Eye Screening technique in community

1. 1
Clinical techniques
Prepared & Presented By :-
Ram Karan Tripathi
Sadguru Netra Chikisalaya
Chitrakoot

2. 2
Contents
1. Visual acuity
2. Inspection
3. Diabetic retinopathy
4. Hypertensive retinopathy
5. Glaucoma

3. 3
Vision
• Dimness of vision
• Mode of onset
• Sudden loss
• Duration
• For distance or near
• Double vision
• Pain in eye
• Redness, Congestion
• Secretion

4. 4
History
• Past history
• Personal history
• Family history
• Medical history

5. 5
Screening of the eye (Inspection)
1. Head
– Paralysis of extraocular muscles and ptosis
2. Face
– Facial paralysis
– Skin infection
– Herpes
3. Eye brow
– Loss of hair
– Leprosy

6. 6
Screening of the eye (Inspection)
4. Orbits
– Exophthalmos
– Endophthalmos
– Orbital cellutis
5. Eye ball
– Position and direction
– Movement
– Shape and size
6. Eye lids
– Position ,Palpebral aperture
– Movement,Margins
– Lashes

7. 7
Screening of the eye (Inspection)
7. Lacrimal sac
– Swelling and redness (mucocele)
– Regurgitation test
– Fistula
8. Conjunctiva
– Congestion
– Follicles
– Papillae
– PTR
9. Cornea
– Micro and magalo, Karatitis and opecity

8. 8
Screening of the eye (Inspection)
10. Anterior chamber
– Shallow (Angle closer)
– Deep AC ( Buphthalmos and chronic iridocyclitis)
– Iregular (Subluxated)
– Cloudy aqueous (Acute iridocyclitis)
– Pus (Hypopyon and corneal ulcer)
– Blood (Hyphaema)
11. Iris
– Muddy (Iritis)
– White atrophic patches(Glaucoma)
– Synechia and colour (Heterochromia)

9. 9
Screening of the eye (Inspection)
12. Pupil
– Size 2 to 4 mm
– Anisocoria
– Miosis and mydriasis

10. 10
Pupillary reaction
- Direct light reflex
- Indirect light reflex

11. 11
Screening of the eye (Inspection)
11. Lens
Color
Jet-black – Normal
Gray – Immature cataract
White – Mature cataract
Brown and black nuclear or mogagnian
Position – Dislocation or Subluxation

12. 12
Diabetic Retinopathy
• Duration of diabetes
• Heredity

13. 13
Hypertensive Retinopathy
• Severity and hypertension – Vascular changes
• Duration hypertension – Retinopathy
• In young – Narrowing of retinal arterioles
• In aged – Involutional sclerosis
• Features
– Grade 0 –Normal
– Grade 1 – Narrowing arteries
– Grade 2 – Copper wire reflex
– Grade 3 – silver wire reflex, retinal edema
– Grade 4 – macular star, hard exudates

14. 14
Glaucoma
Open angle glaucoma
symptoms
– painless
– Mild headache
– Defect of visual field
– Difficulty in near work
– Dark adaptation is slowed
sign
– Visual acuity decreases slowly
– Normal AC depth
– Normal pupillary reaction

15. 15
Glaucoma
close angle glaucoma
– Small and hypermetropic eye
– Anatomical narrow angle
– Shallow anterior chamber
– Iris pushed forward
Symptoms & sign
– Severe unilateral headache, nausea, headache, vomiting
– Redness, lacrimation, photophobia due to corneal edema
– Cloudy cornea, AC shallow, Iris pattern is lost
– Pupil is moderately dilate, vertically dilated
– Hazy media, raised IOP

16. 16
Glaucoma
- Confrontation method
- Digital tension

17. 17
Thank You