Eye exam

8-point eye exam includes

1. Visual acuity
2. Pupil exam
3. EOM and alignment
4. IOP
5. Confrontational visual fields
6. External exam
7. Slit-lamp exam
8. Fundoscopy

Visual Acuity

• (OD (R)/ OS (L))
• Obtain VA while wearing correction
• Pinhole occluder will aid in uncorrected refractive error
• Progression from better to worse:
  • CF, count fingers
  • HM, hand motions only
  • Light perception with projection, LP
    • Eye can determine which direction light is coming from (left, right, up, down)
  • Light perception without projection (cannot tell direction)
  • No light perception, NLP

Slit Lamp

• Lids and Lashes
  • eversion
• Conjunctiva and Sclera
  • injection, hemorrhage, discharge
• Cornea
  • Fluorescein for abrasions, foreign bodies
  • Perforation (staining or pooling - Sidel's sign)
• Ant Chamber
  • cell and flare
• Iris
• Lens
• APD (afferent pupillary defect)
  • Affected pupil enlarges in response to light
  • Due to optic nerve dysfunction-neuritis vs retinal damage

Slit Lamp Abreviations

• L/L (lids/lashes) = nl
• C (conjunctiva) = cl
• K (cornea) = cl
• A/C (anterior chamber) = D/Q (dark/quiet)
• I (iris) = R/R (round/reactive)
• L (lens) = cl

(cl = clear; nl = normal)

Fundoscopic Exam

• optic disc for cupping/pallor/swelling/hemorr
• central retina for hemor/pallor
• periph retina for vessel appearance/hemorr/detach

Other

• Tono-Pen/Applinator/Schiotz
• EOM
• Visual fields
• Xray with concerns of metal/glass/stone
• See here for Optokinetic drum

See Also

• Eye Algorithms (Main)
• Opthalmology eye drop colors

References

Authors

Kevin Lu, Ross Donaldson, Jordan Swartz, Sabin Dang, Daniel Ostermayer, Neil Young