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Visual Acuity
- Use proper technique with Rosenbaum Card
- Use proper technique with Snellen Eye Chart
Inspection of External Eye
- Observe for ptosis, exophthalmia, lesions, deformity, or asymmetry
- Inspect conjunctiva and sclera
- Ask patient to look up, down, left, and right while inspecting bulbar surface
- Wash hands before and after this portion of the exam
Visual Field
- Position and instruct patient
- Screen by confrontation, 4 quadrants, and neglect
Extra Ocular Movements
- Position self and patient
- Instruct patient
- Demonstrate 6 sided cross or "H" pattern
- Check convergence
Corneal Reflections
- Check corneal reflections with penlight
Pupillary Reaction
- Approach from temporal angle
- Test bilaterally
- Check for direct and consensual responses
- Accommodation response
Standard Ophthalmoscope
- Adjust aperture, diopter, and light intensity
- Dim room light
- Use right hand/right eye/index finger technique
- Instruct patient to fixate on a point and elicits a red reflex
- Follow inward thru the pupil to locate optic disc and allows time to focus
PanOptic Ophthalmoscope
- Focus instrument by observing object across the room (10 feet away)
- Adjust rheostat to maximum light intensity
- Follow red reflex into pupil until eye cup contacts brow
- Compress eye cup halfway to maximize view
- Adjust focus as necessary
- Repeat bilaterally
Corneal Reflex
- Use a cotton tip applicator
- Gently and lightly contact the cornea and observe patient's reflex
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