University of the East Ramon Magsaysay Medical Center

DEPARTMENT OF OPHTHALMOLOGY

8 Part
Eye Exam
Cynthia Verzosa, MD, DPBO,
MSc

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

DISCLAIMER

•This power point presentation is

made for educational purposes only
and is intended to be used for UERM
Medical Students, Clinical Clerks or
Post-Graduate Interns only.

•Slides may contain sensitive photos

of actual patients. Please refrain
from taking snapshots or recording
the presentation unless allowed by
the speaker.
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
OBJECTIVE

• To perform an 8-part eye exam

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Parts of an Eye Exam
• Visual Acuity
• External Exam
• Pupils
• Motility Exam
• Palpation Tonometry
• Anterior Segment Exam
• Visual Field Exam
• Ophthalmoscopy
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
Visual Acuity
• Snellen chart
• Test distance: 20 feet
• EDTRS
• Variations of Snellen chart
• Pre- or non-verbal
• Illiterate
• Pocket Snellen
• Test distance: 14 inches

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Visual Acuity
• Snellen chart
• Test distance: 20 feet
• LogMAR / Bailey-Lovie /
EDTRS
• Variations of Snellen chart
• Pre- or non-verbal
• Illiterate
• Pocket Snellen
• Test distance: 14 inches
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
Visual Acuity
• Snellen chart
• Test distance: 20 feet
• EDTRS
• Variations of Snellen chart
• Pre- or non-verbal
• Illiterate
• Pocket Snellen
• Test distance: 14 inches

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Visual Acuity
• Snellen chart
• Test distance: 20 feet
• EDTRS
• Variations of Snellen chart
• Pre- or non-verbal
• Illiterate
• Pocket Snellen
• Test distance: 14 inches

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Visual Acuity
• Snellen chart
• Test distance: 20 feet
• EDTRS
• Variations of Snellen chart
• Pre- or non-verbal
• Illiterate
• Pocket Snellen
• Test distance: 14 inches

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Visual Acuity
• Snellen chart
• Grading
• 20/20 -20/200
• Counting fingers
• Hand movement
• Light projection
• Light perception

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External Exam
• Be systematic
• Adnexa
• Lids
• Globe

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External Exam
• Be systematic
• Adnexa
• Lids
• Globe

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Pupil Exam
• Light Reflex
• Direct, indirect light
reflex
• Swinging light test

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Pupil Exam
• Light Reflex
• Direct, indirect light
reflex
• Swinging light test

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Pupil Exam
• Light Reflex
v v
• Direct, indirect light
reflex
• Swinging light test v v

v v

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Pupil Exam
• Light Reflex
v v
• Direct, indirect light
reflex
• Swinging light test v v

• RAPD

v v

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Extraocular Muscle Movement
• Cardinal
movements of the
eye
• Same direction,
same amplitude

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Palpation Tonometry
• Normal firmness:
tip of the nose
• Soft: lips
• Hard: glabella

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Anterior Segment Exam
• Slit lamp

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Visual Field Exam
• Confrontation test
• Patient’s VF pitted
against the MD’s VF

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Visual Field Exam
• Amsler Grid
• Central 10 degrees

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Ophthalmoscopy
A B
• Fundus exam
• Parts of the 2
ophthalmoscope
• A Patient side 1

• B MD side
• 1 Aperture 3
3
• 2 Brow rest 5
• 3 Dial (Diopter) 6 4
• 4 Window (Diopter)
• 5 Dial (Light beam)
• 6 Switch (Light color)
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
Ophthalmoscopy
• Fundus exam
• Parts of the
ophthalmoscope
• A Patient side Numbers
• B MD side -3, -2, -1, 0, +1, +2, +3
• 1 Aperture 3
• 2 Brow rest Green: Plus lenses
• 3 Dial (Diopter) Red: Minus lenses
4
• 4 Window (Diopter)
• 5 Dial (Light beam)
• 6 Switch (Light color)
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
Ophthalmoscopy
• Fundus exam
• Parts of the
ophthalmoscope
• A Patient side Light spot sizes
• B MD side
• 1 Aperture
Light slit
• 2 Brow rest
5
• 3 Dial (Diopter)
• 4 Window (Diopter)
Light target
• 5 Dial (Light beam)
• 6 Switch (Light color)
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
Ophthalmoscopy
• Fundus exam
• Parts of the
ophthalmoscope
• A Patient side Light color
• B MD side
• 1 Aperture
• 2 Brow rest
• 3 Dial (Diopter) 6
• 4 Window (Diopter)
• 5 Dial (Light beam)
• 6 Switch (Light color)
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
Ophthalmoscopy
• Fundus
• Disc : CD ratio
• Blood vessels: AV
ratio
• Macula

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Ophthalmoscopy
• Fundus
• Disc
• Blood vessels
• Macula

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Ophthalmoscopy
• Fundus
• Disc
• Blood vessels
• Macula

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

Ophthalmoscopy
• Fundus
• Disc
• Blood vessels
• Macula

© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY

SUMMARY
Visual Acuity
External Exam
Pupils
Motility Exam
Palpation Tonometry
Anterior Segment Exam
Visual Field Exam
Ophthalmoscopy
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY
QUESTIONS?

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 Thank You!
© 2020 UERM DEPARTMENT OF OPHTHALMOLOGY