Associate Professor Aim and Objectives Understand the fundamental principles and perform a systematic eye examination On completion of this session you will be able to Recognize ID: 913973
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Slide1
OCULAR EXAMINATION
Dr. Neeti Gupta
Associate Professor
Slide2Aim and Objectives
Understand the fundamental principles and perform a systematic eye examination.
On completion of this session you will be able to:
- Recognize
normal and abnormal anatomy
- Systematically
examine an eye
- Correctly
document examination findings
Slide3Equipment required to examine an eye
Fine beamed
torch
Cotton buds
Local
anaesthetic
eye drops,
eg
Paracaine
Fluorescein
strips
Magnification
– slit lamp, indirect ophthalmoscope, loupes
Slide4Patient Assessment
General Physical Examination
Sclera
–
for jaundice
Conjuntiva
–
Anemia
Lids
–
xanthelesma
Puffy eye lids
–
Nephrotic
syndrome, Thyroid eye ds, Hypertension
Lympadenopathy
–
Tuberculosis, tumor and viral
conjuntivitis
Parotid swelling or lacrimal gland swelling
Slide5Systemic Examination
I
n
view of ocular
diseases as ocular signs can be early manifestation of systemic diseases.
Scleritis
Dry Eye
Peripheral corneal ulcers
Uveitis
Dislocation of lens
Slide6Ocular examination
Vision Assessment
–
- Visual acuity
–
Estimation of its ability to discriminate between two points
- Snellens chart
-
Slide7Slide8Optokinetic
nystagmus
Slide9Projection of rays- PR
Field of vision
Confrontation test
Perimetry
Kinetic
Static
Slide10Head Posture
Slide11Forehead
Slide12Eye
Brows
Level
Whitening
Absence of lashes
Slide13Orbital margins
Trauma
Tumors
Slide14Lids and
Lashes
Slide15Slide16Slide17Slide18Slide19Lagophthalmos
Lid Retraction
Slide20Visual Axis –
Alignment
Slide21Ocular movements
Duction
–
unilateral movement
Version
–
binocular movement in same direction
Slide22Slide23Proptosis
Enophthalmos
Slide24Regurgitation test
Slide25Conjunctiva
Colour
Chemosis
Congestion
Slide26Conjunctiva
Covers
the inside of eyelids and the sclera – does not pass over the cornea; is vascular.
• Normal
– translucent, flat, sclera visible beneath
• Abnormal
– Injected - bloodshot
–
Chemosis
(
oedema
)
– Discharge– Subconjunctival
haemorrhage
– Lacerations
– Lesions
Slide27Eversion of lids
Slide28Double eversion
Slide29Chemosis
Slide30Congestion
Slide31Slide32Episcleritis
Scleritis
Slide33Slide34Conjuntival degenerations
P
terygium
Pinguecula
Slide35Vitamin A Deficiency
Slide36Cornea
Size - 11.7 mm and 12.6 mm
Microcornea
-
<10mm
Megalocornea
- >13mm
Shape
–
watch glass
Surface
–
TransparencySensitivity- Sheen
Slide37Slide38Anterior Chamber
Shallow
–
Deep
–
Irregular
–
Abnormal Content -
Slide39Slide40IRIS
Color-
Heterochromia
iridium- Different
colour
of two eyes
Heterochromia
iridis
–
Different
colour of same irisIris Pattern- Iris Defects
Slide41Slide42Pupil
Size
–
Miosis
,
Mydriasis
,
Anisocoria
Shape
–
Irregular, Festooned
Number - polycoriaReaction – Direct, Indirect, Marcus
gunn
Slide43Slide44Lens
Position
–
Subluxation
Dislocation
Shape
–
Biconvex
Spherophakia
Lenticonus
Coloboma
Color
–
Brown/ Black , Greyish white , Pearly white, Milky White
Slide45Slide46Slide47Snow flake cataract
Sunflower cataract
Rosette cataract
Christmas tree cataract
Slide48Slide49Digital Tension