You shine a light into the left eye and neither constrict. Therefore, we can deduce that there is a problem with the motor pathway in the left eye because it has not reacted to the stimulus. We know that the right eye has no problem in sensation because we have seen it react to the stimulus, and this also tells us the right eye has normal motor responses. Right eye constricts but left eye does not. People classically find this a difficult topic to grasp but if you break it down and get to grips with it, the test can be quite useful in clinical situations. In a normal patient, the eyes will work together so that they both respond equally to a light source, even if only one of the eyes is exposed to it. the response of the right eye when you shine light in to the left eye. The second light is checking for the consensual reflex, i.e. the response of the pupil directly affected by the beam of light. The first light is checking for the direct reflex, i.e. Next, shine your light back in to the left eye again, but this time you need to look at the right eye and make sure that the pupil on the right also constricts when you shine light in to the left pupil. When you do this you need to be looking at the left eye and making sure the pupil constricts in response to the light. “The key point is to get the patient comfortable and relaxed.”Īpproaching from, for example, the patient’s left side, shine your light once in to their left eye. Explain that you are going to shine your small light in to each of their eyes twice in turn, and that they should continue to look forward at their point during this test. It is easier for this part for you to leave your chair and crouch / stand just to one side of the patient with your pen torch in hand.Īsk the patient to look ahead at a specific point that you give them, e.g. If you have not already made a comment about their size and shape then you can do so now. The next step on the visual system test is the pupils. You need to be watching their pupils to make sure you see them constrict as your finger gets closer. Ask the patient to keep focusing on the tip of your index finger and slowly move it towards them, aiming for the tip of their nose. Testing for the accommodation reflex follows nicely on from eye movements. This article will focus on the remaining components: accommodation, pupils, fundoscopy and additional tests. The previous article focused on the first three aspects of examination: visual acuity, visual fields and eye movements. This is the second of a two-part series of articles, which together aim to improve understanding of the individual components of the visual exam and then provide a structure which links them together in a methodical way. Examining the visual system can be a tricky skill for medical students to master, yet it is a task that is frequently tested in examinations.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |