BASIC EXAMINATION OF THE EYE

By: Yohanes Silih I11107004

TOPICS
EXAMINATIONS OF CORNEA EXAMINATIONS OF UVEA EXAMINATION OF LENS EXAMINATION OF ORBITA EXAMINATION SOF RETINA

EXAMINATIONS OF CORNEA
Pachymetry Plasidiscope Test Cornea Reflex Fluoresein Rose Bengal Metilen Blue

Pachymetry
Corneal pachymetry is the measurement of corneal thickness. There are two pachymetr y techniques:
Optical pachymetry with a slit lamp and measuring attachment may be performed on the sitting patient. Ultrasonic pachymetry; this has the advantage of greater precision and can also be performed with the patient supine.

Plasidiscope Test
Device: plasidiscope board with concentric black and white circle. Technique:
Source of Light behind patient Plasidoscope as high as eyes of patient See through space in the middle of plasidoscope picture of patient cornea.

Interpretation:
Concentric shadow normal cornea Oval concentric lines astigmatism Unregulated concentric lines irreguler astigmatism Unclear lines unclear cornea or edema of cornea

Cornea Reflex/ Cornea Sensibility/Wink Reflex

Aim:Trigeminal nerve function test. Technique:
Ask patient to look contrary side of examined cornea. Hold patient eyelid using thumb and index finger. Cotton patched to cornea surface See present of patient wink reflex, pain, and lacrimation

There is wink reflex good sensibility Wink reflex decrese to patient with keratitis, herpes simplex ulcer

Fluoresein Test
Aim: To know damage of cornea epitel using fluoresein. Basic:Fluoresein become green when patched to damage cornea epitel alkali. Material: fluoresien 0,5-2 % and patocain drop Technique:
The eye dropped with pantocain Fluoresein dropped to the eyes Irigate with physiologic salt Examine the cornea

Green colors of cornea defect of cornea epitel

Rose Bengal
Aim: Its sodium salt commonly used in eye drops to stain damaged conjunctival and corneal cells and thereby identify damage to the eye. Basic: Rose bengal will make red coloration to death cell. Material: rose bengal 1 % and local anesthesia eye drop. Technique:
Eye anesthesia Rose bengal dropped to superior limbus. Irigate with physiologic salt.

Red coloration of cornea or conjungtiva cells death

Metilen Blue
Aim:To know defect of cornea nerves. Basic: Metilen blue staning damaged cornea nerves tip. Materials: metilen blue, 5% and Topical anesthesia Technique:
Give eye topical anesthesia Dropped 0,5 % methylen blue 3 times every 5 minutes. See coloration of cornea

Interpretation: blue coloration of cornea damage of cornea nerves tip.

EXAMINATION OF UVEA
Pilokarpin 1 % Test Aim: To ensure cause of midriatic of pupil: compulsion or fault salving (drugs) application . Basic: pilokarpin make miosis to midriatic eyes cause of pupil contusio/trauma but cant make miosis to midriatic eyes cause of drug application. Material: pilokarpin 1 % Technique: give pilokarpin to midriatic eyes and wait during 2 hours. Interpretation: midriatic pupil miosis (+) = compulsion midriatic pupil miosis (-) = midriatic drug

EXAMINATION OF LENS
Shadow Test Aim: to know degree of lens turbidity Basic: more turbid of lens will make bigger shadow of iris. Devices: sentolope lamp and loupe. Technique:
irradiate pupil using sentolop on 45 degree of iris. Using loupe, looking at shadow of iris to the lens.

Interpretation:
Shadow test (+): big shadow of iris and far to pupil a half turbidity Shadow test (-): small shadow of iris and near to pupil total turbidity

EXAMINATION OF ORBITA
Eksolftalmometry Aim: to measure protrusion of orbita. Device: Hertel exophthalmometer. Normal protrusion: 12-20 mm or difference protrusion between both eyes less than 2 mm.

EXAMINATIONS OF RETINA
Oftalmoscope / Funduscope Red reflex Projection Test Confrontation Test

Ophthalmoscopy/Funduscopy
Aim: evaluate condition or abnormalities of fundus. Basic: light to the fundus will showing reflex fundus picture of fundus. There are two type: indirect and direct Ophthalmoscopy.

 Device: oftalmoscope and drug for dilatation of pupil (mydriacyl). Technique:

Examine in dark room! Prinsiple: right with right, left with left. First, use +12.00 D of optalmoscope. Opthalmoscope is about 10 cm from patient eye. Move the opthalmoscope approach the eye and change the lenticular force approach 0 D. Light focus to the papil of optic nerve. Evaluate all part of retina

 Find:
Papil of optic nerve
Papiledema Atropy of optic nerve Lost of vein pulsation of optic nerve

Retina
Subhialoid hemorrage Intraretina hemorrage Edema of retina Edema of macula

Retina vascularisation
Artery-vein rasio Mikroaneurism of vein

Red Reflex
Aim: to evaluate clearness of visual axis. Technique:
Dark room. Irradiate patient eyes with opthalmoscope in 12-18 inch, irradiate both of the eyes alternately. Evaluate present of red reflex.

Interpretation:
Normal red reflex Abnormal white reflex, red reflex (-), turbidity, dark spot.

Projection Test
Aim: to know the function of peripheral retinal Basic: normal retina can recognize the light into the eye. Device: sentolope Technique:
Dark room. Patients were asked to close one eye that is not checked open eyes illuminated from four directions, and ask where the direction of the light.

Interpretation: if patient know the direction of lightnormal peripheral retina function

Confrontation Test
Aim: to know abnormalies of visual field. Basic: comparing patients visual field with examiner visual field. Technique:
Distance between patient and examiner is about 1 metre. Closed left eyes examiner following with closed right eyes of patient. an object is placed between the patient premises examiner at the same distance. objects began to move from peripheral to central direction, till seen by examiner. if the object seen by the examiner then asked if the object has been seen by the patient did in all directions and the other eye patients

Interpretation:
Normal: patients see objects when examiner also see it

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