EXAMINATION
Eyes
Ask patient to sit or stand.
Technique
Findings
Visual Testing
Measure visual acuity in each eye separately
EXPECTED: Vision 20/20 with or without lenses with near and far vision in each eye.
UNEXPECTED: Myopia, amblyopia, or presbyopia.
EXPECTED: Vision 20/20.
UNEXPECTED: Limited fields of vision temporally, 50 degrees superiorly, 70 degrees inferiorly.
External Examination
Inspect eyebrows
EXPECTED: Unusually thin if plucked.
UNEXPECTED: Ending short of temporal canthus.
UNEXPECTED: Coarse.
Inspect orbital area
UNEXPECTED: Edema, puffiness not related to aging, or sagging tissue below orbit. Xanthelasma.
Inspect eyelids
UNEXPECTED: Ectropion or entropion.
EXPECTED: Superior eyelid covering a portion of iris when open.
UNEXPECTED: Fasciculations when lightly closed. Ptosis. Lagophthalmos.
UNEXPECTED: Flakiness, redness, or swelling. Hordeola.
EXPECTED: Present on both lids. Turned outward.
Palpate eyelids
UNEXPECTED: Nodules.
Palpate eye
EXPECTED: Can be gently pushed into orbit without discomfort.
UNEXPECTED: Firm and resists palpation.
Pull down lower lids and inspect conjunctivae and sclerae
EXPECTED: Conjunctivae clear and inapparent. Sclerae white and visible above irides only when eyelids are wide open.
UNEXPECTED: Conjunctivae with erythema. Sclerae yellow or green. Sclerae with dark, rust-colored pigment anterior to insertion of medial rectus muscle.
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