Vision Eye Institute: June 2016
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Do you wear Glasees?
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How many times did you have to get up in the middle of the night and fumble
with your glasses?
Why do we put up with having to wear glasses when we don't have to?
Imagine for a moment you didn't have to worry about glasses anymore.
In 2 visits to the office you can have 20/20 vision or better.
http://www.echicagosports.com/correct/eyes/20/20.html
Bye Bye glasses!
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Bright-N-Brigade
4382 New Holland Road, Mohnton, PA 19540
Terminate News-http://ball.echicagosports.com
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The 8-Point Eye Exam
http://www.aao.org/young-ophthalmologists/yo-info/article/how-to-conduct-eight-point-ophthalmology-exam
Visual acuity
In the clinic, visual acuity is typically measured at distance. Otherwise, in a
consult setting outside of the clinic, it???s measured at near. Don???t forget
to have a near card with you.
Make sure the patient is wearing his or her correction. Always have a pair of
+3.00 readers with you, as many people in the emergency room won???t have their
glasses with them. A pinhole occluder will also reduce the impact of
uncorrected refractive error.
If the patient is unable to see the biggest optotype on the card, the
progression (from better to worse) is counting fingers (CF), hand motions (HM),
light perception (LP) with projection, LP without projection and no light
perception (NLP).
For children who are too young to use Allen pictures, employ the ???central,
steady, maintain (CSM)??? approach. Central: Is the corneal light reflex in the
center of the pupil? Steady: Can the patient continue fixating when the light
is slowly moved around? Maintain: Can the patient maintain fixation with the
viewing eye when the previously covered eye is uncovered?
2. Pupils
Look for anisocoria. If present, carefully check the pupil size in both
well-lit and dark conditions.
Check the reactivity of each pupil with a penlight or Finoff transilluminator.
Use the swinging flashlight test to look for a relative afferent pupillary
defect.
Cartoon:
https://www.youtube.com/watch?v=HSYo7LhfV3A
Patient:
https://www.youtube.com/watch?v=A6My6rI0p-A
3. Extraocular motility and alignment
Have the patient look in the six cardinal positions of gaze. Test with both
eyes open to assess versions ??? repeat monocularly to test ductions. Figure 1
below shows which muscle is tested in each position.
Use the cover/uncover test to assess for heterotropias.
Use the alternate cover test to assess for the total amount of deviation. This
amount minus any heterotropia is the amount of heterophoria.
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