Download MBBS Ophthalmology PPT 38 Ocular Lecture Notes

OCULAR EXAMINATION

Aim and Objectives

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? Understand the fundamental principles and perform

a systematic eye examination.

? On completion of this session you will be able to:

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- Recognize normal and abnormal anatomy
- Systematically examine an eye
- Correctly document examination findings
Equipment required to examine an eye

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? Fine beamed torch
? Cotton buds
? Local anaesthetic eye drops, eg Paracaine
Fluorescein strips
? Magnification ? slit lamp, indirect

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ophthalmoscope, loupes

Patient Assessment

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? General Physical Examination

- Sclera ? for jaundice

- Conjuntiva ? Anemia

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- Lids ? xanthelesma

- Puffy eye lids ? Nephrotic syndrome, Thyroid eye

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ds, Hypertension

- Lympadenopathy ? Tuberculosis, tumor and viral

conjuntivitis

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- Parotid swel ing or lacrimal gland swel ing


Systemic Examination

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? In view of ocular diseases as ocular signs can be

early manifestation of systemic diseases.

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- Scleritis

- Dry Eye

- Peripheral corneal ulcers

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- Uveitis

- Dislocation of lens

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-

Ocular examination

? Vision Assessment ?

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- Visual acuity ? Estimation of its ability to

discriminate between two points
- Snellens chart
-

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Optokinetic nystagmus

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? Projection of rays- PR

? Field of vision
- Confrontation test
- Perimetry

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Kinetic
Static

? Head Posture

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? Forehead

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? Eye Brows
Level
Whitening
Absence of lashes

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Orbital margins

? Trauma

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? Tumors

? Lids and Lashes

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Lagophthalmos

Lid Retraction

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Visual Axis ? Alignment


Ocular movements

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Duction ? unilateral movement

Version ? binocular

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movement in same

direction

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? Proptosis

? Enophthalmos

? Regurgitation test

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? Conjunctiva

- Colour
- Chemosis
- Congestion

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Conjunctiva

Covers the inside of eyelids and the sclera ? does

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not pass over the cornea; is vascular.

? Normal

? translucent, flat, sclera visible beneath

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? Abnormal

? Injected - bloodshot

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? Chemosis (oedema)

? Discharge

? Subconjunctival haemorrhage ? Lacerations

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? Lesions


Eversion of lids

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Double eversion


Chemosis

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Congestion
Episcleritis

Scleritis

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Conjuntival degenerations

Pinguecula

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Pterygium
Vitamin A Deficiency

Cornea

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? Size - 11.7 mm and 12.6 mm

Microcornea - <10mm

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Megalocornea - >13mm

? Shape ? watch glass

? Surface ?

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? Transparency

? Sensitivity-

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? Sheen
Anterior Chamber

Shallow ?

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Deep ?

Irregular ?

Abnormal Content -

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IRIS

? Color-

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Heterochromia iridium- Different colour of two

eyes
Heterochromia iridis ?Different colour of same

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iris
? Iris Pattern-
? Iris Defects

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Pupil

? Size ? Miosis, Mydriasis , Anisocoria

? Shape ? Irregular, Festooned

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? Number - polycoria

? Reaction ? Direct, Indirect, Marcus gunn
Lens

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? Position ?

Subluxation

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Dislocation

? Shape ? Biconvex

Spherophakia

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Lenticonus

Coloboma

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? Color ? Brown/ Black , Greyish white , Pearly

white, Milky White

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? Snow flake cataract
? Sunflower cataract

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? Rosette cataract
? Christmas tree cataract
Digital Tension