ABSTRACT
Positions patient appropriately Inspects for ptosis, squint, exophthalmos and pupil size and irregularity Enquires about and tests for visual acuity (uses Snellen chart if one is available, otherwise asks patient to read ordinary type face/count fingers; visual acuity should be tested with spectacles or contact lenses if usually worn by the patient) States intention to test colour vision using Ishihara colour plates Assesses visual neglect (crude test for visual field loss) Examines visual fields carefully (tests for a peripheral defect and uses red hat pin to delineate the patient’s blind spot and any scotomas, and to test for macular sparing) Examines eye movements vertically and horizontally (enquires about diplopia and observes for nystagmus) Examines for pupillary light and accommodation reflexes Sets and handles ophthalmoscope correctly Assesses for a red reflex with the ophthalmoscope Correct technique for viewing fundi Correct technique for viewing discs
Cleans hands by washing or using alcohol gel
Fluency of examination Competence in presenting findings, summarizing and forming differential diagnoses
KEY Ophthalmologists use sophisticated equipment in clinic, negating the need for them to perform many of the steps opposite. For you to gain the most from an ophthalmology clinic, show the mark-sheet opposite and ask to be taught or observed according to the marking scheme, using basic equipment such as hat pins and a hand-held ophthalmoscope. There are also mannequins that you can practise on, and these are usually found in clinical skills centres.
