there's quite a few important measurements i'm going to be taking today this here is
recording sheets number one take some general notes on your appearance and then we can take
some important and intricate measurements there and then on recording sheet two a little
look at things here with the eyes and then we get very technical
series of measurements here
okay let's start off by having a little look at your facial dimensions just hold the pose
there
levels of asymmetry general face shape
okay
just doing to the left side for me
turn to the right
okay just look behind you now
okay
we're checking the levels of asymmetry there
okay hold it steady
let's place this on top of the head do the head width
temple width
just a little nasal measurement there total length total widths the base and total widths
10 millimeters
give me a full smile please give me a full smile hold
the smile
holding the smile
just turn to the left-hand side for me
any problems with your ears?
okay look to the other side now
back that way
I've got the gloves up
just feeling for any lumps or bumps
we've taken the measurements height and width
asymmetry has been recorded
go all around the lobe there
good
just tilt your head back a little bit
okay hold it there
okay keep the head tilted back a little bit
keep it there
good those measurements appear normal
i can't feel any problems on the ears there's no lumps or bumps um head height
okay so that's recording sheet one
just excuse the handwriting it's not for you to read okay we're on recording sheet two
now
okay so the first thing i need to do is a little look to eyebrows look down i'm going
to look at the upper eyelid
look up
look down again i need to have a feel around the orbits the bony orbit
okay look down as far as you can so a little feel of the lids checking for any carbuncles
such as blocklands
also looking for styes
looking up now lower right
lower left
okay just on the temples now gentle pressure
on the left
okay
just looking into this eye for me i want to have a look at your iris okay looking at about
four o'clock i can see what may be a little iris freckle
i'm going to recommend an appointment with your optometrist they'll have a look at this
on the slit lamp
looking into this eye
so the other iris maybe a freckle at around 11.
colour of the eye light brown
measuring your pupil size
so just checking for any anisocoria
equal pupil size in these conditions at four millimeters
let's check the iris diameter keep looking straight please a little lower
and the other one
it's about the same 12 millimeters
let's check your vertical aperture now looking into this eye
looking into this eye please
9 millimeters each side
eyelashes
all the same color
length slight inward turning left upper eyelash
any foreign body sensation in that left eye?
okay is that when you look up or down?
okay i'll make a note here okay that's something we need to see the optometrist about they
may be able to epilate that lash for you
so it could be exacerbated when looking up being on the top lid there
okay looking up to the ceiling i'm going to lower the lower right checking for any hyperemia,
papillae keep looking up lower left lid no concretions good so uh palpebral conjunctiva
pc clear hyperemia grade one
okay looking down i'm going to evert the upper lid here it'll feel a little bit strange let
me have a look again for redness or foreign bodies checking for normal things like concretions
okay so we conducted all those measurements they're all recorded for you okay all the
technical fine measurements let's move on to some more measurements
okay looking to the one side
okay looking the other way
okay just some nasal measurements now
keep facing me this little scale here is for something called the apical radius
i'll find the perfect fit on the bridge of the nose now
okay
we have to find the attachment for this ruler where is the attachment
okay it's just going to rest on the bridge of the nose again i'm going to bring it until
there's slight contact and then we can take the uh the reading from the scale there okay
that's at 15 below thank you
we need to go 10 this time
ten below
okay i'm just going to rest this on the bridge of the nose i'm going to bring it in very
delicately until we just miss the eyelashes
okay what do we have next oh yes spley angle
okay just using the bridge of the nose there so we have slide contact 10 degrees lovely
just after 10 degrees there
spley angle 10 to 12 degrees there right and left side okay what do we have next ah yes
interpupillary distance
looking into this eye please
63
okay just having a feel of your mandible
any problems chewing any jaw pain? okay
open your mouth
and squeeze
relax the jaw now
okay head back let's feel the neck
any swelling around the neck under the chin?
all clear good so those are all the measurements today thank you for coming in let's just record
the final one
one final question do you suffer with migraines at all how often do your migraines occur?
were they worse as a child?
they've got better as you've gotten older?
okay lovely i'll pass those on to your dermatologist and GP oh yes and also we are recommending
an appointment for you to see your optometrist i'll book that in i'm just going to send a
referral maybe there's a little bit of trichiasis on the upper left this region and we'll mention
the slight iris freckles, potentially, which needs checking it so i'll send that to your
optometrist just booking within the next few days okay bye for now