Examination of the eye

Xiaohui zhao MD.phD.

Wuhan University Renmin Hospital
 Routine ophthalmologic
examination
1)Careful record of history

2)Ocular examination

3)Assessment of visual function

 A. History-taking
1)Patient's complaint

2)Disease process in detail

3)Individual condition
 Key points in history taking

1)To identify which eye is involved

2)To collect the patient ' s subjective abnorm
al feelings
3)Past symptom of ophthalmopathy,course
and treatment,changes of visual function,
history of wearing glasses,etc
4)Person history
5)Family history
The examination of visual function

Two methods:
1)Optic psycophysics
2)Optic electro-physiology
 (1)Visual Acuity

a. The examination of far vision

1)Visual acuity test chart
2)Calculation according to test chart
3)Finger count
4)Hand movement
5)Light perception/light projection
b. The examination of near vision
standard reading chart or Jaeger's
chart
 (3)Color Sensation

(1)Pseudoisochromatic plates(color blindness

book)
(2)Selecting method of wool thread
C. Examination of the globe
and its accessory organs
(1)Examination of accessory organs
of the eye
1)Eyelids
2)Lacrimal apparatus
tear secretion
lacrimal passage:washing or radiographic examination
3)Conjunctiva
4)Position of the globe
5)Orbit
 (2)Examination of anterior
segment of the eye
1)Cornea
corneal curvature
oblique illumination
staining with fluorescein sodium
corneal perception
2)Sclera
3)Anterior chamber
4)Iris
5)Pupil:examination of light reflex
6)Lens
(3)Examination with slit-lamp
microscope
 (5)Tonometry
• 1)Measurement by finger
• 2) Measurement by tonometer
identention:Shidtz tonometer
applanation:Goldmaan tonometer
 (6) Examination of fundus
• 1)Ophthalmoscopy
Direct Ophthalmoscopy
a.transillumination
b.examination of fundus
Indirect Ophthalmoscopy:Image is reversed , magnifie
d,stereoscopic;Visiblescope is large
• 2)Observation of the fundus
Optic disc:oval,pink with clear border ,color, margin,siz
e,C/D ratio
Central retinal artery/vein
Macular region
Retinal
Record of fundus examination
 papilloedema
•

Optic nerve photo, OD. Note grade 2 papille

dema, characterized by 360 degree nerve el
evation without obscuration of the vessels
Optic atrophy

Glaucmatous optic atrophy

Retinal haemorrhages
 Some clinical problems

• Conjunctivitis
• Keratitis
• Iritis
• Acute glaucoma
conjunctivitis

Clinical manifesitation
Symptoms of conjunctivitis
Ocular discomfort
Itching
Foreign-body sensation
Burning
Photophobia
Lacrimation
Pain
keratitis

Clinical manifesitation
Symptoms of kreatitis
Photophobia
Loss of vision
pain
Sign of inflammation
 Sudden loss of vision
• Unilateral
• Vascular disease
• Transient lossof vision
emboli in the vessels
• Permanent loss of vision
central artery occlusion
optic nerve ischemia
 Ocular trauma

• Foreign bodies
• Penetrating injuries
• Blunt injuries
• Chemical injuries
• Thermal injuries