Examination while patient sitting
General Inspection: diagnostic facies
- ptosis
- xanthelasma
- exophthalmos / lid retraction
- cornea: arcus, band keratopathy, K-F rings
- sclera: jaundice / pallor, conjunctival injection
Individual Nerves:
- II
- visual acuity assessed with glasses on and one eye at a time
- visual fields (with glasses off)
- fundoscopic examination
- III / IV / VI
- Inspect pupils (ECC)
- Light Reflex
- Accommodation reflex
- Eye Movements: Up and Down and mark out a “H”
- note any failure, diplopia, nystagmus
- corneal reflex
- V: power, reflexes, sensation (feel muscle)
- pin and touch
- LMN → ear / palate
- + ask about taste sense (anterior 2/3rds of tongue)
- VII: inspect / movements
- VIII:
- IX + X: Say “Ah” (uvula), gag reflex, speech / cough
- XI:
- inspect trapezius and feel muscle
- Power: trapezius and sternomastoid muscles
- XII: inspect, move (tongue)
