1
Abnormalities in Eye Exam
External eye
Description Patho Subjective Data Objective Data
Exophthalm Bulging of the eye Can be due to an Trauma that can Apparent eye
os anteriorly out of increase in the volume of cause complete or protrusion, lids do not
orbit. orbital contents partial dislocation of reach the iris
the eye
The most common cause Measurement of the
is Graves disease degree of
exophthalmos is
In Graves, it is due to performed using an
abnormal connective exophthalmometer,
tissue deposition in orbit typically by an
and extraocular muscles ophthalmologist.
Bilateral or unilateral
When unilateral, a retro-
orbital tumor must be
considered.
, HEENT EXAM 1 - FEB. 2021 2
Episcleritis Inflammation of Simple: Acute onset of mild- Diffuse or localized
the superficial moderate discomfort injection of the bulbar
layers of the Intermittent episodes of or photophobia conjunctiva
sclera anterior to moderate-to-severe
the insertion of inflammation Painless injection Purplish elevation of a
the rectus (redness) and/or few millimeters
muscles Often recur at 1–3-month watery discharge
internals. without crusting Watery discharge
Lasting 7-10 days, and
resolving after 2-3 weeks
Nodular:
Prolonged attacks of
inflammation that are
typically more painful
than simple episcleritis
,HEENT EXAM 1 - FEB. 2021 3
Most cases are
idiopathic; may have an
underlying systemic
condition such as
autoimmune disorders,
including Crohn disease,
rheumatoid arthritis, SLE,
polyarteritis nodosa,
psoriatic arthritis, gout,
atopy, foreign bodies,
chemical exposure, or
infection
, HEENT EXAM 1 - FEB. 2021 4
Band Deposition of Most commonly in Decrease in vision as The line just below the
Keratopath calcium in the patients with chronic deposition progresses pupil; passes over the
y superficial cornea corneal disease cornea rather than
Foreign body around the iris as
It May occur in patients sensation and arcus senilis does
with hypercalcemia, irritation
hyperparathyroidism, Horizontal grayish
and occasionally in bands interspaced
individuals with trauma, with dark areas that
renal failure, sarcoidosis, look like holes
or syphilis
Corneal Disruption of the Rheumatologic Pain Visual acuity affected
Ulcer corneal epithelium disorder: variably, depending
and stroma Photophobia on ulcer location.
Connective tissue
diseases, such as History of wearing Inflammation and
rheumatoid arthritis, contact lenses erythema of the lids
Sjogren syndrome, or a and conjunctiva.
systemic vascular Blurry vision
Abnormalities in Eye Exam
External eye
Description Patho Subjective Data Objective Data
Exophthalm Bulging of the eye Can be due to an Trauma that can Apparent eye
os anteriorly out of increase in the volume of cause complete or protrusion, lids do not
orbit. orbital contents partial dislocation of reach the iris
the eye
The most common cause Measurement of the
is Graves disease degree of
exophthalmos is
In Graves, it is due to performed using an
abnormal connective exophthalmometer,
tissue deposition in orbit typically by an
and extraocular muscles ophthalmologist.
Bilateral or unilateral
When unilateral, a retro-
orbital tumor must be
considered.
, HEENT EXAM 1 - FEB. 2021 2
Episcleritis Inflammation of Simple: Acute onset of mild- Diffuse or localized
the superficial moderate discomfort injection of the bulbar
layers of the Intermittent episodes of or photophobia conjunctiva
sclera anterior to moderate-to-severe
the insertion of inflammation Painless injection Purplish elevation of a
the rectus (redness) and/or few millimeters
muscles Often recur at 1–3-month watery discharge
internals. without crusting Watery discharge
Lasting 7-10 days, and
resolving after 2-3 weeks
Nodular:
Prolonged attacks of
inflammation that are
typically more painful
than simple episcleritis
,HEENT EXAM 1 - FEB. 2021 3
Most cases are
idiopathic; may have an
underlying systemic
condition such as
autoimmune disorders,
including Crohn disease,
rheumatoid arthritis, SLE,
polyarteritis nodosa,
psoriatic arthritis, gout,
atopy, foreign bodies,
chemical exposure, or
infection
, HEENT EXAM 1 - FEB. 2021 4
Band Deposition of Most commonly in Decrease in vision as The line just below the
Keratopath calcium in the patients with chronic deposition progresses pupil; passes over the
y superficial cornea corneal disease cornea rather than
Foreign body around the iris as
It May occur in patients sensation and arcus senilis does
with hypercalcemia, irritation
hyperparathyroidism, Horizontal grayish
and occasionally in bands interspaced
individuals with trauma, with dark areas that
renal failure, sarcoidosis, look like holes
or syphilis
Corneal Disruption of the Rheumatologic Pain Visual acuity affected
Ulcer corneal epithelium disorder: variably, depending
and stroma Photophobia on ulcer location.
Connective tissue
diseases, such as History of wearing Inflammation and
rheumatoid arthritis, contact lenses erythema of the lids
Sjogren syndrome, or a and conjunctiva.
systemic vascular Blurry vision
