how to do the visual confrontation exam?

[Bevo]

Im looking in my clinical exam book by epstein, but I can't find it anywhere.

I got a rough idea of how to do it, but I'm not sure if what Im doing is correct.

Anyone have a website where it illustrates or explains how to do it?

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[eggshell]

I couldn't find a website, but are you at a site where there are ophthalmic medical assistants/technicians working? The reason I ask is, there are wonderful intro books written for ophthalmic technicians who have to do pupil exams, confortational visual field tests, etc. before the patient sees the doctor. So if there are certified ophtho techs there you could borrow one of their books.

One book in particular, Ophthalmic Medical Assisting, is published by the American Academy of Ophthalmology. The AAO wants techs who are performing the tests the proper way, so the book gives really simple instructions on how to perform basic (but essential) tests. These are the same ones that medical students will have to learn how to do.

 

[Runtita]

Something like...







"No, don't look at me. You CAN'T look at me. DO NOT LOOK AT ME. I dare you not to look at me! I saw you try to look at me!"

















Sorry. Biochem has fried my brain.

 

[hedera916]

Im looking in my clinical exam book by epstein, but I can't find it anywhere.

I got a rough idea of how to do it, but I'm not sure if what Im doing is correct.

Anyone have a website where it illustrates or explains how to do it?

I remember reading how to do this from the book Bates' Guide to Physical Examination and History Taking (forgot the title, exactly...but I think that's it). It's something like:

Facing the patient, you stand close to him/her, and extend your arms to around the level of his/her ears, and place your hands around 6 inches away from the back of his head.

From there, you wiggle your fingers and slowly move your hands towards yourself, and you tell your patient to point once he/she sees your wiggling fingers in his/her peripheral vision. The point of the exam is to see whether he has good visual fields, and if they're equal. You can also start from different angles, like from slightly above his ears moving obliquely downwards, etc. As long as you don't move too fast/briskly, and you move equally.🙂

I hope this helps...

 

[AF_PedsBoy]

Yeah, make sure you have him cover one of his eyes (and then switch of course) when you're doing it so you can test the individual visual fields (after all, if it's a lesion past the crossing you still got one good eye that can falsely compensate, especially if you're doing it halfass the way I do!) And since you're staring each other in the eyes, your patient should see the fingers when YOU do. If he doesn't, he may have some deficits - on the other hand if HE sees it first, either he's lying, or maybe YOU need your eyes checked...

Oh and visual acuity, test the bad eye first, go down as far as you can, then have them switch to the good eye - it saves a lot of time and doesn't give them a chance to memorize the lines when they're reading with thier good eye!

 

[Bevo]

thanks.