Malays J Med Sci. 2021;28(5):142–148
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142
Introduction
The eyes are the window to the brain.
Examination of eye is important to unravel
the brain’s pathology. Besides clinical history,
neurological examination remains a classical and
an important bedside exercise. Bedside physical
examination is a mixture of art and science.
Examination of eye is a part that blends the
felds of ophthalmology and neurology. For the
examination of eye, the following fve domains
need to be addressed: i) inspection; ii) testing for
visual function; iii) pupil evaluation; iv) ocular
motor evaluation and v) auscultation (1–3).
The fow of examination is crucial so that no
steps will be missed. Figure 1 shows the fow
and element of eye examination. In this article,
an intercalation or ‘sandwich’ technique is used
to describe each component of bedside neuro-
ophthalmological exam (Figure 2).
To cite this article: Ng PM, Abdullah JM, Idris Z, Ghani ARI, Abdul Halim S. What are your eyes revealing?
the contemporary bedside neuro-ophthalmological examination. Malays J Med Sci. 2021;28(5):142–148.
https://doi.org/10.21315/mjms2021.28.5.15
To link to this article: https://doi.org/10.21315/mjms2021.28.5.15
Abstract
The neuro-ophthalmological evaluation is done to assess the integrity of cranial nerves
II, III, IV, VI. This work does not intend to substitute the examination in a fully equipped
ophthalmology suite. The aim of this manuscript is to describe bedside examination of the eye by
using simple apparatus that are easily available. This work incorporates the usage of smartphone
application, as smartphone is deemed an accessory in almost every resident’s pocket during review
of patients as a consult in the emergency department. However, the essence of traditional physical
examination remains the fundamental. Understanding of neuroanatomy and neurophysiology of
the eye and the central nervous system can enhance the clinician’s performance at the bedside.
Keywords: bedside examination, eye, neuro-ophthalmological, smartphone
What are Your Eyes Revealing?
The Contemporary Bedside Neuro-
Ophthalmological Examination
Pei Meng NG
1,2,5
, Jafri Malin ABDULLAH
1,2,3
, Zamzuri IDRIS
1,2,3
,
Abdul Rahman Izaini GHANI
1,2,3
, Sanihah ABDUL HALIM
1,3,4
1
Department of Neurosciences, School of Medical Sciences, Universiti Sains
Malaysia, Kubang Kerian, Kelantan, Malaysia
2
Department of Neurosciences, Hospital Universiti Sains Malaysia,
Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
3
Brain and Behaviour Cluster, School of Medical Sciences, Universiti Sains
Malaysia, Kubang Kerian, Kelantan, Malaysia
4
Unit of Neurology, Department of Medicine, School of Medical Sciences,
Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
5
Department of Neurosurgery, Sarawak General Hospital, Kuching,
Sarawak, Malaysia
Submitted: 26 Jan 2021
Accepted: 1 Apr 2021
Online: 26 Oct 2021
Brief
Communication