VISUAL ACUITY
Patient evaluation should always begin with
visual acuity assessment
It measures central visual function
Assess the integrity of optical media, macular
area, and its neural elements
Tests are done for both distance and near
DISTANCE VISION TEST
Tests visual acuity in the non-accommodated
state
Makes use of the Snellen’s chart
Test distance of 6 meters
Each eye is tested one at a time
Pinhole test may be done to detect errors in
refraction
Done if the patient scores less than 20/20
without any correction/ eye glasses
SC
PH
CC
CC w/
PH
OD
OS
SC - Without correction / without eye glasses
PH - visual acuity when looking through a pinhole
CC - with correction / with eye glasses
CC w/ PH - visual acuity of the patient when
looking through a pinhole while wearing glasses
OD - right eye
OS - left eye
NEAR VISION TEST
Tests visual acuity in the accommodated state
Makes use of Jaeger’s chart
Test distance is 35 mm (14 in)
May test both eyes at the same time
Usually done on patients >35 years old
SC
CC
OU
OU - both eyes
GROSS EXAMINATION
Involves the gross inspection, and at times
palpation of the external eye and its adnexa
Anatomical relationships, size and symmetry
should be carefully observed
Familiarity with normal dimensions
Inspect the eye under good lighting
Position of globe in relation to lids and lid
aperture
Position of lids and lashes
Physical signs: e.g mass, redness,
discharged, opacities
Corneal light reflex
Pupillary reaction to light
EXTRAOCULAR MUSCLE MOVEMENTS
DUCTION
Tests for 6 cardinal directions of gaze, one eye
at a time
Tests for synergist and antagonist muscle
function
Sherrington’s law of reciprocal Innervation
6 Cardinal Movements of the Eye
When drawing the 6 cardinal movements of
the eye, draw a tip on the end of the arrow for
the right eye and a circle for the left.
VERSION
Simultaneous movement of eyes from a
primary position to secondary position (6
cardinal positions )
Test for yoke muscles (muscles responsible for
directing eyes)
Hering’s Law of Equal Innervation
Record finding by making a drawing of the
cardinal movements (same with duction)
