THE EYE EXAM

  • Keep it basic…
    • APD
    • Intra-ocular Pressures: Tono-pen v Applanator (Goldmann)
    • Visual Acuity
  • or be a Slit Lamp KWEEN
    • Move outside in: Lids → Eyeball
    • Lids: ducts, eyelashes, orbital lesions or findings
    • EYE: Full EOM assessment and conjunctival assessment
      • Anterior:
        • Cornea for opacity, irregularities, fluericin staining for abrasions/ulcerations.
        • Anterior chamber assessment for “cell and flare” or hypopyon.
        • Lens for opacities.
        • Assess for extrusion of IOC contents.
      • Posterior: the dilated exam. Save that for your optho friends — but Ocular US for optic nerve measurements is a neat trick that we can do.
        • Visualize the posterior eye indirectly to assess for retinal detachment vs vitreous hemorrhage
        • Visualize & measure the optic nerve (3mm deep, with 5mm as your upper limit of normal)
    • Applanation for pressure (Goldmann is the GOLD standard…hehehe)
      • Here’s a quick readable how-to: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2206330/
      • And these are youtube demonstrations:
        • https://www.youtube.com/watch?v=mS2HvAN4Uzg
        • https://www.youtube.com/watch?v=0b2Mv54mQcs (start at 07:48)
March 2024
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