ANATOMY OF THE EYE

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

Abnormalities in neural tissue

retina, optic nerve
Ophthalmology examination

COMPONENTS:
Visual acuity
Confrontation visual fields
External examination
Pupillary examination
Motility and alignment examination
Ophthalmoscopic examination
 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
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
 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
Improved: optical light rays to reach retina without interference
of optical problems
Not improved: - neural
- poor compliance
Low vision

Counting fingers (1/60 - 5/60)

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

Picture chart
CONFRONTATION TEST

Distance of 1 m
Examiner considered normal
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)

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

Conjunctival injection

Red eyes Scleral injection

ANTERIOR CHAMBER

HYPOPION
FLUORESCEIN TEST
CORNEAL SENSITIVITY TEST
IRIS

Crypti

Color

Synechia

Iridodialisis
LENS

Katarak
Shadow test
Immature Mature

CATARACT

Morgagnian Hypermature
Senile cataract
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
Motility and Alignment
Examination

Extraocular muscles
Ocular alignment
ESOTROPIA

EXOTROPIA

HYPERTROPIA

HYPOTROPIA
Corneal light reflection test

Normal (ortho)

15 * ET (esotropia)

30* ET

45 *ET
OCULAR MOVEMENTS

Cardinal Gaze Fields

Convergence
Diplopia
Nystagmus
CARDINAL GAZE FIELD
OPHTHALMOSCOPY
FUNDUS EXAMINATION
Reflex

Optic disc

Arteries & Veins

Macula

Retina
Syatematic fundus examination
Optic disc

Normal

Large cupping

Glaucomatuos
cupping
Other examinations
PERIMETRY/CAMPIMETRY

TONOMETRY

EXOPHTHALMOMETRY

ANEL TEST

SCHIRMER TEST

COLOR VISION
GOLDMANN CAMPIMETRY
Digital Palpation

2 hands

1 hand
SCHIOTZ TONOMETER

Callibration
VARIOUS TONOMETERS
ANEL TEST
HERTEL EXOPHTHALMOLMETER
SCHIRMER TEST
Color vision tests:
ISHIHARA PLATES
THANK YOU