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General Eye Examination
A comprehensive eye examination is important for personal health. Every person should have an eye exam at least once a year. It forms the basis for the detection, diagnosis and treatment of eye diseases. A general eye examination consists of the following procedures:
- Listening to the patient’s complaint
- Checking visual acuity (eye measurement)
- Examination of the eyelids
- Examination of eye movements and strabismus
- Examination of light reflex
- Biomicroscopic examination
- Eye pressure examination
- Fundus (fundus, optic nerve and retina examination)
- Examination of the tear film layer
- Eye examination with drops
Advanced eye examinations are performed after general eye examination. These can be listed as fundus angiography, eye tomography, topography, specular microscopy, biometry, eye USG, visual field test, Schirmer test, ERG, and EOG.
General eye examination should be performed once a year even if there are no complaints. It plays an important role in the early diagnosis of diseases such as diabetes, hypertension, some blood diseases, brain tumors, AIDS, heart diseases, metabolic diseases, Alzheimer’s disease, and pituitary adenoma.
Visual Acuity: Refers to the visual capacity of the eye. If the eye can see an object at a standardized distance (usually 6 meters), vision is considered normal or complete. This is expressed in the metric system as 6/6 or in the 20/20 ft (feet) system. If an eye can see an object at 3 meters that it should see at a distance of 6 meters, this means that it sees 3/6 or 50%. This measurement is specific to countries using the metric system. Again, if an eye can see an object normally seen at 20 feet from a distance of 20 feet, this is 20/20. This means normal vision. If this person can only see an object 40 ft away from 20 ft, he/she has 20/40 vision.
Measurement of visual acuity is usually done with the Snellen chart. The Snellen chart was invented by the Dutch ophthalmologist Herman Snellen.
SNELLEN SCHEME
Today, visual acuity is measured with standardized automatic projection devices.
Examination of the Eyelids: Infection, dandruff, functional disorders, sagging of the upper eyelids, swelling of the lower eyelids, outward and inward rotations are diagnosed. Allergic conjunctivitis, infections, stye (dog elbow) and masses can be seen by looking under the lids. Asymmetrical upper eyelids, i.e. ptosis, can be detected.
SAGGING UPPER LID
CHALAZION
PTOSIS
ECTROPION
ENTROPION
Eye Movements and Strabismus Examination: There are six different muscles that move our eyes in nine different directions. These are the upper, lower, inner and outer rectus muscles and the upper and lower oblique muscles.
Sudden onset of double vision can be seen due to certain neurological diseases (myasthenia gravis), diabetes and hypertension. In addition, trauma, sudden falls and strokes may cause double vision.
When examining eye movements, the doctor sits in front of the patient and asks him/her to follow a pencil in his/her hand. In the meantime, he/she monitors both eye movements of the patient. He tries to diagnose the limitation of eye movements by looking at sudden eye movements.
Strabismus can be an outward, inward or upward shift. Certain types of strabismus are corrected by wearing eye glasses. Otherwise, the patient should undergo urgent surgical intervention to prevent amblyopia, or lazy vision. Strabismus has psychosocial and economic consequences.
Biomicroscopic (slit lamp) examination: Biomicroscope (slit lamp) can examine the structures at the front of the eye and the structures at the back of the eye. The eyelids, anterior chamber, iris, pupil, lens, vitreous, retina, optic nerve, eye vessels and macula are examined respectively.
Images are seen in a stereocopically magnified format. The angle is seen with the three-mirror Goldmann lens. The retina observed with the 90D lens.
Eye pressure: It is measured with a tonometer. Today, automatic tonometers have replaced the applanation tonometers. Normal intraocular pressure is 10-20 mmHg.
Fundus examination: Before this examination, the pupil is dilated with eye drops. The retina, optic nerve, macula (yellow spot) and vessels are examined. Retinal tears can be diagnosed especially by looking at the peripheral retina.
Tear film layer: It consists of three parts. These parts can be listed as mucin-acous and lipid layers from the inside to the outside. Dry eye occurs when one or more of these are deficient. It is a common condition.
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