Basic of Ophthalmology Examinations
Basic of Ophthalmology Examinations
Basic of Ophthalmology Examinations
Ophthalmology examinations
1. General eye examinations :
Anamnesis Physical of eye exam Visual function evaluation
ANAMNESIS
Purpose : to pursue the eye diseases history two methods: :
Autoanamnesis (directly to the patients Cooperative) Alloanamnesis (Family of the patients non cooperative)
The collected informations : : 1. General : Identites (name, age, gender, address, job, and so on) 2. Specifics : a. Chief of complain : blurred of vision, dyplopia, pain,irritatif, red eye, trauma b. Other of clinical signs link to the main complain : onset, progressitivity, duration, reversibility, lacrimation, disturbance of eye motility, histrory of trauma, glasses, systemic diseases (DM, HT), and so on
1. Inspection
No equipment Examiner directly observe the eye (good illumination room) The evaluated structures :
Eyelid : supercilia, cilia, skin, fissura, plica, canthus, conjunctiva (eyelid eversion) comparing the right and left eyes Anterior segment of the eye : 1.Conjunctiva: injeksio, redness,chemosis,bleeding, laseration, foreign bodies.
Sclera : color, thickness, or trauma Cornea : diameter, curvature, intact (trauma). Anterior chamber : contents, deep or shallow. Iris : color, vasculature, crypte Pupil : Form, position, color, margin, number Lens : transparancy, position (trauma) Eye movements
2. Oblique Illumination
Equipments : pen light Technique ? : What are the visible structures : more detail than inspection ?
Oblique illuminations
The evaluated structures : 1. Eye lid : (= inspection) 2. Anterior segment : clearer the inspection
a. Cornea : cikatriks nebula, small foreign body, blood stain b. Iris : kripte, sinekia c. Anterior chamber : contents (hyphema, hypopion) d. Pupil : direct/ indirect pupil reflex, regularitasity pupil margin e. Lens : iris shadow & pseudo iris shadow
Myosis
Mydriasis
Anatomy
Physiology
Pen light evaluate : : Hirschberg test (strabismus) Light perception test (visus = 1/) Light projection test (retinal function)
3. Palpation
No equpments, only the finger 1. Tumor mass 2. Palpable of pre auriculer gland 3. Pain pressure (iridocyclitis/uveitis) 4. Finger tension (high of IOP)
Results : 5 category :
Tn .. Normal IOP Tn 1 Low of IOP Tn 2 . ..Very low of IOP Tn + 1. High of IOP Tn + 2. Very high of IOP
Tonometri
Tonometer Schiotz Tehnique : CSL of Special Sense system !
Hasil Pemeriksaan
Ditulis dalam bentuk 2 angka Angka pecahan (tanpa satuan) : sebagai pembilang adalah skala dan beban sebagai penyebut. Angka desimal : dapat diperoleh pada tabel yang ada pada tonometer dengan cara menarik garis hayal horisontal.
= 60 0 = 90 0 = 70 0 = 50 0
VF defects contribute to :
a. Diseases dignosis b. Locations of lesions in retina, visual cortex area in the brain
Examination tests : 1. Confrontaion test (CSL special sense) 2. Amsler grid 3. Perimetri (Goldman VF testing 4. Tangent Screen (campimeter)
7. Visual evaluations
Visual Acuity: the ability of the eye to percept the detail and clear objects. Classification : based on reading distance : 1. Distance visual test : reading distance > 20 feet (5 meter) 2. Intermediate visual test 3. Near visual test : reading distance (1/3 meter)
Distance visual testing Sinonim : Central visual testing Equipments: 1. Reading chart a. Snellen chart (alphabet or numbering) b. E chart (E) c. Allen chart (easy picture) 2. Reading distance 5 or 6 meter 3.Optimal room illumination
Technique ? CSL
Reading-object shifting :
1. Counting Finger (CF) ; reading value : 60 2. Hand movement/hand motion (HM) ; .reading value 300 3. Light perception (LP) ; ..reading value (unlimited value)
4. No light perception : visus = 0
Visual testing results : - 5/40, 1/60, 1/300 and so on - 1,0 ; 0,5 ; 0,1
Ex: VOD : 1/60 = Visual acuity of the right eye is the ability of patient to only see object at 1 meter while the normal individual can see in 60 meter.
8. Refraction test
To indentify the refraction errors : Myopia, Hyperopia, astigmatism Eq. : Snellen Chart & Trial Lenses Therapy : glasses, contact lens, LASIK
RETINA
Ophthalmology scopes :
1. 2. 3. 4. 5. 6. 7. 8. 9. REFRACTION LENS AND CATARACT VITREO-RETINA EXTERNAL EYE DISEASES (EED) TUMOR OF THE EYE TRAUMA DAN RECONSTRUCTION PEDIATRIC AND STRABISMUS NEUROOPHTHALMOLOGY SOCIAL OPHTHALMOLOGI
RED EYE
RED EYE WITH IMPAIR/DECREASE OF VISUAL ACUITY Ex. : Uveitis, Keratitis, acute glaucoma, trauma
RED EYE WITH NORMAL VISUAL ACUITY Ex. : conjunctivitis, Episcleritis, Pterygium
BLINDNESS
SUDDEN BLINDNESS (SUDDEN VISUAL
LOSS)
Ex. : Retinal detachment, neuritis, vitreous bleeding CHRONIC VISUAL LOSS Ex. : cataract, non acute glaucoma, retinitis pigmentosa refraction errors (=myopia, hyperopia, astigmatism)
TRAUMA
PERFORANS TRAUMA NON- PERFORANS TRAUMA (BLUNT TRAUMA) CHEMICAL TRAUMA (ACID OR ALKALI FOREIGN BODIES OF THE EYE BALL