1. Eye Exam You will be presented with clinical images or illustrations. Answers will be provided in the following slide.

2. Describe the conjunctiva.

3. The conjunctiva is translucent and clear. The pink color of palpebral conjunctiva is due to underlying vascular bed. White Sclera is seen through bulbar conjunctiva.

4. Note conjunctival reflection.

5. Note the anterior and posterior chamber • Note ciliary body and lens connection

6. Diagnosis?

7. Sub conjunctival hemorrhage • Sharply demarcated

8. Afferent pathway for visual acuity?

9. Retina-optic nerve-Optic chiasma-Optic radiation-Occiptal lobe visual cortex

10. Note fovea as center for visual field. Locate site for blind spot in retina.

11. Center of optic disc has no retinal receptors and leads to blind spot.

12. Pathway for light reflex?

13. Afferent: Retina-optic nerve-mid brain • Efferent: Both oculo motor nerves

14. Note direct and consensual light reflex.

15. Sorry the pupillary contraction on right is not visible.

16. Note the pathway for pupillary contraction.

18. Direct reflex on right • Consensual reflex on left

19. Note the pathway for light reflex.

20. Is this light reflex normal?

21. Yes. Note direct and consensual light reflex

22. Is this light reflex normal?

23. Afferent path on left eye is abnormal.

24. Which muscles are in action?

25. The right lateral rectus and left medial rectus. Gaze is conjugate.

26. Which nerves are in action?

27. The right abducens (right lateral rectus) and left oculomotor nerve (left medial rectus). Gaze is conjugate.

28. Which nerves are in action?

29. The oculomotor nerves. Superior rectus in action. Gaze is conjugate.

30. Which cranial nerves are in action?

31. Both oculomotor nerves Inferior recti in action

32. Identify the ocular muscles.

33. Levator palpabrae supreioris • Superior rectus • Inferior recrtus

34. Appreciate position of the ocular muscles.

35. Superior oblique: Trochlear nerve • Lateral rectus: Abducens nerve • Oculomotor supplies the rest

36. What ocular muscles are influenced by sympathetic system?

37. Levator palpabrae superioris • Iris muscle • Muscle in floor of orbit

38. Is the technique appropriate?

39. No. You should look at patient’s left fundus with your left eye.

40. Identify the artery and vein.

41. The artery is narrow with light reflex. • The vein is read and thicker than the artery.

42. Diagnosis?

43. Leukemic infiltration

44. Diagnosis?

45. Macroglobulinemia

46. Source for tears?

47. Lacrimal gland • Meibonian glands • Conjunctival glands • Drained by puncta into lacrimal sac and on to nasolacrimal duct into nose.

48. Note pathway for the aqueous humor.

50. Your right eye compared to the subject’s left eye.