Eye Examination
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Anjita LamichhaneEye Examination
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Anjita LamichhaneEYE EXAMINATION
EXAMINATION
• Ocular • Optic nerve by
Movements testing visual
• Corneal Sensation acquity, colour
vision, visual fields,
• Eye Closure
pupillary light reflex
• Optic nerve head
by ophthalmoscope
• Anterior segment
of eye by slit lamp
• Posterior segment
of eye by
opthalmoscope
FUNDUS EXAMINATION
1.Direct Opthalmoscopy
2.Indirect
Ophthalmoscopy
3.Lit Lamp Biomicroscopy
4.Fundus Camera
USES OF FUNDUS
1. Routinely used to assess
EXAMINATION
and diagnose vitreo-retinal
diseases such as diabetic
retinopathy, hypertensive
retinopathy, retinal tear,
choroidal tumor, macular
edema
2. Examine extent of defects
and abnormalities
3. Evaluate success of
treatment
Appearance of normal fundus
Orange to vermilion
Factors responsible
1. Amount of pigment in the choroid
2. Hexagonal epithelium of retina
3. Choroidal vasculature
Direct Ophthalmoscopy
• Performed in a semi dark
room
• Ideally pupils should be
dilated by mydriatic agent
• Patient should be looking
straight
• While examining the left eye,
the examiner should be on
left side of the subject and
should hold the instrument
in the left hand and use left
eye.
Distant Direct Ophthalmoscopy
• Ophthalmoscope at distant of
20-25 cm from patient’s eye.
• Normally red reflex seen at
pupillary area
7
Uses of Distant Direct
Opthalmoscopy
• To visualize opacity in ocular
media, in front of pupil, in the
pupillary plane and behind the
pupillary plane.
• To visualize disc, blood vessels,
macula
Slit Lamp Examination
Instrument with high-
intensity light source that
can be focused to shine as a
slit.
Used in conjunction with a
microscope.
Principle: A “slit” beam of
very bright light produced by
lamp. This beam is focused
on to the eye which is then
viewed under magnification
with a microscope.
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Examination sequence
1.External Structures
and Adnexa
2.Lids and Lashes
3.Conjunctiva and Sclera
4.Cornea
5.Anterior Chamber
6.Iris and Pupil
7.Lens
8.Anterior Vitreous 10
External exam
• Eye and orbit
• Asymmetry in eye and
adnexa
• Basal and squamous cell
carcinoma can be visualized
Lids and Lashes
• Examined when
closed and open both
• Lagophthalmos,
ectropion, entropion,
blepharitis
• Eyelash- trichiasis,
scurf
12
Conjunctiva and Sclera
o Both bulbar and palpebral
conjunctiva
o Sclera- colour, injection and
violaceous injection around
limbus(anterior uveitis)
o See for signs of irritation, scleritis
13
Cornea
• Illumination arm should be
at more oblique angle and
narrow the beam
• Slow sweep of illumination
arm from temporal to nasal
across at surface at low
magnification
14
Anterior Chamber
• Normal: transparent
• See for blood or individual
erythrocytes in aqueous humor,
pus
• Depth of AC-evaluation of painful
red eye consistent with angle
closure glaucoma.
15
Iris and pupil
• Irregularities in
pigmentation, raised
lesions, or asymmetry
• Neovascularization of
iris- advanced ocular
disease
16
Lens
• Ideal tool to
evaluate
cataract
17
Anterior vitreous
• Assess for cell and
flare as in anterior
chamber
• Inflammatory
infiltrates-
iridocyclitis
• Pigmented cells-
retinal tear, vitreous
hemorrhage
18
Uses of slit lamp
1. Routine examination of ocular adnexa, anterior
segment and anterior vitreous
2. Confirm fitting of contact lens
3. Foreign body removal
4. Suture removal
5. Epilation
6. Removal of membrane, crusts
thank you
