Examination Of Eye

Examination of the eye Xiaohui zhao MD.phD. Wuhan University Renmin Hospital

Routine ophthalmologic examination 1)Careful record of history 2)Ocular examination 3)Assessment of visual function

A.

History-taking

1)Patient's complaint 2)Disease process in detail 3)Individual condition

Key points in history taking 1)To identify which eye is involved 2)To collect the patient ' s subjective abnormal feelings 3)Past symptom of ophthalmopathy,course and treatment,changes of visual function, history of wearing glasses,etc 4)Person history 5)Family history

The examination of visual function Two methods: 1)Optic psycophysics 2)Optic electro-physiology

(1)Visual Acuity a. The examination of far vision 1)Visual acuity test chart 2)Calculation according to test chart 3)Finger count 4)Hand movement 5)Light perception/light projection

b. The examination of near vision standard reading chart or Jaeger's chart

(3)Color Sensation (1)Pseudoisochromatic plates(color blindness book) (2)Selecting method of wool thread

C. Examination of the globe and its accessory organs

(1)Examination of accessory organs of the eye 1)Eyelids 2)Lacrimal apparatus tear secretion lacrimal passage:washing or radiographic examination 3)Conjunctiva 4)Position of the globe 5)Orbit

(2)Examination of anterior segment of the eye 1)Cornea corneal curvature oblique illumination staining with fluorescein sodium corneal perception 2)Sclera 3)Anterior chamber 4)Iris 5)Pupil:examination of light reflex 6)Lens

(3)Examination with slit-lamp microscope

(5)Tonometry • 1)Measurement by finger • 2) Measurement by tonometer identention:Shidtz tonometer applanation:Goldmaan tonometer

(6) Examination of fundus • 1)Ophthalmoscopy Direct Ophthalmoscopy a.transillumination b.examination of fundus Indirect Ophthalmoscopy:Image is reversed , magnified,stereoscopic;Visiblescope is large • 2)Observation of the fundus Optic disc:oval,pink with clear border ,color, margin,size,C/D ratio Central retinal artery/vein Macular region Retinal Record of fundus examination

papilloedema • Optic nerve photo, OD. Note grade 2 papilledema, characterized by 360 degree nerve elevation without obscuration of the vessels

Optic atrophy

Glaucmatous optic atrophy

Retinal haemorrhages

Some clinical problems • • • •

Conjunctivitis Keratitis Iritis Acute glaucoma

conjunctivitis Clinical manifesitation Symptoms of conjunctivitis Ocular discomfort Itching Foreign-body sensation Burning Photophobia Lacrimation Pain

keratitis Clinical manifesitation Symptoms of kreatitis Photophobia Loss of vision pain Sign of inflammation

Sudden loss of vision • Unilateral • Vascular disease • Transient lossof vision emboli in the vessels

• Permanent loss of vision central artery occlusion optic nerve ischemia

Ocular trauma • • • • •

Foreign bodies Penetrating injuries Blunt injuries Chemical injuries Thermal injuries