EXAMINATION

Ask patient to sit or stand.

TECHNIQUE	FINDINGS
VISUAL TESTING
Measure visual acuity in each eye separately
Distance vision Use Snellen chart, Landolt C or HOTV chart. If testing with and without corrective lenses, test without lenses first and record readings separately.	EXPECTED:Vision 20/20 with or without lenses with near and far vision in each eye.
	UNEXPECTED:Myopia, amblyopia, or presbyopia.
Near vision Use near-vision card.	EXPECTED:Vision 20/20.
Near vision Use near-vision card.	UNEXPECTED:Fields of vision more limited than temporally, 50 degrees superiorly, 70 degrees inferiorly.
Peripheral vision Test nasal, temporal, superior, inferior fields by moving your finger into field from outside.

EXTERNAL EXAMINATION
Inspect eyebrows
Size/extension	EXPECTED:Unusually thin if plucked.
Size/extension	UNEXPECTED:End short of temporal canthus.
Hair texture	UNEXPECTED:Coarse.
Inspect orbital area
	UNEXPECTED:Edema, puffiness not related to aging, or sagging tissue below orbit. Xanthelasma.
Inspect eyelids
Eyelid position	UNEXPECTED:Ectropion or entropion.
Ability to open wide and close completely Examine with eyes lightly closed, closed tightly, open wide.	EXPECTED:Superior eyelid covering a portion of iris when open.
	UNEXPECTED: Fasciculations when lightly closed. Ptosis. Lagophthalmos.
Eyelid margin	UNEXPECTED:Flakiness, redness, or swelling. Hordeola.
Eyelashes	EXPECTED:Present on both lids. Turned outward.
Palpate eyelids
	UNEXPECTED:Nodules.
Palpate eye
	EXPECTED:Can be gently pushed into orbit without discomfort.
	UNEXPECTED:Firm and resists palpation.
Pull down lower lids and inspect conjunctivae and sclerae
Color Inspect upper tarsal conjunctivae only if presence of foreign body is suspected.	EXPECTED:Conjunctivae clear and inapparent. Sclerae white and visible above irides only when eyelids are wide open.
	UNEXPECTED:Conjunctivae with erythema. Sclerae yellow or green. Sclerae with dark, rust-colored pigment anterior to insertion of medial rectus muscle.
Condition	UNEXPECTED:Exudate. Pterygium. Corneal arcus senilis or opacities.
Inspect lacrimal gland region
Lacrimal gland puncta Palpate lower orbital rim near inner canthus. If temporal aspect of upper lid feels full, evert lid and inspect gland. Only gold members can continue reading. Log In or Register to continue Share this: Click to share on Twitter (Opens in new window) Click to share on Facebook (Opens in new window) Like this: Like Loading... Related Related posts: The Healthy Female Evaluation Reporting and Recording Lymphatic System Abdomen Stay updated, free articles. Join our Telegram channel Tags: Mosby's Physical Examination Handbook Mar 25, 2017 \| Posted by admin in PHYSIOLOGY \| Comments Off on Eyes Full access? Get Clinical Tree Get Clinical Tree app for offline access Get Clinical Tree app for offline access