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21 Steps Revised
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21-
STE
PS
IN
OPT
OM
ETR
Y
Proper
ty of:
Deneb
A.
Daym
on,
O.D.
 

1
OPHTHALM
OSCOPY
An objective
method of
examining the
interior of the
eye.
Instrument:
Ophthalmosco
pe Methods: a)
direct
ophthalmoscop
e b) indirect
ophthalmoscop
e Illumination:
Dim
Illumination
Test Target:
Gross Target
Test Distance:
6ft. Workin
g Distance: 16”
 Manner of
Examination:
OD to OD; OS
to OS
Recording of
expected
normal
findings: (+)
ROR reflex,
clear media
distinct border
(disc), cd ratio,
h. 3; v.3 or .
4mm av ratio
2:3; (-)
exudates (-)
hemorrhages
good foveal
reflex (pinpoint
reflex)
Procedure:
1) start at 16”
w/ +8.00d in
 place in
ophthalmoscop
e power 2)
move closer to
he pxn and go
more minus
until you will
arrive to the
amount of lens
that will give a
clear fundus
image at a
distance of less
than 1”
 
 

2
Ophthalmom
etry
Procedure: -
adjust eye
piece, adjust
body, the
drums (at
44D), align the
patient’s lateral
canthus
with the
canthus marker
-turn on the
instrument and
find the mires
-adjust the
mires that the
circle, + and
–
 signs will be
aligned. -get
the reading
-solve for the
base curve:
337.5/flattest K
-get the corneal
astigmatism:
subtract the
powers then
use the axis of
the meridian of
the least power
*Answer is
always in
minus sign.
SIGNIFICAN
CE: -To
measure the
anterior radius
of curvature of
cornea. -To
determine Base
Curve for CLs
Fitting (hard
CLs) -Assess
the quality of
tears (N°
3secs.) -To
assess if cornea
is steep or flat
-To assess any
ocular
pathology e.g.
Keratoconus /
Kl plana
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