PRACTICUM DAN BASIC CLINICAL SKILL STUDY GUIDE BASIC CLINICAL SKILL VISUAL PHYSIOLOGY STUDY GUIDE
A. GOAL The goals of the study are to enhance the student’s knowledge and skill for examination of:
1. Visual acuity visus 2. Visual field
3. Pupil reflex, consensual reflex and pupil reflex during accomodation. 4. Organic and functional color blindness
5. Cornea arch
B. EQUIPMENT USE:
1.
Optotype Snellen 2.
Perimeter
3.
Flashlight 4.
Ishihara chart and wall thread 5.
Keratoskope placido
C. WORK METHODE: 1. VISUAL ACUITY, Snellen chart
Hang the Snellen chart at the wall at eye height during sitting Ask the subject sit on the chair which 6 meter distance from the Snellen chart
For examination of the right eye, close the left eye with the left hand. Ask the subject to read the letter on the chart, begin with the upper to the lower
raw, without any mistake Repeat this test to the other eye, with same method.
Visual acuity visus is calculatefrom the formula: V = dD, where V= visual acuity, d= the distance of subject from Snellen chart, and D= the distance that
normal person can be read correctly this is write at the Snellen chart. Must be remember that the value from dD, can’t be to simplified.
Learning task: Comprehend the influence of aging process to the visual acuity, what is the cause that problem?
2. VISUAL FIELD use perimeter
The equipment for visual field test is perimeter. Place the perimeter on the laboratory table
Ask the subject sitting face to the perimeter, and close one eye which is note test. If the right eye would be tested, close the feft eye and visepersa.
Palace the subject chic on the chic support and ajust the height so the lower margin of their eye and the eye level equal to the center of perimeter.
Fit he perimeter fist so the perimeter arc on the plane surface Ask the subject to focus their sight to the centre of perimeter during the examination.
Take the sign tool white and move it along the perimeter arc from side to the center , and stop when the subject begin sea it, and read the number at the perimeter
arc, and than write on the form.
Udayana University Faculty of Medicine, DME
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Repeated again that method after move the perimeter arc 30 degree clock wise direction
Do it to the other eye with the same method.
Learning task: comprehend the difference of visual field of right and left eye. What is the mono and binocular vision?
3. PUPIL REFLEX, CONSENSUIL REFLEX and PUPIL REFLEX DURING ACCOMMODATION use flashlight
Ask the subject sitting on the chair and relax Beam of light to the right eye of the subject with flashlight, and look at the change of
pupil diameter of the right eye if the pupil diameter is smaller, it mean pupil reflex positive.
Repeat it again but now look the change of pupil diameter of the left eye consensual reflex, If the diameter of left eye is smaller, it mean consensual reflex positive
Ask the subject to watch the examiner’s fingers from distance around 50 cm and than moving it approach the subject focusing the eyes or accommodation, and
the examiner watching the changes of pupil diameter .During accommodation the pupil diameter should be smaller.
Learning task: describe the mechanism of pupil reflex and consensual reflex. Why the pupil diameter change to smaller during accommodation?
4. ORGANIC AND FUNCTIONAL COLOR BLINDNESS use Ishihara chart and wall thread.
