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Ocular PE :eye: (:melon:Intraocular examination (Iris:leaves: (Abn.,…

- - - - Func: protect Orbit
      - Location @ Orbital rim
      - :!: Noted: Eyebrow ptosis, It’s landmark to approximate wound around eyebrow area
    - - Func
        
        Lacrimal systems :bee:
        
        Protect eyeballs
      - Normal position
        
        Look at Palpebral aperture/fissure during open or close eyes
      - Abnormalities
        
        Ptosis: หนังตาตกsignificant ปิดบัง pupil
        
        Lagophthalmos: หลับตาแล้วยังเห็นตาขาว พอนานไปทำให้ตาแห้ง
        
        Lid lag: มองล่างละ eye lid ไม่คลุม
        
        Lid retraction
      - Margins ~ 3 landmarks
        
        Lash line ~ black color
        ➭ 2-3 rows & Direction to outside
        
        Gray line ~ grey color
        ➭ Mucocutaneous
        
        Meibomian gland opening ~ white color
        ➭ Lipid glands
      - Structures
        (outside to inside)
        
        Skin
        
        Orbicularis oculi
        
        Tarsus
        
        Orbital septum
        
        Levator palpebrae superioris
        
        Conjunctiva
        
        Abnormalities :grapes:
    - - Secretion system
        
        Major:
        Lacrimal gland
        
        Minor:
        Gland of Krause & Wolfring
      - Excretion system
        
        Along the pathway
        
        :!:Cause ที่ทำให้คนไข้ขมคอ เพราะว่าน้ำตามันไหลลงคอทู
      - Lacrimal duct obstruction
        
        Dacryocystitis
        
        Epiphora
        
        Lacrimal sac irrigation
    - - Anatomical subsections
        
        Preseptal
        
        Postseptal
        
        Extraconal
        
        Intraconal
        
        Ocular
      - Orbital bone
      - EOM
      - Ocular alignment
    - - 3 parts
        
        :dango:Bulbar conjunctiva
        
        :dango:Fornical conjunctiva
        
        :dango:Palpebral conjunctiva
        
        Eversion of eyelids
        
        To look for Foreign bodies that cause constant irritation
        
        :warning:C/I in Suspected of ruptured globe (as its already leaking content fr eye)
      - Func
        
        Lubricate eye by producing mucus & tears & involving in immune surveillance
      - Abnormalities
        
        Subconjunctival hemorrhage
        
        Chemosis conjunc บวมน้ำ
        
        Pinguecular ต้อลม
        
        Pterygium ต้อเนื้อ
    - - Normal position: โค้งไปด้านนอก
      - Abnormality
        
        Districhiasis: extra rows of eyelash
        
        Trichiasis: ขนตางุ้ม ➭ โดน cornea ➭ can irritate
        
        Poliosis: ขนขาว
        
        Madarosis: ขนตาหาย
  - - - Smooth surface
      - Refractive power
      - Transparent
    - - เขี่ย cornea
      - Esthesiometer
- - - - Anterior chamber
        
        Ant. Chamber depth accessment
        
        For checking
        
        Glaucoma (แยก open and close ได้)
        
        Head trauma (by look for leaking)
        
        Depth grading
        
        Abn
        
        Hypopyon
        
        Hyphema
        
        Angle assessment
        by Gonioscopy
      - Posterior chamber
    - - Vitreous
      - Background fundus
      - Macular
      - Vss
      - Optic disc
  - - - Symmetry
        
        Miosis (< 2mm)
        
        Mydriasis (>7mm)
      - Asymmetry
        
        Anisocoria
    - - Light
      - Accomodation (near reflex)
        
        3 components
        
        5 Cs
  - - - :eight_pointed_black_star:Cataracts
        clouding of lens/ opacification
      - Position
        
        Anterior dislocation
        
        Posterior dislocation
        
        Subluxation