so today i'm going to be performing an up close and whispered medical
examination to help you relax and help you tingle i've selected the best in class medical devices
some of them are illuminated and we're going to begin by looking with the
ophthalmoscope focusing on the cornea of the eye the five-layered structure
that the light travels through coming up closer focus on the crystalline lens
you can alter its focus there so the crystalline lens is clear through all the zones there
i'm just going to focus on the optic nerve there so really we're looking for any uh any swelling
indistinct neural retinal rim any peripapillary atrophy
i'm just noting the cupping the vascular arrangement on the optic nerve head there
excellent i'm just going to alter the focus with the light
this light just helps me uh observe the blood vessels in a little bit more detail
okay now
i want you to look into the light and now we're just looking at the macula
and the fovea here the central portion of the eye which is associated with a fine vision
lovely okay i want to switch to the left eye and i'm going to bring the focus back
to the cornea with the epithelium bowman's stromal layer
descmet's membrane and the endothelium good and now onto the crystalline lens
that looks clear again and on to the optic nerve
now the optic nerve here is pink and defined the cupping is about 0.5
cupping there is no tortuosity haemorrhaging on or around the disc there's no congestion there
i just want to see that the blood vessel course
is okay i just want to check that there's no nipping or tortuosity on blood vessels good
and just observing the macular region of the eye it's the site where you could see drusen
pigmentation changes haemorrhaging for example
and this is the site where we can say macular degeneration sometimes good
excellent
okay so i'm going to use the otoscope here to look inside your ears
okay if you turn to your left into the ear canal there
really what i'm looking at is the level of wax in the ear i'm also looking for any scarring
or damage from previous events looking for any trauma that might have taken place
i'm also place for any discharge
any inflammation on the tissue there and then we can take a little bit further back and look at
the optic nerve there so we can take it a little bit further back and look at the eardrum there
it's fine it's not much in the way of deposits lovely
just turn the other way now for me please i want to look in the left ear canal
i'm seeing a normal level of wax in the ear there no discharge or scarring
eardrum looks fine there's no perforations there's inflammation
okay so the ears look fine
i'm going to set up another test which involves coming up close this
is the perkins tonometer it's a form of a applanation tonometry where it touches
the front of the eye and we can take a pressure reading using the scale here
okay firstly i want you to look up to the ceiling
i'm going to place a little drop in the right eye and the left eye this is anaesthetic drops
okay just take a few blinks
i'm going to be looking through the viewing portal as it gently touches your eye there
moving the scale and then i can record the reading in millimeters of mercury
then we'll what the intraocular pressure is there
and again
okay so for the right eye we have a reading of 15 millimeters of mercury
okay i'm going to observe the left one now blink and we'll bring it against the
surface of the eye there just make a delicate contact with the cornea
okay a reading of 16 millimeters of mercury there that's 16 mm of mercury
i'm going to use the light and the tongue depressor to have a little look inside the mouth
okay so i'm just observing the tongue and the teeth and the inner tissues
just raise the tongue for me please underneath place the tongue down
just swallow there
okay in the back of the throat just say 'ah' and again good open your mouth again now
and have another look this time just looking along the gums looking for any signs of decay
looks fine
okay i have a little illuminated magnifier here now we've looked inside your eyes but i would
like to observe the external ocular services so just look straight through the magnifier
towards my face now i'm just looking around the eyes looking for any blepharospasm any twitching
i'm also looking for any lumps or bumps around the surrounding area there
looks clear and now i'm just looking at the eyelashes looking for any trichiasis
looking at the colour and the length of the lashes and that looks fine
all normal okay just looking down i'm going to observe the upper lid and skin surrounding tissue
okay
looking up to the ceiling now coming really close to see the lower lid
andalso see the openings there next to the lashes adjacent to those are the
meibomian glands which produce the lipid layer of the tears that's grand just coming from this
side i'm just looking at your right lower puncta otherwise known as your tear duct
let's look at the upper tear duct in the right i want to ensure that we have a
adequate drainage system for your tears