Physical examination maneuver
Physical Exam
Eye Inspection
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Inspect the eyes and surrounding structures. Note the position and alignment of the eyes, the eyelids and lid margins (including any drooping, swelling, or lesions), and the eyelashes. Examine the conjunctiva and sclera for color and injection, the cornea and lens for clarity, and the iris, and note the size, shape, and symmetry of the pupils. Observe for any discharge, excessive tearing, or redness.
How to Interpret
Showing 19 of 35 findings
Anemia
Conjunctival pallor
Rule in
Somewhat helpful
Rule out
Minimally helpful
Evidence:Moderate
Conjunctivitis
Redness visible from 2 feet
Rule in
Minimally helpful
Rule out
HelpfulWide CI
Evidence:Moderate
No discharge
Rule in
—
Rule out
Somewhat helpfulWide CI
Evidence:Moderate
Purulent discharge
Rule in
Somewhat helpful
Rule out
—
Evidence:ModerateResearch in progress
Matting of both eyes in the morning
Rule in
Somewhat helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Absence of morning eye matting
Rule in
Not helpfulDerived CI
Rule out
Somewhat helpfulWide CI
Evidence:Moderate
Involvement of both eyes
Rule in
Somewhat helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Redness completely obscuring the tarsal vessels
Rule in
Somewhat helpfulWide CI
Rule out
Not helpful
Evidence:Moderate
Follicular conjunctivitis
Rule in
Not helpful
Rule out
Not helpful
Evidence:Moderate
Mucous discharge
Rule in
Not helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:ModerateResearch in progress
Papillary conjunctivitis
Rule in
InconclusiveWide CI
Rule out
Not helpful
Evidence:Moderate
Redness located in the periphery only (no ciliary/circumcorneal flush)
Rule in
Not helpfulDerived CI
Rule out
InconclusiveWide CI
Evidence:Moderate
Report of "purulent" secretions
Rule in
Not helpfulWide CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Watery discharge
Rule in
—
Rule out
InconclusiveWide CI
Evidence:Moderate
Hyperthyroidism
Eyelid retraction
Rule in
Very helpfulDerived CI
Rule out
Minimally helpfulDerived CI
Evidence:Moderate
Hypovolemia
Sunken eyes
Rule in
InconclusiveWide CI
Rule out
Somewhat helpful
Evidence:Moderate
Orbital Fracture
Periorbital emphysema after facial trauma
Rule in
Somewhat helpful
Rule out
Not helpful
Evidence:Moderate
Serious Eye Disease
Anisocoria (≥1 mm difference) with the smaller pupil in the red eye
Rule in
HelpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Stroke
Horner syndrome in a patient with acute stroke
Rule in
Very helpfulDerived CI
Rule out
Not helpfulDerived CI
Evidence:Moderate
Related Bedside Tests
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Pupillary Light Reaction
Rule in:VHSerious Eye Disease, HPoor Neurologic Outcome, HStructural Brain Lesion +11 more
Rule out:SHPoor Neurologic Outcome, SHSerious Eye Disease, SHStructural Brain Lesion +11 more
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Blood Pressure
Rule in:VHHypovolemia, VHMortality, VHStructural Brain Lesion +22 more
Rule out:VHCardiac Tamponade, VHHypovolemia, HLow Cardiac Output +22 more
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Hand Inspection
Rule in:HHepatopulmonary Syndrome, HHypoxemia, SHCrohn Disease +17 more
Rule out:SHHepatopulmonary Syndrome, SHOsteoarthritis, MHAnemia +17 more
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Head and Face Inspection
Rule in:HAcromegaly, HStroke, SHCushing Syndrome +5 more
Rule out:SHAcromegaly, SHCushing Syndrome, SHStroke +5 more
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Spleen Palpation
Rule in:VHSplenomegaly, HMalaria, SHCirrhosis +13 more
Rule out:SHMyelofibrosis, MHInfectious Mononucleosis, MHSplenomegaly +13 more
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Extraocular Movements
Rule in:VHStroke, SHHyperthyroidism, SHMyasthenia Gravis +9 more
Rule out:HMyasthenia Gravis, SHHyperthyroidism, NHOrbital Fracture +9 more