Introductions
- Rapport with patient
- Sit on edge of bed □
General Inspection
- Diagnostic facies
- Ptosis
- Conjunctiva
- Cornea
- Sclera
- Pupil Asymmetry
- Xanthelasma
- Eye Patch
- Bruising
- Hearing Aid
Inspect from above & behind
- Exopthalmos
Return to front
Test Lid Lag & Fatigability
Test Visual Acuity with Snellen chart
- Left Eye
- Right Eye
Test Visual Fields
- Left Eye
- Right Eye
Test Light Reflexes
- Direct
- Consensual
- Swinging torch test
Test Accomodation
- Hat Pin
Perform Fundoscopy (Beware the glass eye!)
- Cornea
- Lens
- Vitreous
- Optic Disc
- Retinopathy
Test Ocular Movement (If diplopia occurs test each eye individually)
- Dysconjugate gaze (MLF)
- H pattern testing
- Diplopia
- Test Intorsion (if CN III palsy)
Test for Nystagmus
- Vertical Horizontal
- Gaze fixation
- Frenzel lenses
Test Corneal Reflex
- CN V1
- CN VII
Palpate Orbits
- Step deformity
- Tenderness
Listen for Ocular Bruit
- Left eye
- Right eye
Test for Horner’s Syndrome
- Palpation of brow for anhidrosis
Test for Lateral Medullary Sydnrome
- Ipsilateral
- V:
- Facial Pain &
- Temperature
- VIII:
- Central Nystagmus
- Hearing
- IX & X:
- Dysphonia
- Swallowing
- Cough
- Uvula deviation
- Gag reflex
- Cerebellar function
- V:
- Contralateral
- Trunk & Limbs Pain & Temperature
Test for C8/T1 lesion
- Finger abduction weakness Clubbing
Examine for Neck Causes of Horner’s
- Lymphadenopathy Thyroid Masses
- Carotid Aneurysm
Test for spinal cord causes of Horner’s
- Syringomyelia
- Dissociative sensory loss