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Basic Ophthalmology Examination

This document provides an overview of the basic ophthalmology examination. It describes the routine examination process, which includes obtaining a patient history and symptoms, performing a physical exam of the eyes, and testing visual function. The physical exam involves inspecting the eyes, using oblique illumination to examine the anterior segment, checking intraocular pressure, evaluating the visual field, and examining the posterior segment via ophthalmoscopy. Specialized ocular exams are also mentioned, including using a slit lamp biomicroscope, exophthalmometer, and eye ultrasound. The document provides details on techniques for each part of the examination.

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188 views

Basic Ophthalmology Examination

This document provides an overview of the basic ophthalmology examination. It describes the routine examination process, which includes obtaining a patient history and symptoms, performing a physical exam of the eyes, and testing visual function. The physical exam involves inspecting the eyes, using oblique illumination to examine the anterior segment, checking intraocular pressure, evaluating the visual field, and examining the posterior segment via ophthalmoscopy. Specialized ocular exams are also mentioned, including using a slit lamp biomicroscope, exophthalmometer, and eye ultrasound. The document provides details on techniques for each part of the examination.

Uploaded by

'Ubhe Luphh Dolphin'
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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BASIC OPHTHALMOLOGY

EXAMINATION

Dr. Budu, Sp.M, Ph.D


DEPARTMENT OF OPHTHALMOLOGY, FACULTY
OF MEDICINE, HASANUDDIN UNIVERSITY

OPHTHALMOLOGY EXAMINATION
1. Routine :
Anamnesis
Physical examination
Visual function test

2. Special ocular examinations

Anatomy

ANAMNESIS
Purpose: deep ocular evaluation
2 methods :
Autoanamnesis
Alloanamnesis

Collected infromations:
1. General : name, age, gender, address, jobs).
2. Khusus :
a. Main complain : decrease of vision,
diplopia, pain, etc.
b. Other clinical symptoms link to main
complain: onset, progressvity, duration,
relaps, ocular movement disturbance, injury,
glasses, or systemic diseases (DM, HT) etc

Physical examination
1. Inspection anterior segment of the eye
2. Obliq illumination anterior segment of the eye
3. Palpation finger tension
pain (uveitis)
mass
adenopathy
4. Intra ocular pressure
5. Visual fiield
6. Ophthalmoscopy
7. Visus
8. Refraction

1. Inspection

No instrument
Point of inspection :
Eyelids : supercilia, cilia, skin, fissura, plica,
canthus, konjunctiva Right and left eyes ?
Anterior segment :
1. Bulbus konjunctiva : injeksio konj.,
Inj.perikorneal, hiperemis, chemosis,
hemorrhagic, laseration, corpus alienum, etc

Sclera : color, intact, thinness,


tenderness, etc.
Cornea : clarity,diameter, curvature,
intact, etc
Anterior chamber : content,
deepness.
Iris : color, cripte.
Pupil : structure, position, color,
margen, numbers ?
Lens : clarity, position, posisi lensa
(trauma)
On inspection, position and ocular

2. Obliq illumination
Instruments : light.
Technique : illuminating light 450 from
medial and lateral. In dim light room.
Identified structure : more than inspection.
(Can be added with loupe + 1.00D- +5.00D)

Evaluated structures :
1. Eyelids = inspection
2. Anterior segments:
a. Cornea : Cikatriks nebula, CA, blood stain
b. Iris : Cripte, sinechia
c. Anterior chamber : contents (hifema,
hipopion)
d. Pupil : light reflex (direct & indirect), pupil
margin
e. Lens : iris shadow & pseudo iris shadow

Light can be used as tool in :


Hirschberg test (strabismus)
Light perception test (visus = 1/)
Light projection test (retinal function)

3. Palpation
Instrument : no instrument .... Only finger.
Purpose, to evaluate :
1. Tumor Mass
2. Preauricular gland enlargement
3. Pain (iridocyclitis/uveitis)
4. Finger tension (TIO palpation)

Tumor mass : consistency, pain, pulsation.


Preauricular gland enlargement palpate
with end of finger :
- metastase/ cancer
- Ocular inspection ..... viral

Palpation for Intra ocular pressure :


1. Patient look at inferior
2. Two fingers in superior eyelids 1 cm from
cilia.
3. One finger make palpation and the other
endure eye ball undulation.

Results :
Tn ..TIO normal
Tn 1 TIO hypotoni
Tn 2 . ..TIO hypotoni ++
Tn + 1.TIO high
Tn + 2.TIO hugh ++

4. Intra Okuler pressure


examination :
Two methods :
1. With finger (paplation)
2. Instrument (Tonometer Schiotz) :

Tonometer Schiotz
Technique :
1.
Patient ..... supination
2.
Topical anasthesia instillation (R/ Pantocain 0,5%, 2%)
3.
Desinfection of tonometri schiotz.
4.
Ask patient to look at above.
5.
Indent the tonometri to cornea of patient.
6.
Read tonometri scale

5. Visual field evaluation


To determine the vsual field margin.
Peripheral margin of field :
Nasal/medial = 60 0
Temporal
= 90 0
Superior
= 70 0
Inferior
= 50 0

Examination :
1. Confrontation
2. Amsler grid
3. Perimetri
4. Tangent Screen (campimeter)

Amsler Grid

Perimetri

6. Funduscopy (posterior segment of


eye ball

7. VISUAL ACUITY TEST


Visus (Visual Acuity): the ability to see
objects in detail.
Classification :
1. Distance vision : 20 feet (5 metre)
2. Intermediate vision
3. Near vision : jarak baca (1/3 meter)

Distance vision :
= central vision
Instrument :
1. Reading chart
a. Snellen chart
b. E chart (E)
c. Allen chart
2. Five (5) metre ....
minimal
3. Room illumination.

Fail in Snellen test, we used :


1. Counting Finger (CF) read value : 60
2. Hand movement/hand motion (HM) ;
read value= 300
3. Light perception (LP) ; read value =
Results :
- numeral (5/40, 1/60, 1/300, dll)
- decimal ( 1,0 ; 0,5 ; 0,1)

Pemeriksaan Khusus
1. SLITLAMP BIOMIKROSKOP

2. EKSOFTALMOMETER HERTEL

3. USG MATA

Terima Kasih

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