoma, diabetic retinopathy, and macular degeneration.

The purpose of visual acuity testing is to determine the smallest letters a person can read on a standardized chart, which helps in diagnosing vision problems.

To measure the clarity or sharpness of vision.

Anterior chamber

The prognosis is generally good if the cancer is detected early and treated promptly.

Ear buds.

Orbscan helps in diagnosing corneal diseases, planning refractive surgery, and monitoring post-surgical outcomes by providing detailed corneal maps.

A slitlamp provides a magnified, three-dimensional view of the eye's anterior segment, allowing for detailed examination.

Local anesthetic drops.

20/20 vision means that a person can see at 20 feet what a person with normal vision can see at 20 feet.

MRI.

It is a current eye complaint that may indicate an issue needing further examination.

Double vision.

It indicates severe visual impairment, where the person can see at 20 feet what a person with normal vision can see at 200 feet.

Conditions such as macular degeneration or diabetic retinopathy.

Pupil

It indicates a clear optical path from the cornea to the retina; its absence can suggest cataracts or other obstructions.