B. Ocular and Neurologic Evaluation

I. Ocular and neurologic examinations

Goals:

  1. Know how to perform a detailed ocular examination (adult and child).
  2. Be comfortable with most examination techniques used in ophthalmology.
  3. Know how to perform a detailed neurologic examination (adult and child).

Topics

1. Ocular evaluation

1. Evaluation of visual function (visual acuity, stereopsis, color vision, contrast sensitivity, basics of refraction, confrontation visual fields, Amsler grid, photostress testing) (1)

2. Ocular examination, intraocular pressure(1)

3. Funduscopic examination(1)

4. Use of lensometer, phoropter, slit lamp, direct and indirect ophthalmoscopes(1)

5. Ocular motility, use of prisms, red glass, maadox rod, forced duction test, sensory testing(1)

6. Ocular examination of the young child(1)

2. Neurologic evaluation

1. Neurologic examination (adult and child) (1)

2. Basic cognitive evaluation (mini mental status) (1)

3. Neuro-ophthalmic evaluation of the comatose patient(1)

4. Examination of children:

1. Developmental milestones for children(2)

2. Visual maturation of children(1)

II. Ancillary tests obtained in neuro-ophthalmology

​Goals:

  1. Know how to order and how to interpret most ancillary tests obtained in neurology and ophthalmology.
  2. Know the contraindications and side-effects of these tests

Topics:

1. Visual field testing

1. Automated perimetry(1)

2. Goldmann perimetry(1)

3. Tangent screen(1)

2. Electrophysiology

1. Visual evoked responses(1)

2. Electroretinogram(3)

3. Electrooculogram(3)

4. Dark adaptation(3)

5. Eye movement recordings(2)

3. Ocular and orbital ultrasound(2)

4. Retinal fluorescein angiography(2), ICG angiography(3)

5. Nerve fiber layer analysis

1. Optical coherence tomography (OCT)(2)

6. Imaging

1. Computed tomography(1)

2. Magnetic resonance imaging(1)

3. Vascular imaging (ultrasonography, CTA, MRA, CTV, MRV, conventional angiogram)(1)

4. Functional neuro-imaging (MRI, SPECT, PET)(3)

7. Lumbar puncture with opening pressure(1)

Proposed by the Curriculum of the North American Neuro-Ophthalmology Society (NANOS)

Next: C. Neuro-Ophthalmic Symptoms and Signs