A PRIMARY PHYSICAL

EXAMINATION OF EYE
 1.Care giver
2.Make a list of patient identity
3.Looking for a :
main complaint
additional complaints
pathogenic of disease
4.Knowing a disease treatment history and
previous diseases.

ANAMNESA
ANATOMY OF,,
1. Examination of visual acuity (visual acuity)
determine visual acuity of each eye:
a.Optotip Snellen: 6/6
b. Counting fingers: 1/60 6/60
c. Hand movements: 1/300.
Examination of the projection light from all directions (up,
down, nasal, temporal)

EXAMINATION VISUS AND

REFRACTION
d. Differentiating dark light 1 / ~
examination light projection aims to assess the function of
the retina. Example: if an upward direction can not
distinguish a dark light.
e. Unable to distinguish light-dark: Zero.
normal eye refraction
system

Refraction in the eye

hypemetropia

Refraction in the eye

myopia
Determine the distance between the right and left pupils
(PD):
1) Hold the ruler in front of both eyes.
2) The flashlight beam is directed to the middle between
the two eyes of the patient. Look the light reflex on the
cornea of the eye.
3) Measure the distance between the two reflex in mm,
the importance of the PD for short distances. Add 2 mm to
PD far.

2. EXAMINATION SIMPLE REFRACTION

Do When the vision is not normal (<6/6)
1. Attach the experimental spectacles in
The right position
2. Place the cover (occluder) in front of
one eye that is yet to be examined.
3. Go see Optotip Snellen.

B. MEASURING THE POWER OF SPHERICAL

LENS
 Place the lens S + or S- depending lens
grew brighter or on the eye being examined. Add the
power of the lens to obtain the best visual acuity (Trial
and Error)
a. if it looks myopia: selected for glasses lenses S- that
give the smallest best visual acuity
b. if it looks Hypermetropia: The S + lens
1. When the visual acuity of less than 6/10 did pinhole test,
put the pinhole in front of the eye being examined.
a. When more bluntly: maybe spherical lens (S) is not
enough or there Astigmat. Glasses can be given if the
patient satisfied or check further.
b. b When the fixed / worse: no organic abnormalities in
eye optical systems, find the disorder
c. In patients who complain of close reading
(Presbyopia) generally over the age of 39 years. The
examination was conducted as follows. 1. Adjust the PD to
close 2. Give lenses generally adjusted age S + : S + 1(40), S +
1,5 (45 yrs) ... S + 3 (60 yrs). 3. Read card read at a distance
close
a (+ 30cm, Jaegger 3).
d.Write the prescription eyeglasses, for example A 45-years old
Myopia
R / OD S 2,25 D
OS S 3,24D PD 64/62 MM
Addisi ODS S + 1.50 D initials
OPTOTIP
SNELLEN
TRIAL FRAME
TRIAL LENS SET
1. The shape, position and motion of the
eyeball, eyebrows, eyelashes and eyelids
up and down. Area lacrimal conjunctiva
bulbi. Must be able to fold eyelid to assess
the conjunctiva tarsalis.

C. CHECKING THE EYE ORGAN

SYSTEMATICALLY.
Can wear magnifying glasses and flashlights.
a. Shine the corneal
Look a corneal reflex that light reflexes on the cornea surface in the form of light spots.
1) A bright / shiny:
a) the cornea clear
b) b) scar tissue (white)
2) Gloomy: corneal erosion, inflammation of the cornea or
corneal edema Note reflexes of light on the second surface of the cornea (Test Hirschberg)
a) each in the middle of the pupil: ortofori
b) b) one not the middle of the pupil: heterofori
(squint)

2.EYE OPTICAL SYSTEM

Iris good has a basin - basin radier (kripti).
To know a COA clarity, look at kripti iris .
1. Kripti iris obvious: clear
2. Kripti iris is not clear: cloudy
Depth COA: slices illuminated from the side, and then look the iris
surface area that gets radiation.
1. A small portion gets the iris surface:
shallow COA
2. All / most of the surface of the iris tersinari: COA
in

CAMERA OCULI ANTERIOR (COA)

AND IRIS
THE NORMAL EYE :
- CILIA NORMAL
POSITION
- QUIET
CONJUNCTIVA
- CORNEA IS CLEAR
- NORMAL IRIS
REFLEXES
Look the round pupils regularly.
The pupils were not round / irregular can
result iris adhesions to the lens / cornea
(sinekkia).
Direct pupillary reactions: smaller pupil of
the eye illuminated by indirect pupillary
reactions: pupils shrink upon irradiation
eye next to it

C. PUPIL
Indicate the size of the pupil in mm.
1. Isokor both pupils equal
2. anisokor not as great.
3. Large normal pupils of 3-5 mm.
<2mm called meiosis,> 5mm: mydriasis.
Figure pupil when the pupil is not in place or malformed.
IRIS AND PUPIL
NORMAL
IRIS
OVERVIEW KRIPTI
CLEAR
PUPILS
CONCENTRIC
SPHERICAL
 Examination cataracts.
1. Shine the pupil from the front. look the color of the pupil.
a.pupil black :
- clear lens
- Aphakia
b.pupil white / gray: cloudy / cataract
2. Change the light from the side (approximately 45%), and
D. LENS illuminated iris. Back view of the pupil.
Notice the change in lens opacities:
a. the entire pupil remain white cataract matura
(tests shadow / shadow -)
b. most pupils to black cataract immatura
(tests shadow +)

D. FUNDUSCOPY
should be done in a relatively dark room.
When the right eye to be examined, the examiner standing on the right patient, the
ophthalmoscope is held with the right hand, the examination of the right eye. When the
left eye to be examined, the examination of the left with the left eye.
1. First consider the reflex fundus through an ophthalmoscope seen through the pupil
at a distance of inspection: 30 cm.
When the clear refractive media: yellowish red fundus reflex in the whole circle of the
pupil.
When the refraction turbid media (cornea, lens, glass body)
visible presence of black spots in front of background.
the red-yellow Rate fundus reflex is important to distinguish cataract matura and
immatura. Cataracts mutura reflex.
negative fundus
Furthermore, to see the retina and pupil N II, the ophthalmoscope approximated as
close as possible to the patient's eye.
HOW FUNDUSCOPY
OPHTHALMOSCOP
examiner and patients face approximately 60 cm.

When the left eye to be examined, the patient's right eye closed.

The patient's left eye face / sighted with the right eye of the examiner.
Gestures / objects from all directions, from outside to inside. if there are
parts of the visual field, which is still seen by the examiner, but not by
the patient.
Repeat the same way on the right eye.

E. EXAMINATION OF THE VISUAL FIELD WITH

CONFRONTATION TEST
F. SCHIOTZ TONOMETRY
Measuring intra-ocular pressure.
The examination was conducted in patients lying supine or semi-sitting. In order for
the cornea horizontal position, keep your chin and forehead of the patient lies in a
horizontal plane.
Drop Both eyes topical anesthetic. Tonometer calibrated at test block when
both, the needle indicates zero on the scale and "plunger" can move freely in the
cylinder.
On first inspection have the smallest load of 5.5 gr. Then the "foot plate" in the
disinfection with an alcohol swab to wipe it by 70%. Both eyes were fixed by
looking straight up. When the right eye to be measured, the examiner standing
on the left or behind the patient. Similarly, for the right eye.
 Tonometer held vertically while straight over the
cornea patient after patient eyelids open with fingers
to taste the other examiner without pressing the
eyeball.
Once the patient's eyes to adjust, tonometer lowered
slowly until the "foot plate" thrown down in the middle
of the cylinder. Figures designated scale needle at
the time, remembered and recorded and removed
from corneal tonometer. When the designated
number less than the number 3, tonometer is
repeated with a load of 7.5 g. Might also need to use
load 10 gr.
 Thenext intra-ocular pressure value on
the calibration table. Examples noted
the results: ....... date, hour .......
TOD (right eye) 8/75 = 15.6 mmHg TOS
(left eye) 9/25 = 13.1 mmHg (normal IOP
values 10-21 mmHg) Prior to tonometry,
it is believed there are no contra
indications tonometry, do good
communication with the patient to
remain calm during the examination.
Contra indications generally is an eye
infection.
1. Examination anel: inject saline fluid
through the lacrimal punctum with a blunt needle bent.
2. If the liquid gets into the nose / throat called Anel +. Lacrimal duct
means functioning well. If it does not mean there is a blockage of the
lacrimal duct (Anel -).
3. Examination of books using the Ishihara color blindness.
Defined total or partial color blindness.
4. Examination of hemoglobin and blood sugar checks need to be in
cataract surgery in addition to assessing the patient's general
condition.

G. ADDITIONAL EXAMINATION
syringe with normal saline
Needles anel through the
punctum lacrimal inserted into the
sac lacrimal
Liquid disempritkan into the sac
lacrimal
If you enter the nose, test +

ANEL TEST
 Viewing defect
epithelium - Examination
tonometer - View the
fistula corneal
After
drops pantocain
paper
fluoresceintaped to the
inferior fornix of the
conjunctiva in the area

FLUORESCEIN TEST
ISHIHARA
EVERSION OF EYELID
FLUORESIN TEST