10. The eyes

An eye examination may be carried out in response to a specific eye or vision problem, or it may be part of a general, internal or neurological physical examination. This chapter discusses the types of eye examination that physicians and ophthalmologists have at their disposal. We start by considering the general eye examination, which comprises inspecting the external eye, testing pupil reflexes, ocular alignment and eye movements, and measuring the visual field and intraocular pressure. All these types of examination only require a penlight. More detailed ophthalmic tests require aids or tools (e.g. a visual acuity chart,a pinhole occluder, and a slit lamp or fundoscope). We explain each of these eye tests, where appropriate in relation to the problems with which patients present (e.g. red eye, double vision (diplopia), exophthalmos and enophthalmos). Lastly, we mention some important eye disorders (e.g. diabetic retinopathy, papilloedema, retinal detachment, hypopyon in the anterior chamber) that can be diagnosed using ophthalmic examination.