Ocular examination technique

3 3 6X2
Inspection (3)
1- Gross abnormality, facial deformity, scar,
pigmentation,mass,swelling
Lid ptosis, ectropion, entropion, trichiasis
2- Proptosis …. Looking tangential or from behind ( if positive
what is the direction eg down and out, down and in etc)
3- Alignment of the eyes ….. shining the light from distance and
see the reflex centralized in the pupils. ( if misaligned what is
it , exotropia,esotropia,hypertropia or hypotropia) and
which eye is deviated .

Checking (3)
1- Visual Acuity :
One eye at a time
Distance of 1 meter
Using reduced Snellen’s card
Start with Rt eye then Lt eye
If not 6/6 then should confirm with pinhole to
exclude error of refraction
2- Ocular motility :
Distance 0f 50 cm
Patient doesn’t move his head
 H-shaped manner then approach the object to
check convergence
Patient reports pain during movement or diplopia
(double vision)
Examiner looks for limitation of movement or
nystagmus
Comment :
No limitation in all directions of gaze.
Limited
adduction,abduction,elevation,depression… which
eye
3- Visual Field Checking :
( Value: checking optic nerve function and the
retina)
Done at 50 cm
Object midway between patient and examiner
Each eye at a time
Patient doesn’t move head or eyes, just focus on
examiner’s eye
Examine the four quadrants
Never forget that quadrants represent the opposite
and inverted quadrant in the retina
Blind spot is examined using a red pin

Local Eye examination (6X2)

1- Conjunctiva :
 Injected( local or diffuse) / Not injected
Discharge (describe) / No discharge
2- Cornea :
Clear/Opacified ( central or peripheral,
total or where)
Corneal sensation ( pt looks away, touch
the periphery with cotton tip) ….
Ophthalmic devision of Tigeminal 5th
nerve
3- Anterior Chamber :
Deep/Shallow
Clear/abnormal content
( hyphema,hypopyon)
THEN
DIM THE ROOM LIGHT
4- PUPILS:
Equal and rounded
Pupil reflexes :
Direct – Consensual- RAPD ( swinging
light test)
5- Lens :
Clear/opacified
Red reflex : present/reduced/absent
6- Retina :
Disc: color, cup/disc ratio
Macula : Hge/exudate