Eye Examination

Aka: Eye Examination, Eye Exam, Preventive Eye Examination, Preventive Eye Exam, Eye Vital Signs, Five Vital Signs of the Eye

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II. Indications: Acute Complaints

  1. Eye Injury
  2. Eye Pain
  3. Acute Red Eye
  4. Acute Vision Loss
  5. Eye Discharge
  6. Double Vision
  7. Light Flashes or Floaters

III. Indications: Routine Eye Exams

  1. Black patients (higher risk of Glaucoma)
    1. Age 20 to 40: Baseline exam at age 20 years and then every 2-4 years
    2. Age 40 to 54: Every 1-3 years
    3. Age 55 to 64: Every 1-2 years
  2. White patients
    1. Age 40 to 54: Every 2-4 years
    2. Age 55 to 64: Every 1-3 years
    3. Age over 65: Every 1-2 years

IV. Anatomy: Images

  1. EyePupillaryReactionNeuroPath.png
  2. EyePupillaryReaction.png
  3. eye_eom.png

V. Exam: Basic (primary care and emergency department) - Five Vital Signs of the Eye

  1. Visual Acuity
  2. Visual Field testing
  3. Pupilary light reflex and pupil size (Mydriasis, Miosis)
  4. Eye Neurologic Exam (including Extraocular Movements)
  5. Intraocular Pressure

VI. Exam: Comprehensive Eye Exam (Ophthalmology)

  1. Indications (see routine Eye Exam schedule above)
  2. Visual Acuity
  3. Dilated Eye Exam with Retinal Exam
  4. Tonometry
  5. Visual Field Testing

VII. Exam: Tools

  1. See Emergency Eye Kit
  2. Funduscopic Exam (Retinal Exam)
    1. Strongly consider Mydriatic use in acute presentations where Retinal Exam is key (if not contraindicated)
    2. See Funduscopic Exam
    3. Retinal Artery Occlusion
    4. Retinal Detachment
    5. Papilledema
  3. Tonometry (e.g. Tonopen or Applanation Tonometry)
    1. Glaucoma
  4. Slit Lamp
    1. Corneal Abrasion or other injury
    2. Foreign body
  5. Globe Ultrasound
    1. Evaluate for Retinal Detachment
    2. Evaluate for Increased Intracranial Pressure

VIII. Exam: Eye Injury

  1. See Eye Injury in Sports
  2. See Work-Related Eye Injury
  3. See Blunt Eye Trauma
  4. Apply topical Anesthesia (e.g. topical tetracaine)
  5. Fluorescein
    1. Corneal Abrasion
    2. Corneal Laceration
    3. Globe Rupture
  6. Eye Acidity Test
    1. Eye Chemical Burn
  7. Upper Eyelid Eversion (and lower Eyelid Eversion)
    1. Eye Foreign Body

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