Diagnosis and management of EENT and URIs Week 2.1

Diagnosis and
Management of EENT
and Upper
Respiratory Disorders

,Assessment of the Eye
1. The examiner:


a. Uses right hand for
ophthalmoscope, uses right eye for
patient's right eye
b. Starts with wheel at 0
c. Starts about 12" from the patient
with both eyes open
d. Moves in to within 1 to 2" from
patient's eye
e. Should function as one with
ophthalmoscope.


2. After obtaining a red reflex, exam

,should proceed from the optic disc and
end with the fovea of each eye

, Assessment of the Eye Cont’d

Inspection of the Optic Disc
1. Shape: Doughnut-like with an orange/pink neuroretinal rim and a central white
depression (physiologic cup)
2. Cup/disk ratio: Cup should not be more than 1/2 the size of the disc diameter (if
larger, consider glaucoma)
Retinal vessels
1. Arteries are brighter red and narrower than veins; A:V ratio = 2:3 or 4:5
Macula
1. Centered = 2 to 2.5 disc diameters temporal to the optic disc and is avascular
2. The fovea centralis is a 2.5 mm diameter reflective area that looks slightly darker and
lies in the center of the macular region
3. Patient should look directly into the light of the ophthalmoscope, if the macula is
difficult to visualize