Ophthalmic Evaluation &

Approaches to The Patient

Muhammad Asroruddin
Ophthalmology Department
UNTAN
Modul of Foundation of Clinical Practice

Overview
The purpose of ophthalmic evaluation
is to document objective and
subjective measurements of visual
function and
ocular health

Modul of Foundation of Clinical Practice

Overview
The specific objectives of the comprehensive ophthalmic
evaluation are to:
Obtain an ocular and systemic history
Determine the optical and health status of the eye,
visual system, and related structures
Identify risk factors for ocular and systemic disease
Detect and diagnose ocular abnormalities and disease
Establish and document the presence or absence of
ocular signs and symptoms of systemic disease
Discuss the nature of the findings and implications
with the patient
Initiate an appropriate response (further diagnostic
tests. Treatment, or referral when indicated)

Modul of Foundation of Clinical Practice

Overview
A successful evaluation relies in part
also on the physician approaching
the patient appropriately and with a
certain professional demeanor
(attitude), and is supported by the
keeping of adequate records

Modul of Foundation of Clinical Practice

History

Important first step in an ophthalmic evaluation

Demographic data
Identity of other pertinent health care providers utilized by
the patient
Chief complaint and history of present illness
Present status of vision, including the patients perception
of his/her own visual status, visual needs, and any ocular
symptoms
Past ocular history, incl prior eye diseases, injuries,
diagnoses, treatments, surgeries, and ocular medications
Past systemic history, including allergies, adverse reactions
to medication, medication use, and pertinent medical
problems and hospitalizations
Family history, including poor vision (and cause, if known),
and other pertinent familial ocular and systemic disease
Modul of Foundation of Clinical Practice

Goals of The History

Identifying the patient
Identifying other practitioners who
have cared for the patient
Obtaining a diagnosis
Selecting therapy
Socioeconomic and medicolegal
considerations
Modul of Foundation of Clinical Practice

Examination
Analysis of the physiologic function and anatomic
status of the eye, visual system, and related
structures.
Visual acuity examination, with and without correction
(if any) at distance and at near.
Determination of best-corrected visual acuity utilizing
refraction
Ocular alignment and motility examination
Pupillary examination
Visual field examination (confrontation testing)
External eye and ocular adnexa examination
Anterior segment examination
Tonometry to determine intraocular pressure
Posterior segment examination
Modul of Foundation of Clinical Practice

Ophthalmic Equipment (for

GP)

Snellen acuity chart

Near visual acuity chart
Slit-lamp biomicroscope
Tonometer
Trial frame and trial lens
Penlight
Direct and indirect ophthalmoscope
Color vision
Modul of Foundation of Clinical Practice

Physician Demeanor &

Approach to the Patient
Compassion and professionalism
Listen to patients concern carefully and with
undevided intention
Ask if the patient has any additional questions or
concerns and address them, after completing
evaluation and counseling
Maintain the confidentiality of all patient
information and interactions.
Use the appropriate language, use translator if
needed
Creating an atmosphere of trust, respect, and
openness, so that the patient will communicate
freely, and effective patient-physician
communication can be achieved
Modul of Foundation of Clinical Practice

Ethical Consideration
Provide care with compassion, honesty, integrity, and
respect for human dignity
Do not refer to a patient as the retinal detachment.
Instead, always refer to patients by their names
Seek a healthy personal lifestyle
Understand the psychology of illness
Maintain clinical and moral competence to avoid doing
harm and to ensure provision of excellent care
Communicate openly and honestly with patients
Do not allow fees for ophthalmologic services to
exploit patients or third-party payers
Always strive to preserve, to protect, and to advance
the best interests of the patients.

Modul of Foundation of Clinical Practice

Modul of Foundation of Clinical Practice