OphthoAcademy
Clinical Examination Skills
Visual acuity and refraction, slit-lamp technique, ophthalmoscopy, tonometry, gonioscopy, perimetry, pupillary and motility exam, and orbital measurement — the bedside techniques every other topic in ophthalmology depends on.
Visual Acuity & Refraction
Visual Acuity Chart Design & Scoring
Snellen, ETDRS, and logMAR chart design and scoring; near notation; vernier hyperacuity; the MCID threshold.
ReadVisual Acuity Testing in Special Populations
Preferential looking in infants, the CF/HM/PL/NPL algorithm, pinhole testing, crowding in amblyopia.
ReadRetinoscopy Technique & Interpretation
Working distance, neutralization point, reflex motion, and the scissoring reflex of irregular astigmatism.
ReadSubjective & Manifest Refraction Technique
Phoropter sequence, fogging, duochrome test, Jackson cross cylinder, and the MPMVA endpoint.
ReadAutorefraction & Objective Refraction
Instrument myopia, infrared measurement mechanism, keratometry, and wavefront aberrometry.
ReadCycloplegic Refraction in Children
Why accommodation hides hyperopia, cyclopentolate pharmacology and onset time, agent selection.
ReadSlit-Lamp & Fundus Examination
Slit-Lamp Illumination Techniques
Diffuse, direct focal, retroillumination, sclerotic scatter, and specular reflection — one instrument, seven ways of seeing.
ReadSlit-Lamp Grading Systems & Instrumentation
LOCS III cataract grading, SUN anterior chamber cell grading, magnification and confocal microscopy.
ReadDirect & Indirect Ophthalmoscopy Technique
Three optical systems for viewing the fundus, each trading magnification against field of view.
ReadFundus Imaging & Peripheral Retinal Exam Technique
Fluorescein angiography, ultra-widefield SLO imaging, scleral depression, and PRP laser delivery.
ReadTonometry
Applanation & Contact Tonometry
Goldmann and Perkins applanation, the Imbert-Fick law, and the central-corneal-thickness artifact.
ReadNon-Contact & Alternative Tonometry
Air-puff tonometry, dynamic contour tonometry, rebound (iCare), and corneal hysteresis.
ReadGonioscopy
Gonioscopy Technique
Lens types, direct vs. indirect gonioscopy, indentation technique, and exam sequencing.
ReadGonioscopic Angle Landmarks & Grading Systems
Schwalbe's line, scleral spur, and the Shaffer and Spaeth angle-grading systems.
ReadGonioscopic Pathologic Findings
Angle neovascularization, peripheral anterior synechiae, the Sampaolesi line, and plateau iris.
ReadPerimetry & Visual Fields
Perimetry Principles
Kinetic vs. static perimetry, the SITA algorithm, and reliability and global indices.
ReadVisual Field Defect Localization
Arcuate and altitudinal scotomas, the glaucoma hemifield test, and chiasmal/retrochiasmal patterns.
ReadPupillary Examination
Pupillary Reflex Pathway & Examination Technique
The four-neuron reflex arc, the swinging flashlight test, and RAPD interpretation.
ReadPupillary Disorders — Clinical Syndromes
Horner syndrome pharmacologic testing, Adie tonic pupil, Argyll Robertson pupils, third nerve palsy.
ReadOcular Motility Examination
Ocular Motility Examination — Cover Tests
Cover-uncover, alternate cover, prism cover testing, and the Hirschberg/Krimsky light-reflex tests.
ReadOcular Motility Examination — Incomitant/Vertical Strabismus Tests
Bielschowsky head tilt, the Parks-Bielschowsky three-step test, Maddox rod, and Worth 4-dot.
ReadOrbital Examination
Exophthalmometry Technique & Instrumentation
Hertel, Luedde, and Naugle exophthalmometers, normal values, and the base-setting/parallax pitfalls.
ReadProptosis — Differential & Clinical Correlation
Thyroid eye disease, carotid-cavernous fistula, orbital cellulitis, and blowout-fracture enophthalmos.
ReadTest yourself on Clinical Examination Skills
OphthoAcademy has real practice questions across every technique on this page, with spaced repetition to help it stick.
Try it in your browser