This document discusses various tests and examinations performed during an eye exam, including visual acuity testing, visual field testing, pupillary reactions testing, and ophthalmoscopy. It then provides details on specific eye conditions that may be identified during an exam, such as papilledema, optic neuritis, glaucoma, and cranial nerve palsies. Throughout, it emphasizes the importance of thoroughly testing visual acuity and visual fields and examining all cranial nerves if any abnormality is detected.

2.  To measure the Visual Acuity
 To Examine Pupillary Reactions
 To test the functions of Extra Ocular
muscles
 To Evaluate the Visual Fields
 To Inspect the optic nerve head

3.  Identifying life threatening or vision
threatening neurological disorders
 Other systemic diseases

4.  Visual Acuity testing
 Visual Field testing
 Pupillary Reactions
 Ocular-motility testing
 Opthalmoscopy

5.  One’s visual acuity is an
indication of the clarity or
clearness of one’s vision
 Word “acuity” is derived from
Latin acuitas, which means
sharpness.
 Snellen’s Chart

6.  Visual field defects affect Central Vision
 Gross confrontation field testing.
 Amsler grid test

7.  Swinging flash light test
 Dysfunction of Sympathetic
& Parasympathetic System.
 Optic nerve dysfunction

12.  To examine the occular
fundus

14. Aneurysm compressing upon
CN3
Temporal lobe Herniation compressing
CN3

16. Argyll Robertson Pupil

18.  Causes: Cerebral Aneurysms, Vaso-
occlusive disease, HTN, DM, Trauma
& Brain tumors

19.  Cause: Close head trauma, Small vessel
dieases, HTN, DM
 Vertical Diplopia
 Downward gaze difficulty
 Tilting of head

20.  Cause: Head Trauma,
Small vessel disease,
Viral infection, Increase in
ICP
 Loss of abduction
 Horizontal diplopia
 Greatest separation of
gaze towards the affected
side

21.  CN V
 CN VII
 CN VIII

22.  Autoimmune condition
 Interefering Neuromuscular transmission
 Edrophonium Chloride/ Tencsilon test
 Ptosis
 Diplopia
 Fatigue
 3rd, 4th, 6th nerve diseases
 Gaze paresis
 Internuclear opthalmoplegia

23.  Lesion of medial longitudinal fasiculus
 Cause:
Small vessel disease Old age
Demyelinating dieases Adults
Pontine Glioma Children

25.  Spontaneous, Rhythmic back and forth
movement of one or both eyes
 Horizontal, Vertical, Rotatory &
Combination
 Indicates Central Nervous system
dysfunction, Multiple sclerosis, Brain
Tumor, Degenration of CNS

28.  Referred as
Pseudopapilledema
 Blurring of disc margin
 Elevated disc substance
 Absence of optic cup
 Spontaneous venous pulsation
 Associated with Hyperopia
 Optic disc drusen

29.  Swelling of optic disc
secondary to increased
ICP
 Causes: Intracranial pressure, Brain tumor
(50%), Pseudotumor cerebri, Severe HTN
 Bilateral & Good central vision
 Characterisitics: Hyperemia of disc,
Tortous vessels, Blurring & Elevation of the
margins, Hemorrhages

30.  Inflammatory edema
of the disc
 Opthalmoscopically
indistinguishable to Papilledema
 Unilateral, Decreases visual acuity,
impaired color vision

31.  Pale, Swollen disc,
Splinter Hemorrhages
 Loss of Acuity &
Visual Field(Altitudinal)
 Predominantly involve Superior &
Inferior field

32.  Transient monocular
visual loss
 Cause: Arterial
Insufficiency

33.  Pallor of the optic disc
 Causes: Previous optic neuritis, long
standing papilledema, Compression by
mass lesion, Small vessel disease, Giant
cell Arthritis, Glaucoma
 Disc appears white
 Decrease Visual Acuity & Visual field loss

34.  Scotoma
 Hemianopia
 Homonymous Hemianopia
 Bitemporal Hemianopia

35.  Testing of both visual acuity & visual field is critical in the
evaluation of abnormal optic disc
 A patient with a unilateral optic nerve lesion should have
equal pupils in ambient light but a positive swinging flash light
test
 Blurred disc margin isn’t diagnostic for pailledema, other sign
n symptoms must be considered
 Chiasmal diseases most likely to cause bitemporal field
defects
 If one of the following is abnormal-pupil, lid position or ocular
motility- look closely for the involvement of the others
 CN V & CN VII should be checked if ocular motility is
abnormal & Cranial nerve palsy is suspected
 Slowly progressive visual loss or CN palsy should prompt
consideration of compressive lesions such as Tumor &
Aneurysms