E YE E X AM INATIO N

Gitalisa Andayani
Nila F M oeloek
S etiowati S uhardjono

D ept of O phthalmology,
Faculty of M edicine, University of Indonesia

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ANATOMY OF THE EYE

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 Anamnesis
1. Chief complaint:
- acute persistent visual loss
- chronic progressive visual loss
- flashes, photopsia
- red eye
- proptosis
- tearing, etc
2. History taking
3. Family history
4. Systemic diseases

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 Visual loss
Abnormalities in media of refraction
cornea, anterior chamber, lens,
vitreous body

Abnormalities in neural tissue

retina, optic nerve

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Common causes of visual loss
Acute visual loss:
- Retinal detachment
- Optic neuritis
- Retinal vascular occlusion

Chronic visual loss

- Cataract
- Progressive myopia

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 Ophthalmology examination

COMPONENTS:
Visual acuity
Confrontation visual fields
External examination
Pupillary examination
Motility and alignment examination
Ophthalmoscopic examination

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 Ophthalmology examination
Visual acuity

Determine the smallest object

clearly seen in a certain distance
Distinguishing 2 separate points
Visual angle of 5 minutes to see
a letter, but to analyze the form
completely, require resolution of
1 minute arc
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 Visual acuity testing
Snellen Chart
Snellens notation:

testing distance
____________________

distance of the line of

smallest letters readable

Notation
- Fraction of 6/50 - 6/6 (6/5)
- Decimal

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 PINHOLE TEST
If visual acuity is not
normal
Determine if it is:
- optical (refractive error
or media opacity)
- neural (retinal or optic
nerve lesion) Pinhole: eye shield with a small hole allowing
light rays to reach retina without interference
Improved: optical of optical problems

Not improved: - neural

- poor compliance 9
 Low vision

Counting fingers (1/60 - 5/60)

Hand movement (1/300): vertical and
horizontal
Light perception (1/~)
No light perception

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 Refraction
Refraction Near vision/reading

Picture chart 11
CONFRONTATION TEST

Distance of 1 m
Examiner considered normal 12
 External examination
1. Anterior segment:
Eyebrows, eyelids, tarsal conjunctiva, bulbar
conjunctiva, cornea, anterior chamber, iris,
pupil, and lens
(at least, use a penlight; if available:
loupe)

1. Posterior segment:
Vitreous, retina, optic disc
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Ciliary injection

Conjunctival injection

Red eyes Scleral injection

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ANTERIOR CHAMBER

HYPOPION

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FLUORESCEIN TEST

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CORNEAL SENSITIVITY TEST

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 IRIS

Crypti

Color

Synechia

Iridodialisis
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 LENS

Katarak
Shadow test

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Immature Mature

CATARACT

Morgagnian Hypermature 20
Senile cataract

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 Pupillary examination

Pupil size (in dim and light)

Swinging light test (if dilated: Marcus Gunn
pupil or relative afferent pupillary defect)
optic neuritis, retinal detachment,
vein/artery occlusion
Anisocoria

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Motility and Alignment
Examination

Extraocular muscles
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Ocular alignment
ESOTROPIA

EXOTROPIA

HYPERTROPIA

HYPOTROPIA
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Corneal light reflection test

Normal (ortho)

15 * ET (esotropia)

30* ET

45 *ET

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OCULAR MOVEMENTS

Cardinal Gaze
Fields
Convergence
Diplopia
Nystagmus

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CARDINAL GAZE FIELD

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OPHTHALMOSCOPY

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FUNDUS EXAMINATION
Reflex

Optic disc

Arteries & Veins

Macula

Retina

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Syatematic fundus examination

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Optic disc

Normal

Large cupping

Glaucomatuos
cupping

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 Other examinations
PERIMETRY/CAMPIMETRY

TONOMETRY

EXOPHTHALMOMETRY

ANEL TEST

SCHIRMER TEST

COLOR VISION
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GOLDMANN CAMPIMETRY

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Digital Palpation

2 hands

1 hand

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SCHIOTZ TONOMETER

Callibration 35
VARIOUS TONOMETERS

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ANEL TEST
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HERTEL EXOPHTHALMOLMETER

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SCHIRMER TEST

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Color vision tests:
ISHIHARA PLATES

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THANK YOU

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