1. The document provides an ophthalmic checklist for eye examinations, including steps to take a patient's history and conduct various visual tests and examinations. 2. The recommended history questions focus on presenting complaint, duration of symptoms, medical history, eye history, and trauma history. 3. Key visual tests and exams specified in the checklist include vision and pinhole vision, pupil response, visual fields confrontation, and eye movement assessment, which are aimed to be completed within 2 minutes and 45 seconds.

1. Office Eyes Checks !
Ian Francis

2. The Brief!

3. Skin cancer: another reason to
stop smoking

4. Equipment needed….

5. Ophthalmic Checklist
Modified from Anon NZ
History
Presenting complaint (# 1) … needs 60 seconds
• Duration
• Previous medical history
• Previous eye history
• History of trauma
Examination: surface problems including face
• Vision and pinhole vision (# 2) …needs 45 seconds
• Redness and/or discharge
• Fluorescein staining
For patients with abnormal vision!
• Pupils: size, reaction to light, Relative Afferent Pupil Defect (# 3) …needs 20 seconds
• ‘Afferent pupillary defect’ – does not exist!
• Visual fields to confrontation (# 4) …needs 20 seconds
• Eye movements: Cover test distance, ocular rotations (H pattern) (# 5) … needs 20 seconds
• Amsler grid
• Digital eye pressure
• Ophthalmoscopy: disc/vessels/macula: Just forget it!
TOTAL TIME FOR # 1-5 : 2 mins 45 seconds

6. History
• Presenting complaint
• Duration of symptoms
• Previous medical history
• Previous eye history
• History of trauma

7. All Ophthalmology (apart from cataract
surgery !) may be Neuro-ophthalmology

8. History Taking
• Photopsiae driving home from the NOWR at Prince of
Wales Hospital…..
It isn’t always Neurological!!

9. Taking a
temporal
arteritis history
Courtesy of Dr Shahriar Amjadi

10. Temporal arteritis

11. Temporal Arteritis
Pale, swollen left optic nerve

12. Examination: surface problems
including face
• Vision and pinhole vision
• Redness and/or discharge
• Fluorescein staining

13. For patients with abnormal vision !!
• Pupils: size, reaction to light, Relative Afferent Pupil
Defect
• NB: ‘Afferent pupillary defect’ – does not exist!

14. For patients with abnormal vision
(continued)
Visual fields to confrontation

15. Bitemporal hemianopia ……

16. Confrontation fields reflecting field loss
resulting from
Afferent Visual Pathway
Compression by the Internal Carotid
(AVCIC)

17. Afferent Visual Pathway
Compression by the Internal Carotid
(AVCIC)  RAPD

18. AVCIC RAPD

19. • Eye movements: Cover test distance,
ocular rotations (H pattern)
• Amsler grid
• Digital eye pressure
• Ophthalmoscopy: disc/vessels/macula:
For patients with abnormal vision
(continued)
Just forget Ophthalmoscopy!

20. Summary
1. Presenting complaint
2. Vision and pinhole vision
3. Pupils: size, reaction to light, Relative
Afferent Pupil Defect
4. Visual fields to confrontation
5. Eye movements: Cover test distance,
ocular rotations (H pattern)
THIS TAKES JUST 2 minutes 45 seconds….