Guide to the Bedside Eye Exam
Optional resource on the eye exam
Notes:
1. The basic or 5-point eye exam includes visual acuity testing, gross examination including pupil evaluation, motility testing, evaluation of intraocular pressure, and examination of the fundus.
2. For estimating intraocular pressure through palpation, we don't ask patients to CLOSE their eyes. This will trigger a reflex upgaze known as Bell's phenomenon; the corneas will then be positioned superiorly under the eyelids, where our fingers are supposed to palpate. We ask the patients to LOOK DOWN so that we can safely press on the sclerae beneath the lids.
3. RAPD can also be present when patients have extensive retinal pathology.
4. During gross evaluation of ocular alignment, the corneal light reflex should be at the center of the pupil.
5. During direct funduscopy, it is easier to start at 0 instead of +10. Parts of the ophthalmoscope and their uses are discussed in the BASIC EYE EXAM lecture.