Cranial Nerve Examination

Optic fundus (Ophthalmoscopy)

Ask the patient to fixate on a distant object away from any bright light. Use the right eye to examine the patient's right eye and the left eye to examine the patient's left eye.

Note clarity of the disc edge

Look for haemorrhages or white patches of exudate

Adjust the ophthalmoscope lens until the retinal vessels are in focus and trace these back to the optic disc

Ask the patient to look at the light of the ophthalmoscope. This brings N the macula into view

Note width of blood vessels and look for arteriovenous nipping at cross-over points.

If small pupil size prevents fundal examination, then dilate pupil with homatropine. This is contraindicated if either an acute expanding lesion or glaucoma is suspected.

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