Physical Exam for Eye Pain, Vision Impairment, Vision Loss

Hi Mr. James, I would like to do a quick PE on you that will help me understand better what might be causing your vision problem. Please bear with me and let me know if at any time you feel uncomfortable.
Start with the Gen. Inspection: Be organized and systematic-
1. (Inspect) HEENT
2. Palpate, starting with the head-neck (check for LAD b/l)
3. EOMI (H-pattern)
4. Test for visual acuity (Mr. James, I would like you to cover one eye and see how many fingers are UP, do it both sides at the same time (demonstrate it first)
5. Perform Confrontation exam (Look at my nose, tell me when you see my fingers move, start the wiggling of your fingers from the bottom to Up, then do the opposite side) - Always demonstrate procedures first.
6. Perform PERRLA: Exam Pupil-Equal-Round-Reactive to Light and Accommodation (this is simply testing the ability of the eyes to focus on objects that are close up and faraway).
7. At the point, use equipment: Opthalmascope/Fundoscope (Look for Obstruction, Hemorrhage, Neovascularization, Exudate, and Microaneurysms)

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