Aim Principle Apparatus Procedure Precaution

1. CLINICAL
EXAMINATION OF EYES
PANDIAN
DEPT OF PHYSIOLOGY
DYPMCKOP

2. SLO
• SYMPTOMS
• MATERIAL
• EXAMINATION
• INSPECTION
• OBSERVATIONS
• EXAMINATION OF DIFFERENT PARTS
• PALPATION

3. University of Jordan 3

4. University of Jordan 4

6. SYMPTOMS
•Difficulty in seeing or reading, headache, pain in
or around eyes, redness of eyes, any discharge
from the eyes, etc.

8. •MATERIAL
•Pentorch
•EXAMINATION :
•Subject must be seated in good light.
•Examine both eyes systematically and
separately.

9. INSPECTION
1. Any obvious abnormality : note for ptosis,
exophthalmos, nystagmus or abnormal position
of head & squint.

10. OBSERVATIONS
Inspection
1. Observe for ptosis, exophthalmos, nystagmus,
squint.
Name, Age, Sex, Date & Time.

11. Ptosis
Exophthalmos

15. Squint

16. 2. EXAMINATION OF DIFFERENT
PARTS :
i) eyelids : see thickness, colour and position, size
of the palpebral fissure and condition of margins.

17. EYELIDS
A. Rate of blinking ---
B. Gap between upper eyelid and cornea : present / absent
C. Margin : thickening / swelling / discharge / normal
D. Eyelashes : direction / loss
E. Palpebral fissure : wide / narrow / medium
Compare the two eyes : equal / unequal

20. ii) eyelashes : see condition and direction of the
eyelashes,

22. Palpebral fissure

23. 3. LACRIMAL APPARATUS
A. Can a part of it be located by inspection or
palpation?
B. Punctum : discharge : nil / watery / pus
Lacrimal sac : it is situated at the medial angle of the eye. See
whether there is any swelling in the region. See position and
size of lacrimal puncta.

24. Normal
eye

27. • iv) Conjunctiva : bulbar portion is easily seen.
• To expose the palpebral conjunctiva of lower eyelid, place the
thumb near the margin of the eyelid and press downwards while the
subject looks upwards.
• The palpebral conjunctiva of upper eyelid is exposed by everting it
with the hand while the subject looks downwards.
• Examine both conjunctiva for colour and look for haemorrhagic
spots.
• Also look for shininess, discharge, abnormal vascularity, any
foreign bodies etc.

28. CONJUNCTIVA
A. Palpebral. Angry red / highly vascular / pale/smooth
and pink.
Discharge : present / absent
B. Bulbar conjunctiva : vascular / smooth and shiny.
Folds of conjunctiva (pterygium): present / absent
discharge : present / absent

30. Discharge

31. Bulbar conjunctiva : vascular / smooth and shiny.

32. pterygium
Normal eye

33. v) Cornea : see for abrasion, ulceration,
vascularization, opacities or foreign bodies.
•The corneal reflection derived from the window bars
gives information about its curvature and smoothness.

34. Cornea
A. Window bar reflection : smooth / distorted
B. Opacity : absent / present
If present, its size, shape situation
C. Vascularization : reaching upto cornea / falling short of
cornea.

35. N

36. Opacity

37. VASCULARIZATION
Normal

39. 6. SCLERA
A. Colour: bluish, white, muddy, any other description
B. Haemorrhagic spots : present / absent
sclera : note the colour and look for haemorrhagic spots.

41. Bluish
Muddy

42. Haemorrhagic spots

43. vii) Anterior chamber: See the depth. Look for any
deposits in it and presence of pus, blood etc.
•Normal / shallow / deep
•Pus or blood : present / absent

45. Pus or blood : present / absent

46. 8. IRIS
Colour of pigments :
•Exudation : present / absent
•Adhesions : present / absent
viii) Iris : See colour, smoothness and
thickness. See if it is steady or tremulous.

47. Pigments in Iris

48. Exudation (Hypopyon) Adhesions (iris and lens)

50. 9. PUPILS
•Fixed / oscillatory (hippus).
•Shape : regular / irregular / oval
•(Reaction to the light will be studied under visual
reflexes).
ix) pupil : pupil is noted with regards to size, shape
and position, and also its reaction to light,

52. Hippus (athetosis)

55. 10. LENS
• Present / absent. If present: transparent / translucent / opaque.
x) lens : only central part of the anterior surface is seen. See it for Its
transparency,

56. 11. FUNDUS
• THIS IS EXAMINED BY OPHTHALMOSCOPE.
Normal Retina
xi) fundus : it is to be seen with ophthalmoscope.

57. PALPATION
•Eyeball tension : to ascertain it, direct the subject to
look downward.
•Palpate the eyeball gently by means of the two index
fingers placed upon the upper eyelid,
•The middle finger being supported on the patient's
forehead. Examine the other eye as well.

58. PALPATION
• Eye ball tension : normal / increased / decreased
compare
• The two eyes compare with your own

60. REFERENCE
•HUTCHINSON’S CLINICAL METHODS
•A.K. JAIN, C.L. GHAI, G.K. PAL
•GOOGLE IMAGE FOR PICTURES
•NET SOURCE

61. THANK YOU