Sunday 10 July 2011

Examination of the Cornea

The cornea is examined with a point light source and a loupe. The
cornea is smooth, clear, and reflective. The reflection is distorted in the presence
of corneal disorders. Epithelial defects, which are also very painful, will
take on an intense green color after application of fluorescein dye; corneal
infiltrates and scars are grayish white. Evaluating corneal sensitivity is also
important. Sensitivity is evaluated bilaterally to detect possible differences in
the reaction of both eyes. The patient looks straight ahead during the examination.
The examiner holds the upper eyelid to prevent reflexive closing and
touches the cornea anteriorly. Decreased sensitivity can provide
information about trigeminal or facial neuropathy, or may be a sign of a viral
infection of the cornea.

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