Complaint ( focus on the cause which brought the patient to you ) History of present illness

Duration Onset Acute Gradual

 Course Progressive tationary !egressive

Past history

ystemic diseases
Diabetes mellitus Hypertension others

"rauma

#amily history

History of drugs !$%$%&$! "HA" '$GA"()$ H( "O!* ( A (%PO!"A'" A PO ("()$ H( "O!*

)ision
!ight eye ( OD ) +eft eye ( O ) ,ncorrected ( C ) "hen Corrected ( CC )

,se $ Chart ,se C Chart Distance forms - minute of arc for the ./. line at the nodal point
At . meters ( Conventional light bo0 ) At less with vision chart pro1ectors

Position
'ormal upper eyelid covers the upper 2 mm of

the limbus3 'ormal lower lid touches the limbus3

Abnormal positions of the eyelids

Drooped upper lid ( ptosis ) Congenital Ac4uired
"raumatic

+id margin
$ntropion ( mostly trachomatous ) 5ith trichiasis 5ithout trichiasis $ctropion

wellings
Chala6ion $dema or hematoma ( mostly traumatic7 may be

insect bite ) 8anthelasma Pigmented lesion ( mostly nevi )

%ainly interested in upper lid tarsal con1unctiva for signs of trachomatous scarring Don9t forget to do eversion of the upper eyelid to loo: for the scarring 5hen you do this loo: for follicles ( if only in upper lid diagnose trachoma ;; )or papillae in cases of allergic or atopic con1uctivitis

+oo: for ubcon1unctival Hge in cases of trauma uch condition can also be seen very commonly in viral con1unctivitis (n such conditions loo: for PA'

A common case is pterygium 5hat are the indications for surgery 5hat are the chances for recurrence after surgery

'ormal hori6ontal diameter is --3< mm and vertical diameter is --3- mm ( so what ;; )

Problems with si6e C+! ;;;

'ormal central thic:ness =3>2mm and peripheral thic:ness =3<- mm as measured by pachymetry

Problems with clarity

'ebula %acula +eucoma Adherent 'on adherent

5hich is more troubling to vision a nebula or a leucoma ;

+oo: for loss of luster vi6 a corneal abrasion or ulcer (what9s the difference) How to highlight an ulcer 6one

$0amine corneal sensation

Do you :now what is this lesion;

Comment on depth
'ormal hallow in eyes predisposed to angle closure Deep in high myopes and apha:ics

Comment on contents 'ormally clear a4ueous Abnormal contents may be

&lood in hyphema Pus in hypopyon corneal ulcer

Did you hear about the Purkinje? anson images; (f yes what9s their significance;

+oo: for lens opacities (s this patient pseudopha:ic

5hat are the cardinal directions of ga6e; Are they different from the directions of ga6e;

*ou should :now the pupillary refle0 pathway Comment on

the shape of the pupil7 (t9s regularity

 (t9s e4uality in both eyes ( Anisocoria ) (t9s reaction Direct @ indirect (t9s colour Aet blac: in young children and apha:ics &lac: in young people Grey in older people ( senile sclerosis )

&y confrontation test

Perimetry
%anual Automated

&y the Digital %ethod Confirm by Applanation "onometry or tono pen Don9t forget to instill topical anesthesia

Did you ever see a red refle0 before;;