Royal Australasian College of Physicians Examinations/Resources/Clinical Exam/Short Cases/Neurology/The Eye Examination

Examination of the Eye Procedure General Appearance: Thyroid stare ± goitre Eyelids xanthelasma Ptosis unilateral III palsy (Examination procedure / Sample Case) Horner's Sx Pupil changes Sweating bilateral myaesthenia myotonic dystrophy Exophthalmos Thyroid Stare (goitre) Mass lesion bilateral Eaton-Lambert myaesthenic syndrome Botulism Muscular dystropy Mitochondrial myopathy Cornea: Arcus senilus Kaiser-Fleischer Rings Sclera Jaundice Pallor Blue Osteogenesis Imperfecta Ehlers-Danos Marfan's Syndrome Orbits Palpate for Tenderness Brow sweating for Horner's Neurological: II acuity fields fundoscopy II & III pupils light reflex (direct / consensual) afferent pupillary defect accommodation reflex III IV VI diplopia nystagmus gaze palsies V VII corneal reflex Gaze Fatigue – Myaesthenia Central Blindness: Hemianopia Bitemporal Homonymous --- Patterns of Eye Movement Disorders III only orbital brainstem pupil involved – eg posterior communicating artery aneurysm pupil spared – eg infarct, hypertension, diabetic palsy III, IV, VI superior orbital fissure lesion III, IV, V, VI cavernous sinus pathology check internal carotid III + contralateral hemiparesis – midbrain stroke III + movement disorder - red nucleus lesion Main Page Neurology Index