General eye examination

..

1. (visual acuity;VA)

1.1.

0-1
Blink reflex

6
2-3

3-6

7-10

11-12


1.1.1. Fixation target


(fix)

(follow)

0-2
1.1.2. Visual evoke potential (VEP)


0-2
1.1.3. Optokinetic nystagmus (OKN) OKN drum



OKN drum
30-50 . drum

(nystagmus)
nystagmus OKN drum

-

0-2
1.1.4. Forced choice preferential looking test (Grating acuity test)
6
-




1.1.5. Allen chart
6

1.1.6. E chart, HOTV

Allen chart E chart E E
E E HOTV
H, O, T V
6
1.2. ()
1.2.1. Snellen chart


6 (20 )









6/60 () 20/200
() 6/6 20/20

+ (

) (

6/6 20/20 pin

hole (PH) ( pin hole
0.2-0.5 .)

(refractive error)

pin hole

6/60 6

60
VA 6/12, 6/36
VA c PH 6/6, 6/9
pin hole

6
1
1

Counting finger

3, 2 1

VA Fc 2 (
2 )

Hand movement

VA HM

Light projection

penlight

VA PJ

Light perception

light
projection

VA PL

No light perception

light
projection

VA NPL

1.2.2. E chart


2.

(Penlight examination)

biomicroscope (slit lamp examination)

40
-
(anterior eye segment)
2.1. (orbit)

2 , ()
:


(pthisis
bulbi)
: orbital rim,
(crepitus) ethmoid, maxillary sinus,
superotemporal part orbit
(lacrimal gland)

(dacryoadenitis),
(lacrimal gland
tumor) , inferonasal
(dacryocystitis)
(eyeball and extraocular muscles)
2.2.
(nanophthalmos, microphthalmos),

(anophthalmos), (enophthalmos), (exophthalmos)

2
conjugate eye movement 2 convergence






cranial nerve III, IV / VI palsy, muscle entrapment





1

RSR
RIO
LIO
LSR
RLR

RMR

LMR

LLR

RIR

RSO

LSO

LIR

R=right, L=left, SR=superior rectus, IR=inferior rectus, MR=medial rectus, LR=lateral rectus,
IO=inferior oblique, SO=superior oblique

 Hirschbergs test
2 1 corneal
light reflex

2

(orthotropia)
cornea

(right esotropia)

pupil

(right exotropia)

(right hypertropia)

(right hypotropia)

corneal light reflex

Right eye

Left eye

cover test


(occluder)


occluder



2.3. (eyelid)


(ptosis)
(lagophthalmos)
(lid coloboma)
(blepharospasm)
(blepharitis)

hemangioma, basal cell carcinoma
(internal hordeolum : gland

of Zeis gland of Moll, external hordeolum : Meibomian gland)
(trichiasis)
(entropion)
(ectropion)

Trichiasis

entropion

ectropion

2.4.
(conjunctiva) bulbar part, palpebral part
forniceal part

palpebral
part





tarsal
plate


(conjunctival injection)
o Conjunctival injection
(conjunctivitis)
palpebral conjunctiva limbus
o Ciliary injection (keratitis),
(acute angle closure glaucoma), (anterior
uveitis) limbus
o Mixed injection 2

(chemosis)


(pinguecula),
(pterygium)
(subconjunctival hemorrhage)

(conjunctival tear)
papillae, follicle


2.5. (cornea)

(keratitis)

epithelial defect

(corneal ulcer)
epithelial

defect
infiltration

epithelium



hypopyon
(corneal edema)

(acute angle closure glaucoma)

Fuchs endothelial

,
dystrophy
(corneal abrasion) epithelium

fluorescein

cobalt blue direct ophthalmoscope
(corneal laceration)

full thickness

,
,
(anterior chamber)
2.6.

(
2 )
content



(shallow anterior chamber)
(acute angle closure glaucoma),


(anterior lens subluxation/ dislocation)
(Deep anterior chamber) (apkakia),


(posterior lens subluxation/ dislocation)
(hypopyon)
(corneal ulcer),

Behcet disease,
(endophthalmitis)
(hyphema)



(blunt
trauma)

2
2.7. (iris)

(iritis) ciliary injection

hypopyon
(iridodonesis)

(posterior lens subluxation/ dislocation)


(iris atrophy) atrophy
, ,

(iris root) ciliary body (iridodialysis)
ciliary body



(aniridia)

(neovascular) (rubeosis iridis)

proliferative diabetic retinopathy,

(central retinal vein occlusion)
2.8. (pupil)


,
,



Direct light reflex

brisky react to light

sluggish
react to light not react to light
Consensual light reflex




Relative afferent pupillary defect (Marcus Gunn pupil)

swinging flashlight test
5


5 2

o



swing

RAPD negative
o













2 (


consensual light reflex)
swing


( ) RAPD positive (
)
Right
Left
Right
Left

RAPD negative

RAPD positive
left eye

(posterior synechiae)

(polycoria)

(correctopia) , iris atrophy

pilocarpine, morphine,
pontine hemorrhage, Horners syndrome

mydriacyl,
phenylephrine, atropine , amphetamine over dosage
2.9. (lens)


(cataract)


,


(lens subluxation/ dislocation)

(subluxation)(dislocation) (anterior)

(anterior chamber)

(subluxation)(dislocation) (posterior)

equator
( )


(iridodonesis)
(aphakia)
(pseudophakia)

2.10.
(vitreous)
slit lamp
biomicroscope, direct ophthalmoscope, indirect ophthalmoscope

(vitreous hemorrhage)


()

(vitritis)

2.11. (fundus)

fundus (

direct ophthalmoscope
)
(blurred
(optic disc) : disc
disc margin) (optic

neuritis), (increased intracranial pressure),

(optic atrophy),

cup : disc ratio
0.3

,
,
(optic nerve hypoplasia),
(optic disc coloboma)
(retinal artery and vein)
(A:V ratio) 2:3
A:V
hypertensive retinopathy,

(central retinal vein
occlusion)
(retina)
choroid
choriocapillaris



(retinal break), (retinal detachment)
(macula)

macula (macular edema),
(macular hole)

direct ophthalmoscope

15

 ophthalmoscope








(
1%Mydriacyl +/- 10% Phenylephrine) 4-6 .,

(
)

(

)
direct ophthalmoscope



(
)


direct ophthalmoscope



guard

direct ophthalmoscope


o
-
o
+
direct ophthalmoscope

30 .

red reflex


direct ophthalmoscope red reflex
fundus
(optic disc)

temporal 15


4 quadrant

4 quadrant
macula


fundus

aperture
Aperture
Aperture



Grid

Slit

(red free light) retinal nerve fiber, retinal vessel

aperture

Indirect ophthalmoscope

2 telescope
( )

3-4
direct ophthalmoscope

2.12. (visual field)

Confrontation test
(
)
2
1


( )


periphery 10
360

Tangent screen central 30

fovea
2
1

Goldmann perimetry




360

Automated perimetry Goldmann perimetry

2.13. (intraocular pressure)

Indentation tonometer Schiotz tonometer

o

o
(tetracaine)

 1
calibrate

5.5

0 7.5

0
10
o
o

Goldmann applanation tonometer

slit lamp

Noncontact tonometer (Air blast applanation)

2.14. (colour vision)


Ishihara
pseudochromatic color plate red-green deficiency