hello there welcome to the clinic so i'm going to be performing some illuminated tests on you
today to help you relax and for me to discover a little bit more about your eyes, so the first test
i'm going to perform is retinoscopy. i'm going to be about arm's length distance looking through the
retinoscope, sweeping the light in different meridians to try and roughly gauge what your
prescription is. what your ocular prescription might be. okay so look beyond me into the distance
that's lovely just looking at the different and angle light movement as we sweep there
plus or with movement there at 90 degrees and against movement at 180 degrees
so maybe we should book you in for a refraction check very soon see if you need spectacles.
for the left eye look straight ahead beyond me again
a little bit more plus there 90 degrees and then against movement at 180 again
possibly some hyperopia with astigmatism
certainly get your eyes checked out properly for a proper eye examination
okay that's the end of retinoscopy
a wonderful piece of equipment there
producing some lovely sounds in the clinic
okay that's enough of that, what do we have next?
i'm just going to look through my bifocals here
it appears we have a pen torch here. we have the pen torch
i want to have a little look at your eye movements looking for any overactions or under actions
of the extraocular muscles that control eye movements. all right keep the head
still. i think the light is in working order, follow the light just with the eyes
that's good
marvellous
once more along the horizontal meridian
okay now did you notice any double vision of the light there
whether that was horizontal vertically or diagonally?
if you're not sure i'll repeat the test. i'm going to use a softer light this time
following again just note any double vision
of the light. just the light please
i shall continue to observe. continue to observe
any double vision there?
any double vision?
still single?
still single? to the other side
any double vision there?
or any double vision there?
very well done. single vision is what we want
okay let's turn the light into the eyes. i'm going to check the pupillary reactions to light
look towards my nose please
i'll
be observing both pupils
checking the speed of constriction
in the eye I am shining the lighting, and the other eye
direct and consensual responses. direct
and consensual
i'm going to swing the light from eye to eye
looking for the relative afferent pupillary defect just ensuring there isn't an RAPD
once more
excellent
right maybe we should perform some perkins tonometry, check those intraocular pressures.
you need some anaesthetic in your eyes. it doesn't sting for very long. look up to the ceiling please
okay let's see the eye is yellow, take a few blinks
for the left just one drop required
okay take a blink just observe the fluorescent eyes if you've got
a good enough quantity of anaesthetic with incorporated fluorescent dye.take another blink
look up to the ceiling, up again and look straight ahead at me
that looks good right
let me set up the perkins tonometer here
a very sophisticated piece medical equipment
you see we can have the cobalt blue light projecting from those two probes there,
viewing window, a lovely little headrest for your comfort and keeping it steady
okay
there we go we're all set up. going to start on 16 mil of mercury
okay i'll start with this eye here, i'm going to gently touch the globe
brief few seconds, i'll adjust the wheel
16 still, lovely
and for the other eye take a blink, stare
align the mires there align the mires to give us a reading of two four six seven seventeen
millimetres of mercury there on the scal,e 17 ml of mercury
fairly good looking set of intra ocular pressures there those are your intraocular pressures
now while you still have some fluorescent dye in the eyes i'm going to set up the blue light on
the burton lamp here, a little look at your eyes through the viewing window there just bear with me
okay we're all set
just look straight, let me observe the ocular structures there
notably the cornea and the conjunctiva. look up to the ceiling
and look to the right
and the left
come down to the floor
straight ahead. good
we don't seem to have stained the corneas from contact tonometry there.
okay and for the other eye now
take a blink to check the corneal integrity there
to the right and the left
up to the ceiling
and down to the floor
marvellous another clear cornea there let's switch to the white light for a brief check-up.
this time i'm going to be focusing on the
redness or absence of the limbal area and the conjunctival and scleral regions
take a blink. look right. look left
look down and look up
good
look left, right
1.5, look up, 1.3, look down, limbo superior 1.0 there excellent. any ocular pain or discomfort?
the redness there was very low, it's a good sign and there's no symptoms
okay let's perform some ophthalmoscopy and close up ocular health viewing
okay looking straight ahead, let's observe the crystalline lens, optic nerve, macular
and the mid peripheral zones there, the mid peripheral zones
look up, to the right, to the left, and down
lovely jubbly
the other eye now. look straight ahead
it's a good clear crystalline lens. straight still. optic nerve is defined
to the right, to the left, up, down, look into the light now. increase the
brightness. this is the macular assessment. foveal light reflex, flat, evenly pigmented
no signs of oedema, haemorrhaging there or drusen. let's compare the maculae
yes bright reflex again
well defined
evenly pigmented, no signs of oedema, haemorrhaging
or drusen again. this is why you have good clear vision, due to a good macula
no pathology there. checking the other
no evidence of any ocular pathology. ocular pathology and right.
excellent this concludes the medical assessment. looking good. i'm going
to get you back in for an eye examination to check your prescription. i'll see you next time