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Sr. Lucilla CB
STIK Sint Carolus
Jl. Salemba Raya no 41
The Eye Exam
A Snellen Eye Chart or Pocket Vision
Observation of External Structures:
Normal Appearing Conjunctival
Reflection, Lower Lid
Pale Conjunctiva, due to severe
Subconjunctival Hemorrhage
Patient unable to completely close left upper eyelid due to
peripheral CN 7 dysfunction .
Icteric Sclera
Muddy Brown Sclera
Testing Extra Occular Movements
CNs and the Muscles That Control
Extra Occular Movements
Patient with non-functional left 6th cranial
nerve. He cannot move left eye all the
way to the left.
Right CN3 Lesion:
Entrapment of Left Inferior Rectus
Eye Cross Section
(Picture Courtesy of Ray Kelly)
Retina--Right Eye
(Picture Courtesy of Ray Kelly)
• Observe the patient for ptosis, exophthalmos, lesions,
deformities, or asymmetry.
• Ask the patient to look up and pull down both lower
eyelids to inspect the conjuntiva and sclera.
• Next spread each eye open with your thumb and index
finger. Ask the patient to look to each side and
downward to expose the entire bulbar surface.
• Note any discoloration, redness, discharge, or lesions.
Note any deformity of the iris or lesion cornea.
• If you suspect the patient has conjuntivitis, be sure to
wash your hands immediately. Viral conjuntivitis is
highly contagious - protect yourself!
Pupillary Reactions
• Dim the room lights as necessary.
• Ask the patient to look into the distance.
• Shine a bright light obliquely into each pupil in
• Look for both the direct (same eye) and
consensual (other eye) reactions.
• Record pupil size in mm and any asymmetry or
• If the pupillary reactions to light are
diminished or absent, check the reaction to
accommodation (near reaction):
• Hold your finger about 10 cm from the
patient's nose.
• Ask them to alternate looking into the
distance and at your finger.
• Observe the pupillary response in each eye.
Pemeriksaa Thyroid
Pemeriksaa Kelenjar
Otoscopic Examination
Weber Test
Rinne Test
Alcohol Pad Smell Test
Evaluation of Frontal and Maxillary
Left Peritonsilar Abscess. Note
deviation of uvula towards right.
Tooth Abscess: Tooth abscess involving left molar region.
Associated inflammation of left face can clearly be seen.
Left CN 12 Dysfunction: Stroke has resulted in L CN 12 Palsy.
Tongue therefore deviates to the left.
Right parotid mass.
Note enlargement on right compared with left.
Location of the Thyroid
Thyroid Examination