hello there, welcome to the clinic, so today I'm going to keep things very precise and
concise, I'm going to test you with just the contents of my jacket pocket here so if you're
ready, just ensure that you're relaxing the whole way through, breathing naturally.
We'll start off with vision.
I want you to block your left eye like so, let's increase the light levels a little
through that one eye read the rows
okay for the right eye we're going to select this block here
good, continue reading
to as far down as you can
okay cover the other eye, start from this side please, top to bottom
and for the left eye we're going to opt for here
okay and just try this row here through that eye
marvellous, I'm going to be typing the results down as we go along
Vision right
and vision left
okay also on that chart
we have a pupil size measuring scale there
let's rest up there, just looking into this eye
five, looking into this eye please
pupil sizes at five millimetres right and left there
okay next up let's have a look what we've got, we're going to do a cover test
Okay I want you to look at the target there please.
I'm just going to cover one eye at a time
and just swing from side to side there
just looking into the distance at one, I'm going to do the distance cover test
lovely and we're going to check the Iris diameter incorporating this scale here, so just looking
straight please, just a case of resting just on the brow there
and again a little bit lower than previously
okay equal diameter there as expected
so that was the near cover test, no movement detected distance cover test
a very small exophoria in the distance
but the recovery was very good
rapid recovery and then we did the Iris diameter
okay I have a little bit of light here, I'm going to look off into the distance, I'm going
to check your pupil reactions to light
keep looking into the distance
okay when I say look at the near target, look at the near target please, so distance
near target, back to the distance
looking at the near
back into the distance
and once more at the near target there, excellent
right let's do some ocular movements, I want you to follow the target just with the eyes,
report any ocular discomfort or double vision
excellent
I'm going to switch to a light source for you to follow now so I can observe the corneal
reflexes
just ahead moving
any double vision there?
any double vision up here?
any down there?
any double vision in this quadrant?
and any double vision in the upper quadrant?
marvellous
good
We have the little pocket ophthalmoscope here
right
Let's get the light source as desired.
I'm actually going to make it dark.
Okay I want you to look at the light source, that's all you have to do here, and I'm just
checking the corneal reflexes again
I'm looking for one to two mil nasal displacement each eye there, to check and just with the
primary position there, good, keep observing and the reflections appear symmetrical there
so that's the Hirschberg thank you
okay let's type that down so the last one there was the
Hirschberg , one mil nasal displacement
displacement right and left good, we did ocular motility with the budgie
full and smooth
no diplopia or discomfort, is that right?
and we did motility with the light source as well
marvellous let's have a little look what else we have
ah yes I have the measuring scale here.
okay let me rest this on the bridge of the nose there, looking at the measurement right
to left monocular pupil measurements, lovely
okay just relax I'm going to do the vertical palpable aperture on the right
and on the left side there
good 10 millimetres right and left so that's VPA
right and left monocular pupillary distance
Right 33 mil
Left 33 mil and a total pupillary distance measurement, looking into the eye I've got
open, and the other eye, to this one and this one, thank you
sixty six millimetres
okay looking at the E for me please, I'm going to take another pupillary distance measurement
but at near, keep looking at the target please.
keep looking, excellent about three millimetres less there
near PD
63 millimetres
right so we're coming towards the end
but a majority of this examination will be dedicated to ocular health, a significant
portion at least
okay starting with the right eye just a little bit of light
just look down, look to the right
look left
just look up for me now, and just look into the distance over my right shoulder
so externally fine, just reviewed the cornea and the surface of the crystalline lens towards
the posterior as well, no evidence of any deposits or lenticular opacities there, a
little bit closer
let's look at the optic nerve head, looking for definition and a nice pink colour there
I've got no signs of PPA.
CD ratio
non-stereoscopic 0.4
nice vascular arrangement, no signs of any optic pits, lovely
looking into the light now I want to check the macula showing it's flat, clear
and we're looking for the foveal reflex, medium brightness I'd estimate there, lovely
okay just looking into the light again checking for any eccentric fixation there, non-present,
thank you
let's have a look at your peripheral retina, looking up
up and right, up and left, directly left
to the right, looking down with a wide eye please
and to the right
down into the left
okay just look ahead again
Okay just going to use the green filter, look into the distance again
a little look at the nerve fibres where visible and
the blood vessels
good, take a short break please
okay for the left eye
look down
look right, left, up, straight ahead again
Take a blink.
Again nice clear crystalline lens, cornea is grossly clear, externally looks fine, may
need the slit lamp a little bit later.
Right just look as straight as possible but not into the light, checking the optic nerve
again
That's approximately 0.5 ratio there, again no evidence of PPA, no pits, it's pink, defined.
Excellent.
Vascular arrangements surrounding and on absolutely fine
okay
look into the light please
Looking into the light again
straight down and down and right
Look into the distance again at one point please, just a green light evaluation of the
mid peripheral zones
excellent that concludes the test, I'm just going to record the results, that was direct
ophthalmoscopy
So for the right eye what did we say?
0.4 CD ratio, pink and defined
No abnormal features
Macula flat and clear, good foveal light reflex, clear retina, normal looking nerve fibres
with the green light
and all the same for the left eye but for the exception of the CD ratio
What did we say point five CD ratio for the left, excellent
okay I do hope you've had a relaxing time in the clinic being tested, I'm going to save
the results there and I'll see you again in two years time, thank you