Intraocular Melanoma; Eye Melanoma; Ocular Melanoma; Melanoma of the Uvea; Uveal Melanoma
Intraocular (uveal) melanoma is a rare cancer that forms in the eye. It usually has no early signs or symptoms. As with melanoma of the skin, risk factors include having fair skin and light-colored eyes. Learn about the signs and symptoms of intraocular melanoma and find out how it can be treated.
Malignant melanoma of the choroid
Image by Wellcome Trust
What Is
Intraocular (Uveal) Melanoma (Melanoma of the Eye) - About
Image by Hellerhoff
Intraocular (Uveal) Melanoma (Melanoma of the Eye) - About
Right eye melanoma (left side), MRI image in T2 sequence
Image by Hellerhoff
What Is Intraocular (Uveal) Melanoma?
Key Points
Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye.
Being older and having fair skin may increase the risk of intraocular melanoma.
Signs and symptoms of intraocular melanoma may include blurred vision or a dark spot on the iris.
Tests that examine the eye are used to diagnose intraocular melanoma.
A biopsy of the tumor is rarely needed to diagnose intraocular melanoma.
Certain factors affect prognosis (chance of recovery) and treatment options.
Intraocular melanoma is a disease in which malignant (cancer) cells form in the tissues of the eye.
Intraocular melanoma begins in the middle of three layers of the wall of the eye. The outer layer includes the white sclera (the "white of the eye") and the clear cornea at the front of the eye. The inner layer has a lining of nerve tissue, called the retina, which senses light and sends images along the optic nerve to the brain. The middle layer, where intraocular melanoma forms, is called the uvea or uveal tract, and has three main parts: the iris, the ciliary body, and the choroid.
The middle layer, where intraocular melanoma forms, is called the uvea or uveal tract, and has three main parts:
Iris
The iris is the colored area at the front of the eye (the "eye color"). It can be seen through the clear cornea. The pupil is in the center of the iris and it changes size to let more or less light into the eye. Intraocular melanoma of the iris is usually a small tumor that grows slowly and rarely spreads to other parts of the body.
Ciliary body
The ciliary body is a ring of tissue with muscle fibers that change the shape of the lens. It is found behind the iris. Changes in the shape of the lens help the eye focus. The ciliary body also makes the clear fluid that fills the space between the cornea and the iris. Intraocular melanoma of the ciliary body is often larger and more likely to spread to other parts of the body than intraocular melanoma of the iris.
Choroid
The choroid is a layer of blood vessels that bring oxygen and nutrients to the eye. Most intraocular melanomas begin in the choroid. Intraocular melanoma of the choroid is often larger and more likely to spread to other parts of the body than intraocular melanoma of the iris.
Anatomy of the eye, showing the outside and inside of the eye including the sclera, cornea, iris, ciliary body, choroid, retina, vitreous humor, and optic nerve. The vitreous humor is a liquid that fills the center of the eye.
Intraocular melanoma is a rare cancer that forms from cells that make melanin in the iris, ciliary body, and choroid. It is the most common eye cancer in adults.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (12)
Uveal Melanoma, A Modern Approach to Ocular Oncology | Tara McCannel, MD | UCLAMDChat
Video by UCLA Health/YouTube
Overview of Uveal Melanoma, Dr. Prithvi Mruthyunjaya
Video by Ocular Melanoma Foundation/YouTube
Understanding metastatic uveal melanoma
Video by MD Anderson Cancer Center/YouTube
Metastatic Uveal Melanoma Program at Jefferson
Video by Jefferson Advancement/YouTube
New Hope for Melanoma Patients
Video by ABC News/YouTube
Treating Melanoma-Mayo Clinic
Video by Mayo Clinic/YouTube
Melanoma Research Alliance Presents: The Promise of Immunotherapy
Video by MelanomaReAlli/YouTube
Identifying Melanoma (Health Tip)
Video by Healthguru/YouTube
Understanding Melanoma (Skin Cancer #7)
Video by Healthguru/YouTube
Treating Melanoma (Skin Cancer #8)
Video by Healthguru/YouTube
The 4 Stages of Melanoma: The Deadliest Form of Skin Cancer - Mayo Clinic
Video by Mayo Clinic/YouTube
Melanoma Animation
Video by MELASciences/YouTube
28:43
Uveal Melanoma, A Modern Approach to Ocular Oncology | Tara McCannel, MD | UCLAMDChat
UCLA Health/YouTube
35:18
Overview of Uveal Melanoma, Dr. Prithvi Mruthyunjaya
Ocular Melanoma Foundation/YouTube
2:12
Understanding metastatic uveal melanoma
MD Anderson Cancer Center/YouTube
2:24
Metastatic Uveal Melanoma Program at Jefferson
Jefferson Advancement/YouTube
2:09
New Hope for Melanoma Patients
ABC News/YouTube
2:41
Treating Melanoma-Mayo Clinic
Mayo Clinic/YouTube
4:12
Melanoma Research Alliance Presents: The Promise of Immunotherapy
MelanomaReAlli/YouTube
1:00
Identifying Melanoma (Health Tip)
Healthguru/YouTube
3:18
Understanding Melanoma (Skin Cancer #7)
Healthguru/YouTube
3:08
Treating Melanoma (Skin Cancer #8)
Healthguru/YouTube
3:17
The 4 Stages of Melanoma: The Deadliest Form of Skin Cancer - Mayo Clinic
Mayo Clinic/YouTube
3:01
Melanoma Animation
MELASciences/YouTube
Risk Factors
Sensitive content
This media may include sensitive content
Eye and ocular adnexa: malignant melanoma
Image by The Armed Forces Institute of Pathology (AFIP)
Sensitive content
This media may include sensitive content
Eye and ocular adnexa: malignant melanoma
Variably pigmented, mushroom-shaped choroidal tumor has ruptured the Bruch membrane and grown into the subretinal space. A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines. (National Cancer Institute NCI)
Image by The Armed Forces Institute of Pathology (AFIP)
What Are the Risk Factors for Intraocular (Uveal) Melanoma?
Being older and having fair skin may increase the risk of intraocular melanoma.
Anything that increases your risk of getting a disease is called a risk factor. Having a risk factor does not mean that you will get cancer; not having risk factors doesn’t mean that you will not get cancer. Talk with your doctor if you think you may be at risk.
Risk factors for intraocular melanoma include the following:
Having a fair complexion, which includes the following:
Fair skin that freckles and burns easily, does not tan, or tans poorly.
Blue or green or other light-colored eyes.
Older age.
Being White.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (1)
New Treatments for Ocular Melanoma | Tara McCannel, MD | UCLAMDChat
Video by UCLA Health/YouTube
29:53
New Treatments for Ocular Melanoma | Tara McCannel, MD | UCLAMDChat
UCLA Health/YouTube
Symptoms
Uveal melanoma
Image by Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center
Uveal melanoma
Iris melanoma : Malignant uveal melanoma. A form of cancer that begins in melanocytes (cells that make the pigment melanin). It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines. (National Cancer Institute NCI)
Image by Jonathan Trobe, M.D. - University of Michigan Kellogg Eye Center
What Are the Signs and Symptoms of Intraocular (Uveal) Melanoma?
Signs of intraocular melanoma include blurred vision or a dark spot on the iris.
Intraocular melanoma may not cause early signs or symptoms. It is sometimes found during a regular eye exam when the doctor dilates the pupil and looks into the eye. Signs and symptoms may be caused by intraocular melanoma or by other conditions. Check with your doctor if you have any of the following:
Blurred vision or other change in vision.
Floaters (spots that drift in your field of vision) or flashes of light.
A dark spot on the iris.
A change in the size or shape of the pupil.
A change in the position of the eyeball in the eye socket.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (3)
Conjunctival nevus
Conjunctival nevus of a 32 years old male
Image by Imrankabirhossain
Ocular Melanoma: Mayo Clinic Radio
Video by Mayo Clinic/YouTube
Uveal Melanoma, A Modern Approach to Ocular Oncology | Tara McCannel, MD | UCLAMDChat
Video by UCLA Health/YouTube
Conjunctival nevus
Imrankabirhossain
9:16
Ocular Melanoma: Mayo Clinic Radio
Mayo Clinic/YouTube
28:43
Uveal Melanoma, A Modern Approach to Ocular Oncology | Tara McCannel, MD | UCLAMDChat
UCLA Health/YouTube
Diagnosis
laser photocoagulation surgery
Image by MarkPanin
laser photocoagulation surgery
Laser photocoagulation
Image by MarkPanin
How Is Intraocular (Uveal) Melanoma Diagnosed?
Tests that examine the eye are used to help diagnose intraocular melanoma.
The following tests and procedures may be used:
Physical exam and health history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. A history of the patient’s health habits and past illnesses and treatments will also be taken.
Eye exam with dilated pupil: An exam of the eye in which the pupil is dilated (enlarged) with medicated eye drops to allow the doctor to look through the lens and pupil to the retina. The inside of the eye, including the retina and the optic nerve, is checked. Pictures may be taken over time to keep track of changes in the size of the tumor. There are several types of eye exams:
Ophthalmoscopy: An exam of the inside of the back of the eye to check the retina and optic nerve using a small magnifying lens and a light.
Slit-lamp biomicroscopy: An exam of the inside of the eye to check the retina, optic nerve, and other parts of the eye using a strong beam of light and a microscope.
Gonioscopy: An exam of the front part of the eye between the cornea and iris. A special instrument is used to see if the area where fluid drains out of the eye is blocked.
Ultrasound exam of the eye: A procedure in which high-energy sound waves (ultrasound) are bounced off the internal tissues of the eye to make echoes. Eye drops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a picture of the inside of the eye and the distance from the cornea to the retina is measured. The picture, called a sonogram, shows on the screen of the ultrasound monitor.
High-resolution ultrasound biomicroscopy: A procedure in which high-energy sound waves (ultrasound) are bounced off the internal tissues of the eye to make echoes. Eye drops are used to numb the eye and a small probe that sends and receives sound waves is placed gently on the surface of the eye. The echoes make a more detailed picture of the inside of the eye than a regular ultrasound. The tumor is checked for its size, shape, and thickness, and for signs that the tumor has spread to nearby tissue.
Transillumination of the globe and iris: An exam of the iris, cornea, lens, and ciliary body with a light placed on either the upper or lower lid.
Fluorescein angiography: A procedure to look at blood vessels and the flow of blood inside the eye. An orange fluorescent dye (fluorescein) is injected into a blood vessel in the arm and goes into the bloodstream. As the dye travels through blood vessels of the eye, a special camera takes pictures of the retina and choroid to find any areas that are blocked or leaking.
Indocyanine green angiography: A procedure to look at blood vessels in the choroid layer of the eye. A green dye (indocyanine green) is injected into a blood vessel in the arm and goes into the bloodstream. As the dye travels through blood vessels of the eye, a special camera takes pictures of the retina and choroid to find any areas that are blocked or leaking.
Ocular coherence tomography: An imaging test that uses light waves to take cross-section pictures of the retina, and sometimes the choroid, to see if there is swelling or fluid beneath the retina.
A biopsy of the tumor is rarely needed to diagnose intraocular melanoma.
A biopsy is the removal of cells or tissues so they can be viewed under a microscope to check for signs of cancer. Rarely, a biopsy of the tumor is needed to diagnose intraocular melanoma. Tissue that is removed during a biopsy or surgery to remove the tumor may be tested to get more information about prognosis and which treatment options are best.
The following tests may be done on the sample of tissue:
Cytogenetic analysis: A laboratory test in which the chromosomes of cells in a sample of tissue are counted and checked for any changes, such as broken, missing, rearranged, or extra chromosomes. Changes in certain chromosomes may be a sign of cancer. Cytogenetic analysis is used to help diagnose cancer, plan treatment, or find out how well treatment is working.
Gene expression profiling: A laboratory test that identifies all of the genes in a cell or tissue that are making (expressing) messenger RNA. Messenger RNA molecules carry the genetic information that is needed to make proteins from the DNA in the cell nucleus to the protein-making machinery in the cell cytoplasm.
A biopsy may result in retinal detachment (the retina separates from other tissues in the eye). This can be repaired by surgery.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (1)
Understanding metastatic uveal melanoma
Video by MD Anderson Cancer Center/YouTube
2:12
Understanding metastatic uveal melanoma
MD Anderson Cancer Center/YouTube
Ophthalmoscopy
Ophthalmoscopy
Also called: Funduscopy, Retinal Examination
Ophthalmoscopy is an exam that uses a magnifying lens and a light to check the fundus of the eye (back of the inside of the eye, including the retina and optic nerve). Ophthalmoscopy may be used to check for eye problems, such as glaucoma, macular degeneration, eye cancer, optic nerve problems, or eye injury.
Ophthalmoscopy
Also called: Funduscopy, Retinal Examination
Ophthalmoscopy is an exam that uses a magnifying lens and a light to check the fundus of the eye (back of the inside of the eye, including the retina and optic nerve). Ophthalmoscopy may be used to check for eye problems, such as glaucoma, macular degeneration, eye cancer, optic nerve problems, or eye injury.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
The retina, blood vessels, and the optic disc appear normal.
Related conditions
https://medlineplus.gov/ency/article/003881.htm [accessed on Feb 15, 2019]
https://www.verywellhealth.com/eye-exam-tests-and-procedures-3421854 [accessed on Feb 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (50)
ophthalmoscopy video
Video by CHECT UK/YouTube
Approach to Fundoscopy / Ophthalmoscopy
Video by Stanford Medicine 25/YouTube
Veterinary Medicine
"GUANTANAMO BAY, Cuba %u2013 Army Sgt. Ardicio Galvao, an animal care non-commissioned officer at the Guantanamo Bay Veterinary Treatment Facility, performs an eye examination on a kitten up for adoption.
Image by The National Guard
Retinoblastoma - Treatment Option Overview
Retinoblastoma (Rb) is a rapidly developing cancer that develops from the immature cells of aretina, the light-detecting tissue of the eye and is the most common malignant tumor of the eye in children.
Image by Tero Kivela
ophtalmogram of the retina, optic nerve, fovea and macula. The spot to the left (temporal side) of the centre is the macula.
Self made ophtalmogram of the retina of the right eye. It shows the optic disc as a bright area on the right (nasal side) where blood vessels converge. The spot to the left (temporal side) of the centre is the macula. The grey, more diffuse spot in the centre is a shadow artifact.
Image by Ske.
Diabetic retinopathy - Diabetic Eye Disease NIDDK
Proliferative retinopathy Description: Proliferative retinopathy, an advanced form of diabetic retinopathy, occurs when abnormal new blood vessels and scar tissue form on the surface of the retina.
Image by National Eye Institute, National Institutes of Health
Retinitis
Fundus, photograph-CMV retinitis
Image by National Eye Institute, National Institutes of Health
Age Related Macular degeneration - How is AMD detected?
Description: A fundus photo showing intermediate age-related macular degeneration.
Image by National Eye Institute, National Institutes of Health
Fluorescein angiography
Fluorescein retinography of a 33 years old patient (right eye), showing the optical disc at the inferior right quadrant and the macula lutea at the inferior left quadrant (darker spot). No anomalies detected.
Image by Mekhahertz
Age-Related Macular Degeneration Overview
Macular Degeneration
Image by Ralf Roletschek
Retinoblastoma - Treatment Option Overview
Ocular fundus aspect of retinoblastoma
Image by Aerts, I, Lumbroso-Le Rouic, L, Marion Gauthier-Villars, M, Brisse, H, Doz, F, Desjardins, L. Retinoblastoma.
Cytomegalovirus retinitis
Fundus photograph of CMV retinitis
Image by National Eye Institute, National Institutes of Health
Macular degeneration - Charles Bonnet syndrome (Visual Hallucinations)
This image shows an eye fundus viewed through a retinal camera, with signs of macular degeneration
Image by Tmhlee
Scanning laser ophthalmoscopy
Retinal image of a left eye via Optos Optomap.
Image by Modified by Overand - Original by Judgesurreal777
In background retinopathy, a slight deterioration in the small blood vessels of the retina, portions of the vessels may swell and leak fluid into the surrounding retinal tissue.
Retinopathy in fundus of eye
Image by National Eye Institute, National Institutes of Health
Optic Nerve
Healthy optic nerve
Image by Esteve.olm
Leber Congenital Amaurosis
Retina Photo of LCA : Retina photo of a patient with Leber congenital amaurosis (LCA), an inherited retinal disease that causes severe visual impairment early in childhood. Special gene testing is necessary to determine if the patient has the RPE65-associated type of the disease.
Image by National Eye Institute, National Institutes of Health.
Retinopathy of Prematurity (Small Animation)
Retinopathy of Prematurity (ROP)
Image by National Eye Institute/NIH
central retinal artery
Image by self
Drusen
Drusen in Optical Coherence Tomography
Image by Ipoliker
Chloroquine retinopathy
Chloroquine retinopathy in the left eye of a 55-year-old woman who had taken chloroquine for rheumatoid arthritis for more than 4 years, with an estimated total dose of 365 gr (250 mg daily). She first presented with a history of gradually decreasing visual acuity without any other symptoms approximately two years earlier. The latest examination revealed that her visual acuity was 30/200 right eye and 60/200 left eye. Left image shows typical bull's eye sign and right image is the fluorescien angiogram of the same eye showing increased fluorescence in the macular area and round-shaped blocked fluorescence in the central fovea.
Image by Doctors:Xiaoyun Ma, Liang Yan, Linping He Dongyi He, Hao Lu from Shanghai, China
Cone dystrophy
Fundus of cone rod dystrophy : Fundus of a 34 year-old patient with cone rod dystrophy due to Spinocerebellar Ataxia Type 7 (SCA7). Note that the macular area, and also the mid periphery, are atrophic.
Image by Christian P Hamel
Bardet-Biedl syndrome
Bardet-Biedl syndrome : Fundus of a 31 year-old patient with Bardet Biedl syndrome. The peripheral retina does not show any large lesion but the macula is atrophic.
Image by Beales PL, Elcioglu N, Woolf AS, Parker D, Flinter FA
Diabetic Retinopathy
Fundus photo showing scatter laser surgery for diabetic retinopathy.
Image by National Eye Institute, National Institutes of Health
Central retinal vein occlusion
Branch retinal vein occlusion (BRVO) Color fundus photograph of the left eye shows occlusion of the superotemporal branch of retinal vein resulting in intraretinal hemorrhages and retinal exudates in the corresponding sector of retina.
Image by Kim Baxter, Cambridge University Hospitals NHS Foundation Trust, Wellcome Images
Infant Eye cross section
Cross-section of the healthy eye of an infant, showing a retina that is in perfect condition, having never been exposed to smoke-borne toxins that would compromise circulation and result in retinal damage. Image supports content showing the health benefits of smoke cessation.
Image by TheVisualMD
Chorioretinitis
Chorioretinitis AIDS : Photograph taken of the back of the eye of an AIDS patient with chorioretinitis, which is an inflammation of the retina and choroid (thin pigmented vascular coat of the eye).
Image by NCI
Drusen
Macular Soft Drusen : Fundus image of macular soft Drusen in the right eye of a 70 year old male
Image by Ipoliker
Ocular larva migrans granuloma via toxocara canis infection from newborn puppies
Ocular larva migrans granuloma via toxocara canis infection from newborn puppies
Image by enableuser
Smoking and the eye
The effects of cigarette smoke have been associated with many ailments, including two sight-threatening eye conditions. Left, an eye that shows signs of macular degeneration. The yellow or off-white deposits, called drusen, that form beneath the retinal layer are a common sign that macular degeneration is in progress. Right, an eye with a cataract. The lens of the eye is usually crystal clear to allow unobstructed vision. Cataract also means \"waterfall.\" Doctors have likened the difficulty of seeing through a lens with a cataract to trying to see clearly through a rushing waterfall.
Image by TheVisualMD
Tuberous Sclerosis - What is the prognosis?
The prognosis for individuals with TSC is highly variable and depends on the severity of symptoms. Those individuals with mild symptoms usually do well and have a normal life expectancy, while paying attention to TSC-specific issues. Individuals who are severely affected can suffer from severe mental retardation and persistent epilepsy.
Image by National Eye Institute of the NIH
Retinitis pigmentosa
Fundus of patient with retinitis pigmentosa, end stage: Fundus of patient with retinitis pigmentosa, end stage (Pigment deposits are present all over the retina. Retinal vessels are very thin and optic disc is pale.
Image by Christian Hamel
Retinopathy - Cerebroretinal microangiopathy with calcifications and cysts. Exudative retinopathy and vitreos hemorrhage: A fundus photograph of a child with cerebroretinal microangiopathy with calcifications and cysts, in which red vitreous bleeding and yellowish lipid under a detached retina are seen.
Cerebroretinal microangiopathy with calcifications and cysts. Exudative retinopathy and vitreos hemorrhage: A fundus photograph of a child with cerebroretinal microangiopathy with calcifications and cysts from a mutation in the CTC1 gene, in which red vitreous bleeding and yellowish lipid under a detached retina are seen.
Image by Tero Kivela, MD, FEBO
Left, an eye that shows signs of macular degeneration. Right, an eye with a cataract.
This image features two sight-threatening eye conditions. Left, an eye that shows signs of macular degeneration. The yellow or off-white deposits, called drusen, that form beneath the retinal layer are a common sign that macular degeneration is in progress. Right, an eye with a cataract. The lens of the eye is usually crystal clear to allow unobstructed vision. Cataract also means \"waterfall.\" Doctors have likened the difficulty of seeing through a lens with a cataract to trying to see clearly through a rushing waterfall.
Image by TheVisualMD
Presumed Ocular Histoplasmosis Syndrome
Retinal photograph of ocular histoplasmosis
Image by Wickedthought
Neuro-ocular syphilis
This funduscopic image reveals the effects of late neuro-ocular syphilis on the optic disk and retina. Note the typical features of neuro-ocular syphilis, which includes severe optic nerve atrophy, and chorioretinitis, or inflammation of the choroidal and neural layers of the retina.
Image by CDC/ Susan Lindsley
Fundus Photography
An eye care professional takes fundus autofluorescence photographs to study the retina.
Image by National Eye Institute, National Institutes of Health
Complications of diabetes mellitus
Diabetes and Small Vessel Disease : High levels of blood glucose damage the smallest vessels in your body, the capillaries, just as they do the larger vessels. One cause of this damage may be the high levels of advanced glycation end products (AGEs) that glucose creates inside capillary cells.
Image by TheVisualMD
Cross-section of retina, close-up of the photoreceptors
DHA and vision
Image by TheVisualMD
Eye with Diabetic Retinopathy
Eye with cross section revealing diabetic retinopathy; the damaged retina due to diabetes. The visible damaged includes yellow patches of fatty deposits and tiny dark dots, or microaneurysms.
Image by TheVisualMD
DiabeticRetinopathy
Diabetic Retinopathy
Image by Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Macula of Retina
photograph of the retina of the human eye, with overlay diagrams showing the positions and sizes of the macula, fovea, and optic disc
Image by National Eye Institute of the NIH
Partially Sectioned Human Eye Exposing front and back of the eye including the Retina
Three-dimensional visualization reconstructed from human data. Anteriolateral view of a partially sectioned eye, as well as associated eye muscles. As well as being protected by the bony orbital cavity of the skull, the eyeball is anchored in place by several thin strap muscles that attach to virtually every one of its sides except the front. These muscles tug in concert, allowing the eye to move in any direction to track objects. The clear cornea covers and protects the front exterior of the eye while the colored iris dilates and constricts to insure the proper amount of light is striking the back of the eye. The lens contorts to focus the incoming light back to the retina, which covers roughly the entire back half of the eye. Special cells embedded within the retina are responsible for the sensation of light: the cones, for color perception, and rods, for black and white perception. Electrical nerve impulses are channeled into the optic nerve at the back of the eye to the visual cortex in the brain.
Image by TheVisualMD
Month 1
A newborn sleeps 12-20 hours per day, but don't let that fool you: your baby will go through enormous transformations in his first month. Your womb was safe, warm, dark, and quiet. Now your baby has to adapt to the outside world, full of bright lights, noises, and unfamiliar sensations.
Image by TheVisualMD
Retina close-up
A picture of a patient’s retina is displayed at the optometry clinic March 11, 2016, at Malmstrom Air Force Base, Mont. The clinic is the only one in Montana that has a retinal imagining device called an Optos, used to look at the retina without diluting it. (U.S. Air Force photo/Senior Airman Jaeda Tookes)
Image by U.S. Air Force photo/Senior Airman Jaeda Tookes
Macula of Retina
Animation of Optic cup and macula - 3D motion parallax -The optic cup and macula of a healthy 24 year old female. Image is released to wikimedia commons with patient consent. GIF displays a three dimensional view of the cup via motion parallax. Imaged with a non-mydriatic fundus camera at Pacific University College of Optometry.
Image by Eric Wiessner
Fundus photo showing focal laser surgery for diabetic retinopathy
Fundus photo showing focal laser surgery for diabetic retinopathy.
Image by National Eye Institute, National Institutes of Health
Eye with Diabetic Retinopathy
Image showing diabetic retinopathy , a condition caused by diabetes and affects the capillaries of the retina causing eventual blindness unless treated.
Image by TheVisualMD
Retina showing reticular pseudodrusen - early age-related macular degeneration (AMD)
A new clinical study led by the National Eye Institute (NEI), part of the National Institutes of Health, will follow 500 people over five years to learn more about the natural history of early age-related macular degeneration (AMD). By using the latest technologies to visualize structures within the eye and measure their function, researchers hope to identify biomarkers of disease progression, well before it advances to late-stage disease and causes vision loss. AMD is the leading cause of vision impairment and blindness among people age 50 and older in the United States.
Image by NIH Image Gallery
Hypotrichosis with juvenile macula dystrophy
ophthalmoscopy left eye of a 5-year-old boy with HJMD
Image by BazokaSmurf
9:33
ophthalmoscopy video
CHECT UK/YouTube
8:56
Approach to Fundoscopy / Ophthalmoscopy
Stanford Medicine 25/YouTube
Veterinary Medicine
The National Guard
Retinoblastoma - Treatment Option Overview
Tero Kivela
ophtalmogram of the retina, optic nerve, fovea and macula. The spot to the left (temporal side) of the centre is the macula.
Ske.
Diabetic retinopathy - Diabetic Eye Disease NIDDK
National Eye Institute, National Institutes of Health
Retinitis
National Eye Institute, National Institutes of Health
Age Related Macular degeneration - How is AMD detected?
National Eye Institute, National Institutes of Health
Fluorescein angiography
Mekhahertz
Age-Related Macular Degeneration Overview
Ralf Roletschek
Retinoblastoma - Treatment Option Overview
Aerts, I, Lumbroso-Le Rouic, L, Marion Gauthier-Villars, M, Brisse, H, Doz, F, Desjardins, L. Retinoblastoma.
Cytomegalovirus retinitis
National Eye Institute, National Institutes of Health
Macular degeneration - Charles Bonnet syndrome (Visual Hallucinations)
Tmhlee
Scanning laser ophthalmoscopy
Modified by Overand - Original by Judgesurreal777
In background retinopathy, a slight deterioration in the small blood vessels of the retina, portions of the vessels may swell and leak fluid into the surrounding retinal tissue.
National Eye Institute, National Institutes of Health
Optic Nerve
Esteve.olm
Leber Congenital Amaurosis
National Eye Institute, National Institutes of Health.
Retinopathy of Prematurity (Small Animation)
National Eye Institute/NIH
central retinal artery
self
Drusen
Ipoliker
Chloroquine retinopathy
Doctors:Xiaoyun Ma, Liang Yan, Linping He Dongyi He, Hao Lu from Shanghai, China
Cone dystrophy
Christian P Hamel
Bardet-Biedl syndrome
Beales PL, Elcioglu N, Woolf AS, Parker D, Flinter FA
Diabetic Retinopathy
National Eye Institute, National Institutes of Health
Central retinal vein occlusion
Kim Baxter, Cambridge University Hospitals NHS Foundation Trust, Wellcome Images
Infant Eye cross section
TheVisualMD
Chorioretinitis
NCI
Drusen
Ipoliker
Ocular larva migrans granuloma via toxocara canis infection from newborn puppies
enableuser
Smoking and the eye
TheVisualMD
Tuberous Sclerosis - What is the prognosis?
National Eye Institute of the NIH
Retinitis pigmentosa
Christian Hamel
Retinopathy - Cerebroretinal microangiopathy with calcifications and cysts. Exudative retinopathy and vitreos hemorrhage: A fundus photograph of a child with cerebroretinal microangiopathy with calcifications and cysts, in which red vitreous bleeding and yellowish lipid under a detached retina are seen.
Tero Kivela, MD, FEBO
Left, an eye that shows signs of macular degeneration. Right, an eye with a cataract.
TheVisualMD
Presumed Ocular Histoplasmosis Syndrome
Wickedthought
Neuro-ocular syphilis
CDC/ Susan Lindsley
Fundus Photography
National Eye Institute, National Institutes of Health
Complications of diabetes mellitus
TheVisualMD
Cross-section of retina, close-up of the photoreceptors
TheVisualMD
Eye with Diabetic Retinopathy
TheVisualMD
DiabeticRetinopathy
Blausen.com staff (2014). "Medical gallery of Blausen Medical 2014
Macula of Retina
National Eye Institute of the NIH
Partially Sectioned Human Eye Exposing front and back of the eye including the Retina
TheVisualMD
Month 1
TheVisualMD
Retina close-up
U.S. Air Force photo/Senior Airman Jaeda Tookes
Macula of Retina
Eric Wiessner
Fundus photo showing focal laser surgery for diabetic retinopathy
National Eye Institute, National Institutes of Health
Eye with Diabetic Retinopathy
TheVisualMD
Retina showing reticular pseudodrusen - early age-related macular degeneration (AMD)
NIH Image Gallery
Hypotrichosis with juvenile macula dystrophy
BazokaSmurf
Slit-Lamp Exam
Slit-Lamp Exam
Also called: Biomicroscopy, Slit Lamp Exam, Slit Lamp Test
A slit lamp exam is an eye examination using an instrument that combines a low-power microscope with a light source that makes a narrow beam of light. The instrument may be used to examine the retina, optic nerve, and other parts of the eye.
Slit-Lamp Exam
Also called: Biomicroscopy, Slit Lamp Exam, Slit Lamp Test
A slit lamp exam is an eye examination using an instrument that combines a low-power microscope with a light source that makes a narrow beam of light. The instrument may be used to examine the retina, optic nerve, and other parts of the eye.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result indicates that the eyelashes, eyelids, and lining of the eyelids (conjunctiva) look normal. All of the structures inside the eye are found to be normal.
Related conditions
https://medlineplus.gov/ency/article/003880.htm [accessed on Feb 15, 2019]
https://www.cancer.gov/publications/dictionaries/cancer-terms/def/slit-lamp-eye-exam [accessed on Feb 15, 2019]
https://www.verywellhealth.com/eye-exam-tests-and-procedures-3421854 [accessed on Feb 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Fleck dystrophy
Fleck corneal dystrophy. Appearance of the cornea by slit-lamp biomicroscopy (left image) and by confocal microscopy (right image) (Courtesy Dr. Charles N. McGhee). Klintworth Orphanet Journal of Rare Diseases
Image by Klintworth GK
Sensitive content
This media may include sensitive content
Slit Lamp Exam
Maj. Ivy Madson, 99th Air Base Squadron optometry flight commander, uses a Slit Lamp to examine the interior of the eye during an exam for Airman 1st Class Hunter, 18th Reconnaissance Squadron Airman, Jan. 13, 2015, at Creech Air Force Base, Nevada. The Creech Medical Aid Station now offers optometry services to all personnel assigned to Creech AFB Tuesdays from 7:30 a.m. to 3 p.m. (Last names have been withheld for security purposes). (U.S. Air Force photo by Staff Sgt. Adawn Kelsey/Released)
Image by U.S. Air Force photo by Staff Sgt. Adawn Kelsey/Released
Cystinosis
Slit-lamp photographs of three-year-old patient with nephropathic cystenosis before (left) and after (right) cysteamine eyedrop therapy. Treatment targeting metabolic defect dramatically dissolves painful crystals in the eye's cornea.
Image by NIH Clinical Center Location: National Institutes of Health, Bethesda, MD
Slit Lamp Photo of Eye
Slit Lamp Photo of Eye
Image by U.S. Air Force photo by Senior Airman Zachary Hada/Released
How is a cataract detected?
Slit lamp image of the cornea, iris and lens (showing mild cataract)
Image by Baristoprak~commonswiki
Lisch nodules
Lisch nodules on surface of iris. The patient was a 14-year-old male with pulsating exophthalmos of the left eye and poor vision of this highly myopic left eye. There was also some ptosis of the left eye with mild puffiness. Upward gaze of the left eye was limited. Slit lamp examination showed multiple, slightly raised nodules of the right iris.
Image by National Eye Institute
Von Hippel-Lindau Disease
Von Hippel-Lindau Disease : Slit lamp photograph showing retinal detachment in Von Hippel-Lindau disease
Image by National Eye Institute of the NIH
Stress female student studying
Young female in a green shirt, viewed from the back at left, concentrating on work materials at a desk with a lamp lamp. Computer monitor, phone and bulletin board are visible, as are stacks of books and papers. Image supports content about identifying harmful patterns in your life, including work-related stress, so you can plan to replace them with more beneficial patterns
Image by TheVisualMD
What are the symptoms of a cataract?
Slit lamp camera view of Cataract in Human Eye
Image by Rakesh Ahuja, MD
Congenital stromal corneal dystrophy
The cornea is particularly opaque in the anterior stroma by slit-lamp biomicroscopy.
Image by Klintworth GK
Ocular tonometry
Goldmann mires : Semicircles seen during Goldmann tonometry through slit lamp
Image by Manimury
Cystinosis
The patient was a 4 1/2-year-old male who looked about 2 1/2 years old at his first visit. He was admitted to the hospital because of poor growth and polydipsia. The patient was admitted to the hospital in uremia and coma. An examination of the cornea showed the surface and the immediate subepithelial region to be studded with golden-brown, fine scintillating particles, uniformly distributed throughout the entire cornea, but possibly sparing the most peripheral zone ([1]). The stroma appeared to be clear, but the posterior surface of the cornea showed the same type of particles in the lower nasal quadrant, although sparser than was the case on the surface. There were apparently also some crystals in the conjunctiva. The tentative diagnosis was cystinosis or Fanconi's syndrome, but unlike the other cases reported, the crystals appeared to be at the anterior and posterior surfaces and not in the stroma. The patient was seen again at age 8 years old, when he was back in the hospital. The cornea still contained crystals ([2]). The only noteworthy event in the recent history was a nosebleed of 20 hours duration. His non-protein nitrogen was 140 and he appeared very pale, but he was lively and alert. He had a persistent anemia and potassium depletion. Presumably both the anemia and the hemorrhagic diathesis were attributed to uremia. The patient died in the hospital. Noteworthy was the fact that his three siblings all showed clear corneas without crystals. However, the youngest was age three months and when she was examined again at age two years, she had abundant crystals and nephropathic cystinosis.
Image by National Eye Institute
What are the risks of cataract surgery?
Royal Australian Navy Lt. Elizabeth Livingstone and Singapore army Maj. Paul Zhao, both doctors embarked aboard the Military Sealift Command hospital ship USNS Mercy (T-AH 19), perform cataract surgery on a Vietnamese patient aboard Mercy during a Pacific Partnership 2010 visit to Quy Nhon, Vietnam. Pacific Partnership is the fifth in a series of annual U.S. Pacific Fleet humanitarian and civic assistance endeavors to strengthen regional partnerships.
Image by U.S. Navy photo by Mass Communication Specialist 2nd Class Eddie Harrison
Sensitive content
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Fundoscopic (Ophthalmoscopic) Exam
Dr. (Maj.) Michael Bogaard, 509th Medical Operations Squadron optometrist, uses a binocular indirect ophthalmoscope to perform an eye assessment on Senior Airman Jeffrey Afemon, 509th MDOS public health technician, in the optometry clinic at Whiteman Air Force Base, Mo., Sept. 4, 2013. The ophthalmoscope helps focus the light inside the patient’s eye and provides an image that the doctor uses to judge the health of the retina.
Image by U.S. Air Force photo by Staff Sgt. Nick Wilson/Released
Slit lamp photograph showing c in Von Hippel-Lindau disease
Slit lamp photograph showing retinal detachment in Von Hippel-Lindau disease.
Image by National Eye Institute/National Institutes of Health
Neurofibromatosis type 1(>90% of cases) together with scattered café au lait pigmented skin lesions and multiple neurifibromas (superficial or deep) in skin or other organs.
Lisch nodules are numerous nodules of dendritic melanocytes in aggregates within the iris. They are brown-yellow, round shape, raised papules as seen with slit lamp examination in the iris of patients with Neurofibromatosis type 1(>90% of cases) together with scattered café au lait pigmented skin lesions and multiple neurifibromas (superficial or deep) in skin or other organs. Similar nodules are also found in Watson syndrome which is in addition characterized by macrocephaly, pulmonary stenosis, short status and low intelligence. No treatment is required but a close follow-up of main diseases is mandatory for avoiding any serious complications.
Image by Dimitrios Malamos
Ocular tonometry
The PASCAL Dynamic Contour Tonometer
Image by Tonywirthlin at English Wikipedia
Slit Lamp Exam and Techniques
Video by iSEE/YouTube
Slit Lamp Examination (Biomicroscopy) in English
Video by TheIACLE/YouTube
Slit Lamp Exam
Video by Brian Nelson/YouTube
Fleck dystrophy
Klintworth GK
Sensitive content
This media may include sensitive content
Slit Lamp Exam
U.S. Air Force photo by Staff Sgt. Adawn Kelsey/Released
Cystinosis
NIH Clinical Center Location: National Institutes of Health, Bethesda, MD
Slit Lamp Photo of Eye
U.S. Air Force photo by Senior Airman Zachary Hada/Released
How is a cataract detected?
Baristoprak~commonswiki
Lisch nodules
National Eye Institute
Von Hippel-Lindau Disease
National Eye Institute of the NIH
Stress female student studying
TheVisualMD
What are the symptoms of a cataract?
Rakesh Ahuja, MD
Congenital stromal corneal dystrophy
Klintworth GK
Ocular tonometry
Manimury
Cystinosis
National Eye Institute
What are the risks of cataract surgery?
U.S. Navy photo by Mass Communication Specialist 2nd Class Eddie Harrison
Sensitive content
This media may include sensitive content
Fundoscopic (Ophthalmoscopic) Exam
U.S. Air Force photo by Staff Sgt. Nick Wilson/Released
Slit lamp photograph showing c in Von Hippel-Lindau disease
National Eye Institute/National Institutes of Health
Neurofibromatosis type 1(>90% of cases) together with scattered café au lait pigmented skin lesions and multiple neurifibromas (superficial or deep) in skin or other organs.
Dimitrios Malamos
Ocular tonometry
Tonywirthlin at English Wikipedia
4:58
Slit Lamp Exam and Techniques
iSEE/YouTube
13:20
Slit Lamp Examination (Biomicroscopy) in English
TheIACLE/YouTube
7:10
Slit Lamp Exam
Brian Nelson/YouTube
Eye Examinations
Eye Examinations
Also called: Eye Exams, Routine Eye Examination, Standard Ophthalmic Exam, Vision Tests
A standard eye exam is a series of tests done to check your vision and the health of your eyes. Key elements of an eye examination include dilation, tonometry, visual field test and a visual acuity test.
Eye Examinations
Also called: Eye Exams, Routine Eye Examination, Standard Ophthalmic Exam, Vision Tests
A standard eye exam is a series of tests done to check your vision and the health of your eyes. Key elements of an eye examination include dilation, tonometry, visual field test and a visual acuity test.
Eye examinations tend to follow a certain pattern: After talking with your doctor about the type and severity of your symptoms, both eyes will usually be tested to measure the visual acuity (sharpness of sight). Then the doctor will look at your eyes from the outside, take a closer look at them using a slit lamp, and measure the intraocular pressure (the pressure inside the eyeball). Eye drops are given before some tests to dilate (enlarge) the pupil of the eye for a certain amount of time. This makes it easier for the doctor to see the back of the eye. Depending on the symptoms and any other medical conditions you may have, the eye examination might be carried out differently and additional tests might be done.
Structure of the eye
Eye examinations may be necessary for various reasons, for instance due to external eye injuries or sudden vision problems. Vision also tends to get worse with age, so many people end up going to see an eye doctor at some point.
General eye examinations typically involve testing your vision and your pupillary response (how your pupils react). Pupils usually automatically contract and get smaller when light enters the eye.
The doctor first looks at the eye from the outside to see whether, for instance, the conjunctiva or eyelids are red and inflamed. The conjunctiva are the membranes lining the exposed part of the eyeball and inner surface of the eyelids. If your eye hurts, it is important to describe exactly where it hurts – e.g. on the surface of the eye, inside the eye or only when you move your eye? Eye pain can also radiate to your forehead or temples.
If you aren't sure whether your vision has got worse, you can have your visual acuity (sharpness of sight) tested by an eyespecialist. To do this eye test, one of your eyes is covered and you are asked to look at an eye chart with your other eye. The chart may have letters, numbers or C-shapes on it. These get smaller as you go down the chart.
Your visual acuity is measured by determining which of the figures you can still recognize from five meters away. The eye doctor will also check your near vision by holding a card with a similar chart on it at reading distance (about 30 centimeters). If necessary, this eye test can then be repeated using corrective lenses. Technically speaking, visual acuity is a measure of how well you can see two points as being separate. The closer together the points are, the more difficult this becomes.
Vision is often assessed using other tests too. These include color vision tests, where you are asked to identify certain patterns in multicolored pictures. Eye movement and the position of your eyes relative to one another are important too. In children who have a squint, for example, the relative position of their eyes is abnormal due to different abilities of their left and right eye to see clearly. Tests to check your field of vision are also common.
Your field of vision (or visual field) is what you can see without moving your eye. The test is done using a bowl-shaped instrument known as a perimeter. With your head supported by a chin rest, you focus on a fixed spot at the center of the bowl. Lights flash in the bowl, and may move around or become increasingly brighter. If you see a flash or notice a change, you press a button. The more areas in your field of vision are tested, the more accurate the diagnosis – but the test will then take longer as a result.
Perimetry test: Press a button everytime you see a flash
Your field of vision is very important as it helps you know what is around you. Because various medical conditions affect the field of vision, perimetry tests are often done if damage to the retina or optic nerve is suspected, or if someone has headaches or dizzinessfor no known reason. Eye diseases like glaucoma and age-related macular degeneration also lead to changes in the field of vision. Although perimetry tests aren't painful, they can be quite tiring because you have to concentrate for a long time.
A slit lamp is a microscope that projects a narrow, slit-shaped light. It is one of the main instruments used by eye specialists. You are asked to place your head on a chin rest. The doctor sits across from you and shines the light into your eyes, one at a time.
The intense line of light and various lighting options (direct, indirect, diffuse) enable the doctor to see most of the different areas of the eye magnified up to 60 times: the front, middle and back of the eye, and even as far back as the retina in the fundus of the eye. Modern slit lamps also include a device that measures intraocular pressure (the pressure inside the eyeball).
A special device known as an ophthalmoscope can be used to look at the fundus (back) of the eye through the pupil and examine structures like the retina, optic nerve, blood vessels and the choroid coat. This examination is known as ophthalmoscopy or funduscopy ("fundus" is the Latin word for "bottom" or "base"). About 20 minutes before the examination, the pupils of the eyes are dilated (enlarged) using eye drops.
In the direct exam, the doctor positions the ophthalmoscope close to the eye and shines a beam of light directly into it to see a small magnified section of the back of the eye. This is particularly useful for examining the structures at the center of the eye's fundus, including the optic nerve, the blood vessels and the macula.
In the indirect exam, the doctor uses a condensing lens with a bright light to examine the eye from a distance of about 60 centimeters. This allows them to see a larger area of the fundus, providing a better overview as well as a three-dimensional image. A slit lamp is sometimes used at the same time. Doing so greatly magnifies the retina and provides better lighting.
Conditions such as retinal detachment and optic nerve damage can be diagnosed using ophthalmoscopy. This examination can also be a good idea in people who have diabetes or high blood pressure because both of these conditions can damage blood vessels in the eye.
If your pupils are dilated using eye drops, your eyes become very sensitive to light and your vision becomes blurred. For this reason, you are only allowed to drive a car or operate machinery again once the effect of the eye drops has worn off.
The measurement of intraocular pressure (tonometry) is one of the most common eye examinations. The pressure inside the eyeball becomes too high if a fluid produced in the eye (called aqueous humor) cannot drain properly and starts to build up. An intraocular pressure of between 10 and 21 mmHg (millimeters of mercury) is considered to be normal in adults.
Various instruments can be used to measure the pressure in the eye. In what is known as applanation tonometry, the cornea is first numbed using eye drops. Then a small measuring device is placed against the surface of the cornea, putting a little pressure on the eye.
The device measures how much pressure is needed to flatten the cornea by 3 millimeters. This is a measure of the pressure inside the eye.
Intraocular pressure can also be measured using an approach known as non-contact tonometry. Here the pressure is measured by applying a short puff of air to the cornea. Neither of these examinations are painful.
Other eye examinations can be done to confirm certain diagnoses and help plan treatment. For instance, the retina can be examined using fluorescein angiography. This involves injecting a fluorescent dye into a vein in the arm. The dye spreads through all the blood vessels in the body, including those in the retina. The doctor can then use a special camera to detect changes in the blood vessels of the eye.
Optical coherence tomography (OCT) is another type of eye examination. OCT uses a laser to measure things like the thickness of the retina. This technique can be applied to detect the build-up of fluid in the retina.
Standard eye exam: MedlinePlus Medical Encyclopedia [accessed on Sep 03, 2018]
Additional Materials (41)
Sclera (White of the Eye)
Human eye revealing sclera
Image by agnesliinnea
Slit Lamp Photo of Eye
Slit Lamp Photo of Eye
Image by U.S. Air Force photo by Senior Airman Zachary Hada/Released
Tuberous Sclerosis - What is the prognosis?
The prognosis for individuals with TSC is highly variable and depends on the severity of symptoms. Those individuals with mild symptoms usually do well and have a normal life expectancy, while paying attention to TSC-specific issues. Individuals who are severely affected can suffer from severe mental retardation and persistent epilepsy.
Image by National Eye Institute of the NIH
Eye diagram — side view
Image by National Eye Institute (NEI)
Pupil Response
Dilated and Undilated Pupil - Portions of the retina that can be seen through an undilated versus a dilated pupil.
Image by National Eye Institute, National Institutes of Health
Low Vision
What is Low Vision Infographic. Information on low vision: causes, numbers, what we can do, and vision rehabilitation.
Image by National Eye Institute
Human Eye
Anatomy of the human eye with corneal cross-section
Image by National Eye Institute
Dilated Pupil
My friend had a scratch down her eye and had to have it dilated at hospital for three days with drops.
Image by Sophie Riches
Eye Drops
Eye drops ophthalmology service Hospital Douala Cameroun
Image by Happi Raphael/Wikimedia
Retinography
Self made ophtalmogram of the retina of the right eye. It shows the optic disc as a bright area on the right (nasal side) where blood vessels converge. The spot to the left (temporal side) of the centre is the macula. The grey, more diffuse spot in the centre is a shadow artifact.
Image by Ske.
Age-Related Macular Degeneration Overview
Macular Degeneration Projected Statistics
Image by National Eye Institute
Sensitive content
This media may include sensitive content
Eye exam
Capt. Luanne Danes uses a light to check the anterior segment of Master Sgt. Timothy Vanderhoff's eye during his visit to the Optometry Clinic Nov. 19, 2009, Eielson Air Force Base, Alaska. Captain Danes is looking for healthy structure of the eye and ensuring no corneal disease is present. Captain Danes, officer in charge of Optometry, is assigned to the 354th Medical Operation Squadron. Sergeant Vanderhoff, crew chief, is assigned to the 168th Aircraft Maintenance Squadron. (U.S. Air Force photo/Staff Sgt. Christopher Boitz)
Image by U.S. Air Force photo/Staff Sgt. Christopher Boitz
Eye exam
U.S. Navy Lt. Patricia Salazar examines a patient's eyes at a Continuing Promise medical clinic set up by staff assigned to the hospital ship USNS Comfort in Paita, Peru
Image by Petty Officer 1st Class Brian A. Goyak, U.S. Navy
Eye Examination
Eye Examination
Image by 12019
Infant Eye cross section
Cross-section of the healthy eye of an infant, showing a retina that is in perfect condition, having never been exposed to smoke-borne toxins that would compromise circulation and result in retinal damage. Image supports content showing the health benefits of smoke cessation.
Image by TheVisualMD
Cornea
Cornea - transparent covering over the eye
Image by www.keratomania.com Eye diagram by Chabacano via Wikimedia Commons
anatomy of the human eye, iris, cornea, pupil
Image by skeeze
Animation: Dilated Eye Exam
Video by National Eye Institute, NIH/YouTube
Iris (anatomy)
Image by Shanon
Pupil
Dilated and Undilated Pupil - Portions of the retina that can be seen through an undilated versus a dilated pupil.
Image by National Eye Institute, National Institutes of Health
How is glaucoma detected?
The PASCAL Dynamic Contour Tonometer
Image by Tonywirthlin at English Wikipedia
Optical Coherence Tomography
A detailed cross-sectional image of the back of the eye is obtained using an optical coherence tomography (OCT).
Image by National Eye Institute, National Institutes of Health
Help protect yourself from getting and spreading Pink Eye (conjunctivitis)
Help protect yourself from getting and spreading Pink Eye (conjunctivitis)
Image by CDC
Dry Eye
Diffuse lissamine green staining in a person with severe dry eye.
Image by Jesse Vislisel, MD and Brice Critser, CRA
Tear Production
Cornea - Structures involved in tear production.
Image by National Eye Institute
Eyeglasses on display
Eyeglasses are displayed at the optometry clinic March 11, 2016, at Malmstrom Air Force Base, Mont. The clinic hosts an internship program open to students including primary care, ocular disease and two specialty clinics, lasting two months each. (U.S. Air Force photo/Senior Airman Jaeda Tookes)
Image by U.S. Air Force photo/Senior Airman Jaeda Tookes
Extrinsic Eye Muscles
Extrinsic Eye Muscles
Image by OpenStax
Eye movements elevators
Eye movements elevators
Image by Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist
Treating Amblyopia
In addition to patching the eye, one hour of “near” work, or close-up work, such as coloring, is part of the treatment for amblyopia.
Image by National Eye Institute, National Institutes of Health
Sensitive content
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Routine eye exam, rare diagnosis
This image shows deposits of cholesterol on the back of an eye affected by Coats’ Disease. The rare, congenital disease, only found in about one in 100,000 people, is caused by abnormal blood vessel development behind the retina. The affected blood vessels leak blood content into the eye leading to partial or complete retinal detachment if not treated. (Courtesy photo)
Image by Courtesy photo
Checking an elderly patient's eyes
U.S. Air Force Capt. Eric Noll, an optometrist with the 354th Medical Group, Eielson Air Force Base, Alaska, checks a patient’s eyesight at Tata Primary and Secondary School during Pacific Angel 18-3 in Luganville, Espiritu Santo Island, Vanuatu, July 16, 2018. The optometry team handed out 228 pairs of eye glasses and 534 pairs of sunglasses during the first two days of the clinic. Now entering its eleventh year Operation PAC ANGEL ensures that the region’s militaries are prepared to work together to address humanitarian crises. (U.S. Air Force photo by Senior Airman Kelsey Tucker)
Image by U.S. Air Force photo by Senior Airman Kelsey Tucker
Eye Exam
U.S. Air Force Maj. Brett Ringger, an optometrist from the Texas Air National Guard’s 136th Airlift Wing, tests a patient’s vision at a health-care clinic being operated by the Air National Guard and U.S. Navy Reserve at Lee County High School in Beattyville, Ky., June 23, 2018. The clinic is one of four that comprised Operation Bobcat, a 10-day mission to provide military medical troops with crucial training in field operations and logistics while offering no-cost health care to the residents of Eastern Kentucky. The clinics, which operated from June 15-24, offered non-emergent medical care; sports physicals; dental cleanings, fillings and extractions; eye exams and no-cost prescription eye glasses. (U.S. Air National Guard photo by Lt. Col. Dale Greer)
U.S. Air Force Maj. Brett Ringger, an optometrist from the Texas Air National Guard’s 136th Airlift Wing, tests a patient’s vision at a health-care clinic being operated by the Air National Guard and U.S. Navy Reserve at Lee County High School in Beattyville, Ky., June 23, 2018. The clinic is one of four that comprised Operation Bobcat, a 10-day mission to provide military medical troops with crucial training in field operations and logistics while offering no-cost health care to the residents of Eastern Kentucky. The clinics, which operated from June 15-24, offered non-emergent medical care; sports physicals; dental cleanings, fillings and extractions; eye exams and no-cost prescription eye glasses. (U.S. Air National Guard photo by Lt. Col. Dale Greer)
Image by U.S. Air National Guard photo by Lt. Col. Dale Greer
Vision Exam
U.S. Air Force Maj. Robert Groves, an optometrist from the New Hampshire Air National Guard’s 157th Air Refueling Wing, conducts a vision exam at a health-care clinic being operated by the Air Guard and U.S. Navy Reserve at Estill County High School in Irvine, Ky., June 21, 2018. The clinic is one of four that comprised Operation Bobcat, a 10-day mission to provide military medical troops with crucial training in field operations and logistics while offering no-cost health care to the residents of Eastern Kentucky. The clinics, which operated from June 15-24, offered non-emergent medical care; sports physicals; dental cleanings, fillings and extractions; eye exams and no-cost prescription eye glasses. (U.S. Air National Guard photo by Lt. Col. Dale Greer)
Image by U.S. Air National Guard photo by Lt. Col. Dale Greer
Eyeglasses selection
U.S. Air Force Master Sgt. Julie Brown (left), a medic from the Texas Air National Guard’s 136th Airlift Wing, helps Lindsey Howard of Richmond, Ky., select frames for a new pair of eyeglasses at a health-care clinic being operated by the Air Guard and U.S. Navy Reserve at Estill County High School in Irvine, Ky., June 21, 2018. The clinic is one of four that comprised Operation Bobcat, a 10-day mission to provide military medical troops with crucial training in field operations and logistics while offering no-cost health care to the residents of Eastern Kentucky. The clinics, which operated from June 15-24, offered non-emergent medical care; sports physicals; dental cleanings, fillings and extractions; eye exams and no-cost prescription eye glasses. (U.S. Air National Guard photo by Lt. Col. Dale Greer)
Image by U.S. Air National Guard photo by Lt. Col. Dale Greer
Eye Exam
U.S. Air Force Maj. Robert Groves, an optometrist from the New Hampshire Air National Guard’s 157th Air Refueling Wing, examines a patient’s eyes at a health-care clinic being operated by the Air Guard and U.S. Navy Reserve at Estill County High School in Irvine, Ky., June 21, 2018. The clinic is one of four that comprised Operation Bobcat, a 10-day mission to provide military medical troops with crucial training in field operations and logistics while offering no-cost health care to the residents of Eastern Kentucky. The clinics, which operated from June 15-24, offered non-emergent medical care; sports physicals; dental cleanings, fillings and extractions; eye exams and no-cost prescription eye glasses. (U.S. Air National Guard photo by Lt. Col. Dale Greer)
Image by U.S. Air National Guard photo by Lt. Col. Dale Greer
Optometry
U.S. Air Force Senior Airman Dane Mendelsohn, a medic from the Kentucky Air National Guard’s 123rd Airlift Wing, screens an optometry patient at a health-care clinic being operated by the Air Guard and U.S. Navy Reserve at Breathitt County High School in Jackson, Ky., June 20, 2018. The Jackson clinic is one of four that comprised Operation Bobcat, a 10-day mission to provide military medical troops with crucial training in field operations and logistics while offering no-cost health care to the residents of Eastern Kentucky. The clinics, which operated from June 15-24, offered non-emergent medical care; sports physicals; dental cleanings, fillings and extractions; eye exams and no-cost prescription eye glasses. (U.S. Air National Guard photo by Lt. Col. Dale Greer)
Image by U.S. Air National Guard photo by Lt. Col. Dale Greer
Visual Test
Visual Test - Comprehensive Eye exam
Image by Paul Diaconu
Slit Lamp test
Slit Lamp test - Comprehensive Eye exam
Image by Paul Diaconu
Presbyopia
Presbyopia - Visual Test
Image by Tumisu
Eye Exam
Eye Exam
Image by David Mark
Sclera (White of the Eye)
agnesliinnea
Slit Lamp Photo of Eye
U.S. Air Force photo by Senior Airman Zachary Hada/Released
Tuberous Sclerosis - What is the prognosis?
National Eye Institute of the NIH
Eye diagram — side view
National Eye Institute (NEI)
Pupil Response
National Eye Institute, National Institutes of Health
Low Vision
National Eye Institute
Human Eye
National Eye Institute
Dilated Pupil
Sophie Riches
Eye Drops
Happi Raphael/Wikimedia
Retinography
Ske.
Age-Related Macular Degeneration Overview
National Eye Institute
Sensitive content
This media may include sensitive content
Eye exam
U.S. Air Force photo/Staff Sgt. Christopher Boitz
Eye exam
Petty Officer 1st Class Brian A. Goyak, U.S. Navy
Eye Examination
12019
Infant Eye cross section
TheVisualMD
Cornea
www.keratomania.com Eye diagram by Chabacano via Wikimedia Commons
anatomy of the human eye, iris, cornea, pupil
skeeze
3:24
Animation: Dilated Eye Exam
National Eye Institute, NIH/YouTube
Iris (anatomy)
Shanon
Pupil
National Eye Institute, National Institutes of Health
How is glaucoma detected?
Tonywirthlin at English Wikipedia
Optical Coherence Tomography
National Eye Institute, National Institutes of Health
Help protect yourself from getting and spreading Pink Eye (conjunctivitis)
CDC
Dry Eye
Jesse Vislisel, MD and Brice Critser, CRA
Tear Production
National Eye Institute
Eyeglasses on display
U.S. Air Force photo/Senior Airman Jaeda Tookes
Extrinsic Eye Muscles
OpenStax
Eye movements elevators
Patrick J. Lynch, medical illustrator; C. Carl Jaffe, MD, cardiologist
Treating Amblyopia
National Eye Institute, National Institutes of Health
Sensitive content
This media may include sensitive content
Routine eye exam, rare diagnosis
Courtesy photo
Checking an elderly patient's eyes
U.S. Air Force photo by Senior Airman Kelsey Tucker
U.S. Air National Guard photo by Lt. Col. Dale Greer
Vision Exam
U.S. Air National Guard photo by Lt. Col. Dale Greer
Eyeglasses selection
U.S. Air National Guard photo by Lt. Col. Dale Greer
Eye Exam
U.S. Air National Guard photo by Lt. Col. Dale Greer
Optometry
U.S. Air National Guard photo by Lt. Col. Dale Greer
Visual Test
Paul Diaconu
Slit Lamp test
Paul Diaconu
Presbyopia
Tumisu
Eye Exam
David Mark
Visual Acuity Test
Visual Acuity Test
Also called: Snellen Test
A visual acuity test is an eye exam that checks the smallest letters you can read on a standardized chart (Snellen chart) or a card held 20 feet (6 meters) away. Visual acuity refers to your ability to recognize the shapes and details of the things you see.
Visual Acuity Test
Also called: Snellen Test
A visual acuity test is an eye exam that checks the smallest letters you can read on a standardized chart (Snellen chart) or a card held 20 feet (6 meters) away. Visual acuity refers to your ability to recognize the shapes and details of the things you see.
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Use the slider below to see how your results affect your
health.
ratio
0.02
0.04
0.125
0.32
0.8
Your result is Normal vision.
US: 20/25 to 20/12 (Metric: 6/7.5 to 6/4)
Visual acuity is expressed as a decimal or a fraction. 1 = US 20/20 or metric 6/6 is considered optimal vision.
The top number refers to the distance you stand from the chart. This is often 20 feet (6 meters).
The bottom number indicates the distance at which a person with normal eyesight could read the same line you correctly read.
Related conditions
If you aren't sure whether your vision has got worse, you can have your visual acuity (sharpness of sight) tested by an eye specialist. To do this eye test, one of your eyes is covered and you are asked to look at an eye chart with your other eye. The chart may have letters, numbers or C-shapes on it. These get smaller as you go down the chart.
Your visual acuity is measured by determining which of the figures you can still recognize from five meters away. The eye doctor will also check your near vision by holding a card with a similar chart on it at reading distance (about 30 centimeters).
If necessary, this eye test can then be repeated using corrective lenses. Technically speaking, visual acuity is a measure of how well you can see two points as being separate. The closer together the points are, the more difficult this becomes.
https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0027947/ [accessed on Sep 04, 2018]
Visual acuity test: MedlinePlus Medical Encyclopedia [accessed on Sep 04, 2018]
http://www.icoph.org/downloads/visualstandardsreport.pdf [accessed on Sep 04, 2018]
Visual acuity - Wikipedia [accessed on Sep 04, 2018]
Visual Acuity: What is 20/20 Vision? [accessed on Sep 04, 2018]
https://www.nist.gov/sites/default/files/documents/el/isd/ks/Visual_Acuity_Standards_1.pdf [accessed on Sep 04, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (24)
Snellen Eye Chart vs Prescription Glasses
Getting things in focus.
Image by David Travis/Unsplash
The Snellen Chart
The Snellen chart for visual acuity presents a limited number of Roman letters in lines of decreasing size. The line with letters that subtend 5 minutes of an arc from 20 feet represents the smallest letters that a person with normal acuity should be able to read at that distance. The different sizes of letters in the other lines represent rough approximations of what a person of normal acuity can read at different distances. For example, the line that represents 20/200 vision would have larger letters so that they are legible to the person with normal acuity at 200 feet.
Image by CNX Openstax
Saccadic Eye Movements
Saccades are rapid, conjugate movements of the eyes to survey a complicated visual stimulus, or to follow a moving visual stimulus. This image represents the shifts in gaze typical of a person studying a face. Notice the concentration of gaze on the major features of the face and the large number of paths traced between the eyes or around the mouth.
Image by CNX Openstax
Pituitary Tumor
The pituitary gland is located in the sella turcica of the sphenoid bone within the cranial floor, placing it immediately inferior to the optic chiasm. If the pituitary gland develops a tumor, it can press against the fibers crossing in the chiasm. Those fibers are conveying peripheral visual information to the opposite side of the brain, so the patient will experience “tunnel vision”—meaning that only the central visual field will be perceived.
Image by CNX Openstax
Vestibulo-ocular Reflex
If the head is turned in one direction, the coordination of that movement with the fixation of the eyes on a visual stimulus involves a circuit that ties the vestibular sense with the eye movement nuclei through the MLF.
Image by CNX Openstax
Muscles Controlled by the Accessory Nerve
The accessory nerve innervates the sternocleidomastoid and trapezius muscles, both of which attach to the head and to the trunk and shoulders. They can act as antagonists in head flexion and extension, and as synergists in lateral flexion toward the shoulder.
Image by CNX Openstax
Human Eye
Detailed Illustration of the cross section of the Human Eye - 1:posterior segment of eyeball 2:ora serrata 3:ciliary muscle 4:ciliary zonules 5:canal of Schlemm 6:pupil 7:anterior chamber 8:cornea 9:iris 10:lens cortex 11:lens nucleus 12:ciliary process 13:conjunctiva 14:inferior oblique muscle 15:inferior rectus muscle 16:medial rectus muscle 17:retinal arteries and veins 18:optic disc19:dura mater 20:central retinal artery 21:central retinal vein 22:optic nerve 23:vorticose vein 24:bulbar sheath 25:macula 26:fovea 27:sclera 28:choroid 29:superior rectus muscle 30:retina
Image by Chabacano
Dilated fundus examination
Diagram of the Eye Before and After Dilated Eye Exam
Image by National Eye Institute (NEI), National Institutes of Health (NIH)
Macular
Cross-sectional view in grayscale of right human eye
Image by National Eye Institute, National Institutes of Health
What is Presbyopia?
Image by National Eye Institute, NIH
Age Related Macular degeneration - What are some low vision devices?
A scene as it might be viewed by a person with age-related macular degeneration.
Image by National Eye Institute, National Institutes of Health
The Visual System: How Your Eyes Work
Video by National Eye Institute, NIH/YouTube
Your Baby - Visual Development - Birth to One Month
Video by movementlesson/YouTube
Bionic Eye Cures Blindness
Video by Seeker/YouTube
Vision Simulation
Video by Light12434/YouTube
What is Vision Impairment? - Vision Awareness Training Part One
Video by ouhnhs/YouTube
Low Vision
Video by EyeSmart — American Academy of Ophthalmology/YouTube
Structure and working of Human Eye
Video by Enliveeducation/YouTube
Visual Acuity Test with Snellen Eye Chart Exam | Cranial Nerve 2 Assessment Nursing
Video by RegisteredNurseRN/YouTube
How to Check Your Patient's Visual Acuity
Video by dkcalgary/YouTube
Visual Acuity in 5 min
Video by Nick Smith/YouTube
Testing Your Visual Acuity
Video by University of Rochester/YouTube
Part 2: Visual Acuity Exam
Video by ALiEM Educational Videos/YouTube
Visual Acuity - OPHTHALMOLOGY - Ep 4
Video by UBC Medicine - Educational Media/YouTube
Snellen Eye Chart vs Prescription Glasses
David Travis/Unsplash
The Snellen Chart
CNX Openstax
Saccadic Eye Movements
CNX Openstax
Pituitary Tumor
CNX Openstax
Vestibulo-ocular Reflex
CNX Openstax
Muscles Controlled by the Accessory Nerve
CNX Openstax
Human Eye
Chabacano
Dilated fundus examination
National Eye Institute (NEI), National Institutes of Health (NIH)
Macular
National Eye Institute, National Institutes of Health
What is Presbyopia?
National Eye Institute, NIH
Age Related Macular degeneration - What are some low vision devices?
National Eye Institute, National Institutes of Health
2:20
The Visual System: How Your Eyes Work
National Eye Institute, NIH/YouTube
5:40
Your Baby - Visual Development - Birth to One Month
movementlesson/YouTube
3:13
Bionic Eye Cures Blindness
Seeker/YouTube
2:04
Vision Simulation
Light12434/YouTube
11:26
What is Vision Impairment? - Vision Awareness Training Part One
ouhnhs/YouTube
4:11
Low Vision
EyeSmart — American Academy of Ophthalmology/YouTube
5:16
Structure and working of Human Eye
Enliveeducation/YouTube
2:09
Visual Acuity Test with Snellen Eye Chart Exam | Cranial Nerve 2 Assessment Nursing
RegisteredNurseRN/YouTube
12:25
How to Check Your Patient's Visual Acuity
dkcalgary/YouTube
4:58
Visual Acuity in 5 min
Nick Smith/YouTube
2:17
Testing Your Visual Acuity
University of Rochester/YouTube
2:53
Part 2: Visual Acuity Exam
ALiEM Educational Videos/YouTube
2:14
Visual Acuity - OPHTHALMOLOGY - Ep 4
UBC Medicine - Educational Media/YouTube
Visual Field Test
Visual Field Test
Also called: Perimetry, Tangent screen exam, Automated perimetry exam, Goldmann visual field exam, Humphrey visual field exam
A visual field test is an eye examination that can detect dysfunction in central and peripheral vision which may be caused by various medical conditions such as glaucoma, stroke, pituitary disease, brain tumors or other neurological deficits.
Visual Field Test
Also called: Perimetry, Tangent screen exam, Automated perimetry exam, Goldmann visual field exam, Humphrey visual field exam
A visual field test is an eye examination that can detect dysfunction in central and peripheral vision which may be caused by various medical conditions such as glaucoma, stroke, pituitary disease, brain tumors or other neurological deficits.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
The peripheral vision is normal.
Related conditions
Your field of vision (or visual field) is what you can see without moving your eye. The test is done using a bowl-shaped instrument known as a perimeter. With your head supported by a chin rest, you focus on a fixed spot at the center of the bowl. Lights flash in the bowl, and may move around or become increasingly brighter. If you see a flash or notice a change, you press a button. The more areas in your field of vision are tested, the more accurate the diagnosis – but the test will then take longer as a result.
Your field of vision is very important as it helps you know what is around you. Because various medical conditions affect the field of vision, perimetry tests are often done if damage to the retina or optic nerve is suspected, or if someone has headaches or dizziness for no known reason. Eye diseases like glaucoma and age-related macular degeneration also lead to changes in the field of vision. Although perimetry tests aren't painful, they can be quite tiring because you have to concentrate for a long time.
Visual field: MedlinePlus Medical Encyclopedia [accessed on Oct 03, 2018]
Visual field test - Wikipedia [accessed on Oct 03, 2018]
Visual Field Testing for Glaucoma and Other Eye Problems [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (28)
Macular degeneration - Charles Bonnet syndrome (Visual Hallucinations)
This image shows an eye fundus viewed through a retinal camera, with signs of macular degeneration
Image by Tmhlee
Advanced age-related macular degeneration with fibrosis
Advanced age-related macular degeneration with fibrosis.
Image by National Eye Institute, National Institutes of Health
Retinal Disparity
Because of the interocular distance, which results in objects of different distances falling on different spots of the two retinae, the brain can extract depth perception from the two-dimensional information of the visual field.
Image by CNX Openstax
Advanced age-related macular degeneration
A fundus photo showing advanced age-related macular degeneration.
Image by National Eye Institute, National Institutes of Health
Age-Related Macular Degeneration Overview
A fundus photo showing.
Image by National Eye Institute, National Institutes of Health
Perimetry, a visual field test
Image by Institute for Quality and Efficiency in Health Care (IQWiG)
Age-Related Macular Degeneration Overview
A medical illustration depicting macular degeneration.
Image by BruceBlaus
Age-Related Macular Degeneration Overview
Macular Degeneration Projected Statistics
Image by National Eye Institute
Age-Related Macular Degeneration Overview
Age-Related Macular Degeneration information at-a-glance.
Image by NEHEP
Age-Related Macular Degeneration Overview
Macular Degeneration
Image by Ralf Roletschek
Human Head Showing Visual Pathway
3D visualization of the visual pathway based on scanned human data. Electrical nerve impulses travel from the eyes to the occipital lobe in the back of the brain via millions of nerves that make up the \"visual pathway.\" The white matter of the brain is made up of millions of nerve extensions (axons) which connect nerve fibers to other nerve fibers, target tissues or organs. In this illustration, bundles of axons in the white matter (colored blue and red) are seen radiating from the eyes to the visual centers of the brain.
Image by TheVisualMD
Topographic Mapping of the Retina onto the Visual Cortex
The visual field projects onto the retina through the lenses and falls on the retinae as an inverted, reversed image. The topography of this image is maintained as the visual information travels through the visual pathway to the cortex.
Image by CNX Openstax
Ventral and Dorsal Visual Streams
From the primary visual cortex in the occipital lobe, visual processing continues in two streams—one into the temporal lobe and one into the parietal lobe.
Image by CNX Openstax
Brain Revealing Visual Pathway
3D visualization reconstructed from scanned human data of a superior view of the brain revealing the visual pathway and superior sagittal sinus. Electrical nerve impulses travel from the eyes to the occipital lobe in the back of the brain via millions of nerves fibers that make up the \"visual pathway\".
Image by TheVisualMD
The optic disc, optic cup, and macula of a healthy 24 year old female (healthy rim tissue with a deep cup).
The optic disc, optic cup, and macula of a healthy 24 year old female (healthy rim tissue with a deep cup).
Image by Eric Wiessner
Sensitive content
This media may include sensitive content
Muscle and Nerve of Human Eye
3D visualization of the nerves associated with the human eye. Several different nerve types serve the special functions of the structures associated with sight. The optic nerves are paired bundles of fibers that send visual signals from the retina to the brain. The oculomotor, trochlear and abducent nerves control voluntary movements of the eye muscles and eyelids in addition to controlling pupil dilation and lens focusing.
Image by TheVisualMD
Macula of Retina
Instead of getting those crazy eye drops to dilate your eyes so the doctor can look at your retina, they just take a high-resolution digital picture. Much faster and easier. And they keep them on record so they can compare photos from year to year and better diagnose potential problems. The bright spot in the middle is the optic nerve (the blind spot); the darker spot next to the optic nerve is the macula, a small crater in the retina with a higher density of rods and cones, making it the best seeing portion of the eye.
Image by derivative work: Chmee2 (talk) Left_Retina.jpg: Hey Paul
Retina
This image schematically represents optic pathways from each of the 4 quadrants of view for both eyes simultaneously.
Image by Original uploader was Ratznium at en.wikipedia
Vestibulo-ocular Reflex
Connections between the vestibular system and the cranial nerves controlling eye movement keep the eyes centered on a visual stimulus, even though the head is moving. During head movement, the eye muscles move the eyes in the opposite direction as the head movement, keeping the visual stimulus centered in the field of view.
Image by CNX Openstax
Optic Nerve - A bundle of more than 1 million nerve fibers that carries visual messages from the retina to the brain.
Optic Nerve - A bundle of more than 1 million nerve fibers that carries visual messages from the retina to the brain.
Image by TheVisualMD
Partially Sectioned Human Eye Exposing front and back of the eye including the Retina
Three-dimensional visualization reconstructed from human data. Anteriolateral view of a partially sectioned eye, as well as associated eye muscles. As well as being protected by the bony orbital cavity of the skull, the eyeball is anchored in place by several thin strap muscles that attach to virtually every one of its sides except the front. These muscles tug in concert, allowing the eye to move in any direction to track objects. The clear cornea covers and protects the front exterior of the eye while the colored iris dilates and constricts to insure the proper amount of light is striking the back of the eye. The lens contorts to focus the incoming light back to the retina, which covers roughly the entire back half of the eye. Special cells embedded within the retina are responsible for the sensation of light: the cones, for color perception, and rods, for black and white perception. Electrical nerve impulses are channeled into the optic nerve at the back of the eye to the visual cortex in the brain.
Image by TheVisualMD
Human Eye
Detailed Illustration of the Anatomy of the Human Eye
Image by A Hoofring ncbi/nlm/nih
Vestibulo-ocular Reflex
If the head is turned in one direction, the coordination of that movement with the fixation of the eyes on a visual stimulus involves a circuit that ties the vestibular sense with the eye movement nuclei through the MLF.
Image by CNX Openstax
Visual Neural Pathways and Visual Field Defects
Video by PhysioPathoPharmaco/YouTube
Visual field processing | Processing the Environment | MCAT | Khan Academy
Video by khanacademymedicine/YouTube
How to Take a Visual Field Examination? - Sheryl S. Wizov, COA
Video by WillsEye GlaucomaApp/YouTube
Visual Pathway and Lesions
Video by Armando Hasudungan/YouTube
What is Glaucoma? Explained using Animation.
Video by Devin Prabhakar/YouTube
Macular degeneration - Charles Bonnet syndrome (Visual Hallucinations)
Tmhlee
Advanced age-related macular degeneration with fibrosis
National Eye Institute, National Institutes of Health
Retinal Disparity
CNX Openstax
Advanced age-related macular degeneration
National Eye Institute, National Institutes of Health
Age-Related Macular Degeneration Overview
National Eye Institute, National Institutes of Health
Perimetry, a visual field test
Institute for Quality and Efficiency in Health Care (IQWiG)
Age-Related Macular Degeneration Overview
BruceBlaus
Age-Related Macular Degeneration Overview
National Eye Institute
Age-Related Macular Degeneration Overview
NEHEP
Age-Related Macular Degeneration Overview
Ralf Roletschek
Human Head Showing Visual Pathway
TheVisualMD
Topographic Mapping of the Retina onto the Visual Cortex
CNX Openstax
Ventral and Dorsal Visual Streams
CNX Openstax
Brain Revealing Visual Pathway
TheVisualMD
The optic disc, optic cup, and macula of a healthy 24 year old female (healthy rim tissue with a deep cup).
Eric Wiessner
Sensitive content
This media may include sensitive content
Muscle and Nerve of Human Eye
TheVisualMD
Macula of Retina
derivative work: Chmee2 (talk) Left_Retina.jpg: Hey Paul
Retina
Original uploader was Ratznium at en.wikipedia
Vestibulo-ocular Reflex
CNX Openstax
Optic Nerve - A bundle of more than 1 million nerve fibers that carries visual messages from the retina to the brain.
TheVisualMD
Partially Sectioned Human Eye Exposing front and back of the eye including the Retina
TheVisualMD
Human Eye
A Hoofring ncbi/nlm/nih
Vestibulo-ocular Reflex
CNX Openstax
5:29
Visual Neural Pathways and Visual Field Defects
PhysioPathoPharmaco/YouTube
4:10
Visual field processing | Processing the Environment | MCAT | Khan Academy
khanacademymedicine/YouTube
4:00
How to Take a Visual Field Examination? - Sheryl S. Wizov, COA
WillsEye GlaucomaApp/YouTube
6:12
Visual Pathway and Lesions
Armando Hasudungan/YouTube
1:10
What is Glaucoma? Explained using Animation.
Devin Prabhakar/YouTube
Color Vision Testing
Color Vision Testing
Also called: Color Blindness Test, Color Perception Test, Ishihara Color Test
Eye care professionals use a variety of tests to diagnose color blindness. These tests can quickly diagnose specific types of color blindness. People with color blindness aren’t aware of differences among colors that are obvious to the rest of us.
Color Vision Testing
Also called: Color Blindness Test, Color Perception Test, Ishihara Color Test
Eye care professionals use a variety of tests to diagnose color blindness. These tests can quickly diagnose specific types of color blindness. People with color blindness aren’t aware of differences among colors that are obvious to the rest of us.
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Use the slider below to see how your results affect your
health.
Your result is Normal.
You should be able to distinguish between all colors.
Related conditions
Most of us share a common color vision sensory experience. Some people, however, have a color vision deficiency, which means their perception of colors is different from what most of us see. The most severe forms of these deficiencies are referred to as color blindness. People with color blindness aren’t aware of differences among colors that are obvious to the rest of us. People who don’t have the more severe types of color blindness may not even be aware of their condition unless they’re tested in a clinic or laboratory.
Inherited color blindness is caused by abnormal photopigments. These color-detecting molecules are located in cone-shaped cells within the retina, called cone cells. In humans, several genes are needed for the body to make photopigments, and defects in these genes can lead to color blindness.
There are three main kinds of color blindness, based on photopigment defects in the three different kinds of cones that respond to blue, green, and red light. Red-green color blindness is the most common, followed by blue-yellow color blindness. A complete absence of color vision —total color blindness – is rare.
Eye care professionals use a variety of tests to diagnose color blindness. These tests can quickly diagnose specific types of color blindness.
The Ishihara Color Test is the most common test for red-green color blindness. The test consists of a series of colored circles, called Ishihara plates, each of which contains a collection of dots in different colors and sizes. Within the circle are dots that form a shape clearly visible to those with normal color vision, but invisible or difficult to see for those with red-green color blindness.
The newer Cambridge Color Test uses a visual array similar to the Ishihara plates, except displayed on a computer monitor. The goal is to identify a C shape that is different in color from the background. The “C” is presented randomly in one of four orientations. When test-takers see the “C,” they are asked to press one of four keys that correspond to the orientation.
The anomaloscope uses a test in which two different light sources have to be matched in color. Looking through the eyepiece, the viewer sees a circle. The upper half is a yellow light that can be adjusted in brightness. The lower half is a combination of red and green lights that can be mixed in variable proportions. The viewer uses one knob to adjust the brightness of the top half, and another to adjust the color of the lower half. The goal is to make the upper and lower halves the same brightness and color.
The HRR Pseudoisochromatic Color Test is another red-green color blindness test that uses color plates to test for color blindness.
The Farnsworth-Munsell 100 Hue Test uses a set of blocks or pegs that are roughly the same color but in different hues (shades of the color). The goal is to arrange them in a line in order of hue. This test measures the ability to discriminate subtle color changes. It is used by industries that depend on the accurate color perception of its employees, such as graphic design, photography, and food quality inspection.
The Farnsworth Lantern Test is used by the U.S. military to determine the severity of color blindness. Those with mild forms pass the test and are allowed to serve in the armed forces.
The most common types of color blindness are inherited. They are the result of defects in the genes that contain the instructions for making the photopigments found in cones. Some defects alter the photopigment’s sensitivity to color, for example, it might be slightly more sensitive to deeper red and less sensitive to green. Other defects can result in the total loss of a photopigment. Depending on the type of defect and the cone that is affected problems can arise with red, green, or blue color vision.
Red-green color blindness
The most common types of hereditary color blindness are due to the loss or limited function of red cone (known as protan) or green cone (deutran) photopigments. This kind of color blindness is commonly referred to as red-green color blindness.
Protanomaly: In males with protanomaly, the red cone photopigment is abnormal. Red, orange, and yellow appear greener and colors are not as bright. This condition is mild and doesn’t usually interfere with daily living. Protanomaly is an X-linked disorder estimated to affect 1 percent of males.
Protanopia: In males with protanopia, there are no working red cone cells. Red appears as black. Certain shades of orange, yellow, and green all appear as yellow. Protanopia is an X-linked disorder that is estimated to affect 1 percent of males.
Deuteranomaly: In males with deuteranomaly, the green cone photopigment is abnormal. Yellow and green appear redder and it is difficult to tell violet from blue. This condition is mild and doesn’t interfere with daily living. Deuteranomaly is the most common form of color blindness and is an X-linked disorder affecting 5 percent of males.
Deuteranopia: In males with deuteranopia, there are no working green cone cells. They tend to see reds as brownish-yellow and greens as beige. Deuteranopia is an X-linked disorder that affects about 1 percent of males.
Blue-yellow color blindness
Blue-yellow color blindness is rarer than red-green color blindness. Blue-cone (tritan) photopigments are either missing or have limited function.
Tritanomaly: People with tritanomaly have functionally limited blue cone cells. Blue appears greener and it can be difficult to tell yellow and red from pink. Tritanomaly is extremely rare. It is an autosomal dominant disorder affecting males and females equally.
Tritanopia: People with tritanopia, also known as blue-yellow color blindness, lack blue cone cells. Blue appears green and yellow appears violet or light grey. Tritanopia is an extremely rare autosomal recessive disorder affecting males and females equally.
Complete color blindness
People with complete color blindness (monochromacy) don’t experience color at all and the clearness of their vision (visual acuity) may also be affected.
There are two types of monochromacy:
Cone monochromacy: This rare form of color blindness results from a failure of two of the three cone cell photopigments to work. There is red cone monochromacy, green cone monochromacy, and blue cone monochromacy. People with cone monochromacy have trouble distinguishing colors because the brain needs to compare the signals from different types of cones in order to see color. When only one type of cone works, this comparison isn’t possible. People with blue cone monochromacy, may also have reduced visual acuity, near-sightedness, and uncontrollable eye movements, a condition known as nystagmus. Cone monochromacy is an autosomal recessive disorder.
Rod monochromacy or achromatopsia: This type of monochromacy is rare and is the most severe form of color blindness. It is present at birth. None of the cone cells have functional photopigments. Lacking all cone vision, people with rod monochromacy see the world in black, white, and gray. And since rods respond to dim light, people with rod monochromacy tend to be photophobic – very uncomfortable in bright environments. They also experience nystagmus. Rod monochromacy is an autosomal recessive disorder.
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (19)
What It's Like To Be Color Blind
Video by BuzzFeed Multiplayer/YouTube
Colorblind - A Colorful Guide to Colorblindness (infographic) V1
Video by gleiberkid/YouTube
How Many Colors Can We See?
Video by SciShow/YouTube
This Is What Color Blind People See With These Viral Glasses
Video by Tech Insider/YouTube
Chromosome X&Y (23) - Colour Blindness
Video by The Royal Institution/YouTube
How Vision Tests Work | Living Healthy Chicago
Video by LivingHealthyChicago/YouTube
Colorblindness
An Ishihara test image as seen by subjects with normal color vision and by those with a variety of color deficiencies.
Image by Eddau processed File:Ishihara 2.svg by User:Sakurambo,
Ishihara Plate 9
Ishihara Plate 9
Image by Unknown
Tritanopia color-blind
How tritanopia color-blind people see the world.
Image by Tohaomg
Cone Cells
Illustration of Cone cell structure in the retina
Image by Ivo Kruusamagi
Rod Cells
Illustration of Rod cell structure in the retina
Image by Madhero88
Rod Cells
Cross section of the retina. Rods are visible at far right.
Image by Cajal , Anka Friedrich (talk) , vectorisation by chris
Cone Cells
Seeing red. A. Light from the sun hits the apple. Some wavelengths are blocked by the chemicals in the apple's skin. B. Reflected wavelengths pass through the pupil and excite the cone cells at the back of the eye. C. The cones send a coded message to the brain about the wavelengths entering the eye. In this example, the L-cones are very excited, the M-cones are a little bit excited and the S cones are hardly excited at all. The brain translates this code into a sensation of "red".
Image by Wade A and Benjamin A
Ishihara Plate for testing on Deuteranopia
Ishihara Plate for testing on Deuteranopia. Test for color blindness.
Image by Dan-yell / https://commons.wikimedia.org/wiki/File:Ishihara-Test.svg
Ishihara 3
Ishihara colourblindness test No 3
Image by en:Shinobu Ishihara (died January 3, 1963)/Wikimedia
Ishihara 1
Ishihara Plate No. 1 (Number 12). Used to for the en:Ishihata test of color blindness.
Image by Nicoguaro/Wikimedia
Rough gray and white representation of a test chart so that people with complete color blindness can also get an impression of the test.
Image by Barbarossa at Dutch Wikipedia/Wikimedia
Ishihara 19
Image by /Wikimedia
Red-green colour blindness, do you have it?
Video by Demystifying Medicine/YouTube
2:38
What It's Like To Be Color Blind
BuzzFeed Multiplayer/YouTube
2:47
Colorblind - A Colorful Guide to Colorblindness (infographic) V1
gleiberkid/YouTube
2:35
How Many Colors Can We See?
SciShow/YouTube
3:43
This Is What Color Blind People See With These Viral Glasses
Tech Insider/YouTube
2:23
Chromosome X&Y (23) - Colour Blindness
The Royal Institution/YouTube
3:32
How Vision Tests Work | Living Healthy Chicago
LivingHealthyChicago/YouTube
Colorblindness
Eddau processed File:Ishihara 2.svg by User:Sakurambo,
Ishihara Plate 9
Unknown
Tritanopia color-blind
Tohaomg
Cone Cells
Ivo Kruusamagi
Rod Cells
Madhero88
Rod Cells
Cajal , Anka Friedrich (talk) , vectorisation by chris
en:Shinobu Ishihara (died January 3, 1963)/Wikimedia
Ishihara 1
Nicoguaro/Wikimedia
Rough gray and white representation of a test chart so that people with complete color blindness can also get an impression of the test.
Barbarossa at Dutch Wikipedia/Wikimedia
Ishihara 19
/Wikimedia
6:29
Red-green colour blindness, do you have it?
Demystifying Medicine/YouTube
Eye Pressure Test
Eye Pressure Test
Also called: Intraocular Pressure (IOP) Measurement, Tonometry
Eye pressure, also called intraocular pressure (IOP), is a measurement of the fluid pressure inside the eye. Measuring it is like measuring blood pressure using a method called tonometry. Having eye pressure that’s too low or too high can damage your vision.
Eye Pressure Test
Also called: Intraocular Pressure (IOP) Measurement, Tonometry
Eye pressure, also called intraocular pressure (IOP), is a measurement of the fluid pressure inside the eye. Measuring it is like measuring blood pressure using a method called tonometry. Having eye pressure that’s too low or too high can damage your vision.
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Use the slider below to see how your results affect your
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mm Hg
10
21
Your result is Normal.
A normal result means your eye pressure is within the normal range. However, the thickness of your cornea can affect measurements. A corneal thickness measurement (pachymetry) is needed to get a correct pressure measurement.
Related conditions
The measurement of intraocular pressure (tonometry) is one of the most common eye examinations. The pressure inside the eyeball becomes too high if a fluid produced in the eye (called aqueous humor) cannot drain properly and starts to build up. An intraocular pressure of between 10 and 21 mmHg (millimeters of mercury) is considered to be normal in adults.
Various instruments can be used to measure the pressure in the eye. In what is known as applanation tonometry, the cornea is first numbed using eye drops. Then a small measuring device is placed against the surface of the cornea, putting a little pressure on the eye.
The device measures how much pressure is needed to flatten the cornea by 3 millimeters. This is a measure of the pressure inside the eye.
Intraocular pressure can also be measured using an approach known as non-contact tonometry. Here the pressure is measured by applying a short puff of air to the cornea. Neither of these examinations are painful.
Tonometry: MedlinePlus Medical Encyclopedia [accessed on Oct 03, 2018]
Eye Pressure Testing - American Academy of Ophthalmology [accessed on Oct 03, 2018]
What is low eye pressure and does it cause any damage to your eyes? - American Academy of Ophthalmology [accessed on Oct 03, 2018]
Five Common Glaucoma Tests | Glaucoma Research Foundation [accessed on Oct 03, 2018]
High Eye Pressure and Glaucoma | Glaucoma Research Foundation [accessed on Oct 03, 2018]
Tonometry: Purpose, Procedure, and Results [accessed on Oct 03, 2018]
IOP and Tonometry - EyeWiki [accessed on Oct 03, 2018]
Tonometry [accessed on Oct 03, 2018]
Intraocular pressure - Wikipedia [accessed on Oct 03, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (6)
Ocular tonometry
Goldmann mires : Semicircles seen during Goldmann tonometry through slit lamp
Image by Manimury
Ocular tonometry
The PASCAL Dynamic Contour Tonometer
Image by Tonywirthlin at English Wikipedia
Vestibulo-ocular Reflex
Connections between the vestibular system and the cranial nerves controlling eye movement keep the eyes centered on a visual stimulus, even though the head is moving. During head movement, the eye muscles move the eyes in the opposite direction as the head movement, keeping the visual stimulus centered in the field of view.
Image by CNX Openstax
Neuro-ocular syphilis
This funduscopic image reveals the effects of late neuro-ocular syphilis on the optic disk and retina. Note the typical features of neuro-ocular syphilis, which includes severe optic nerve atrophy, and chorioretinitis, or inflammation of the choroidal and neural layers of the retina.
Image by CDC/ Susan Lindsley
SVC Insight - Tonometry
Video by Linda Young/YouTube
Tonometer
A noncontact tonometer scans the eye of U.S. Air Force Staff Sgt. Timothy Gallagher, 23d Wing public affairs broadcast journalist, during an optometry appointment Feb. 4, 2014, at Moody Air Force Base, Ga. The tonometer is used to screen for glaucoma. (U.S. Air Force photo by Airman 1st Class Ceaira Tinsley/Released)
Image by U.S. Air Force photo by Airman 1st Class Ceaira Tinsley/Released
Ocular tonometry
Manimury
Ocular tonometry
Tonywirthlin at English Wikipedia
Vestibulo-ocular Reflex
CNX Openstax
Neuro-ocular syphilis
CDC/ Susan Lindsley
6:01
SVC Insight - Tonometry
Linda Young/YouTube
Tonometer
U.S. Air Force photo by Airman 1st Class Ceaira Tinsley/Released
Schirmer Test
Schirmer Test
Also called: Basal Secretion Test, Dry Eye Test, Tearing Test
A Schirmer test tells your eye doctor how quickly your eyes make tears. Your eye doctor will put a small piece of paper on the edge of your eyelid and see how long it takes for your body to make tears.
Schirmer Test
Also called: Basal Secretion Test, Dry Eye Test, Tearing Test
A Schirmer test tells your eye doctor how quickly your eyes make tears. Your eye doctor will put a small piece of paper on the edge of your eyelid and see how long it takes for your body to make tears.
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Use the slider below to see how your results affect your
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mm
5
10
15
Your result is Normal.
More than 10 mm of moisture on the filter paper after 5 minutes is a sign of normal tear production. Both eyes normally release the same amount of tears.
Related conditions
https://nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye/testing-dry-eye [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/003501.htm [accessed on Sep 15, 2019]
https://www.medicalnewstoday.com/articles/315974.php [accessed on Sep 15, 2019]
https://www.hopkinssjogrens.org/disease-information/diagnosis-sjogrens-syndrome/schirmers-test/ [accessed on Sep 15, 2019]
https://www.healthline.com/health/schirmers-test#results [accessed on Sep 15, 2019]
https://en.wikipedia.org/wiki/Schirmer%27s_test [accessed on Sep 15, 2019]
Tear Break-Up Time Test
Tear Break-Up Time Test
Also called: TBUT
A tear break-up time (TBUT) test checks how long your tear film (layer of tears on your eyes) lasts after you blink. If your tear film does not last long, you may have dry eye.
Tear Break-Up Time Test
Also called: TBUT
A tear break-up time (TBUT) test checks how long your tear film (layer of tears on your eyes) lasts after you blink. If your tear film does not last long, you may have dry eye.
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Use the slider below to see how your results affect your
health.
s
5
10
Your result is Normal.
Tear film break-up time (TBUT) is a method for determining the stability of the tear film and checking evaporative dry eye. Generally, >10 seconds is thought to be normal.
Related conditions
https://nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye/testing-dry-eye [accessed on Sep 15, 2019]
https://medlineplus.gov/ency/article/000426.htm [accessed on Sep 15, 2019]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3570579/ [accessed on Sep 15, 2019]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Retinoscopy
Retinoscopy
Also called: Ret, Shadow Test, Skiametry, Skiascopy
Retinoscopy is an objective determination of the refractive state of the eye (nearsightedness, farsightedness, astigmatism). By using a retinoscope, the amount of correction and the power of lens needed can be determined.
Retinoscopy
Also called: Ret, Shadow Test, Skiametry, Skiascopy
Retinoscopy is an objective determination of the refractive state of the eye (nearsightedness, farsightedness, astigmatism). By using a retinoscope, the amount of correction and the power of lens needed can be determined.
Retinoscopy is an accurate objective measurement of the refractive state of the eye, such as the degree of nearsightedness, farsightedness or astigmatism. It uses light reflected off the back of the eye and hand-held lenses to measure refractive error.
A retinoscopy can be especially useful in determining refractive error in very young children and infants or people with special needs, as it requires minimal cooperation.
Refractive errors occur when the shape of the eye prevents light from focusing directly on the retina. The length of the eyeball (longer or shorter), changes in the shape of the cornea, or aging of the lens can all cause refractive errors.
The most common types of refractive errors are myopia, hyperopia, and astigmatism.
Myopia (nearsightedness) is a condition where objects up close appear clearly, while objects far away appear blurry. With myopia, light comes to focus in front of the retina instead of on the retina.
Hyperopia (farsightedness) is a common type of refractive error where distant objects may be seen more clearly than objects that are near. However, people experience hyperopia differently. Some people may not notice any problems with their vision, especially when they are young. For people with significant hyperopia, vision can be blurry for objects at any distance, near or far.
Astigmatism is a condition in which the eye does not focus light evenly onto the retina, the light-sensitive tissue at the back of the eye. This can cause images to appear blurry and stretched out.
https://www.aapos.org/terms/conditions/95 [accessed on Feb 14, 2019]
https://nei.nih.gov/health/errors [accessed on Feb 14, 2019]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5646585/ [accessed on Feb 14, 2019]
https://www.aao.org/young-ophthalmologists/yo-info/article/retinoscopy-101 [accessed on Feb 14, 2019]
https://www.allaboutvision.com/eye-exam/expect.htm [accessed on Feb 14, 2019]
https://www.lybrate.com/lab-test/retinoscopy [accessed on Feb 14, 2019]
https://www.northrangeeyecare.com/your-eye-health/eye-exams/common-tests/retinoscope/ [accessed on Feb 14, 2019]
https://www.slideshare.net/laxmieyeinstitute/retinoscopy-and-its-principles [accessed on Feb 14, 2019]
Additional Materials (17)
B&L Retinoscope
Bausch & Lomb Copeland Streak Retinoscope
Image by Janee
Retinoscopy of the eye (Ophthalmology)
Video by Tim Root/YouTube
Performing a Retinoscopy
An eye care professional performs retinoscopy to determine the child’s refractive error (eyeglass prescription).
Image by National Eye Institute
Determining Eyeglass Prescription
An eye care professional performs retinoscopy to determine the child’s refractive error (eyeglass prescription).
Image by National Eye Institute
Refractive Error Fact Sheet
Refractive errors occur when the shape of the eye prevents light from focusing directly on the retina. The length of the eyeball (longer or shorter), changes in the shape of the cornea, or aging of the lens can all cause refractive errors.
Document by National Eye Institute
Nearsightedness Fact Sheet
Nearsightedness, also known as myopia, is a common type of refractive error where close objects appear clearly, but distant objects appear blurry.
Document by National Eye Institute
Pediatric Eye Exam
An eye care professional conducts a pediatric eye exam on a child.
Image by National Eye Institute
Pediatric Eye Exam
An eye care professional performs retinoscopy to determine the child’s refractive error (eyeglass prescription).
Image by National Eye Institute
Retinoscopy
This woman was pictured in her doctor’s office, while undergoing an eye exam. Using an ophthalmoscope, the doctor was looking inside the interior of the patient’s right eyeball, in order to see if any intraocular damage had occurred, as a result of this patient's diabetic condition. Note the eye chart in the background, which is known as an E chart, or a tumbling E chart.
Image by CDC/ Amanda Mills
Retinoscopy
This woman was pictured in her doctor’s office, while undergoing an eye exam. Using an ophthalmoscope, the doctor was looking inside the interior of the patient’s left eyeball, in order to see if any intraocular damage had occurred, as a result of this patient's diabetic condition.
Image by CDC/ Amanda Mills
Retinoscopy
This woman was pictured in her doctor’s office, while undergoing an eye exam. Using an ophthalmoscope, the doctor was looking inside the interior of the patient’s left eyeball, in order to see if any intraocular damage had occurred, as a result of this patient's diabetic condition. Note the eye chart in the background, which is known as an E chart, or a tumbling E chart.
Image by CDC/ Amanda Mills
Eye exam
The woman pictured here, was undergoing an eye exam, whereupon, she was testing her visual acuity, by covering her left eye, and reading from a door-mounted eye chart, which used numbers as its symbols. Note that this eye chart was intended to be used with the patient standing at a distance of 10 feet from the chart.
Image by CDC/ Amanda Mills
Retinoscopy
The woman pictured here, was undergoing an eye exam, whereupon, she was testing her visual acuity, by covering her left eye, and reading from a door-mounted eye chart, which used numbers as its symbols. The clinician was pointing to each of the various numbers, and the patient was reciting the highlighted number. Note that this eye chart was intended to be used with the patient standing at a distance of 10 feet from the chart.
Image by CDC/ Amanda Mills
Retinoscopy
This seated female patient was in the process of receiving an eye examination, being conducted by a female physician, who was using a handheld ophthalmoscope, enabling her to see into the patient’s left eye.
Image by CDC/ Amanda Mills
Retinoscopy
This seated female patient was in the process of receiving an eye examination from a female physician, who was using a hand-held ophthalmoscope to see into her right eye.
Image by CDC/ Amanda Mills
Retinoscopy
This seated young female patient was in the process of receiving an eye examination from a male clinician, who was using a hand-held ophthalmoscope to see into her right eye.
Image by CDC/ Amanda Mills
Middle schoolers receive health screenings
A 52nd Aerospace Medicine Squadron optometrist, uses lenses to perform a retinoscopy on a Spangdahlem Middle School student during a school health screening on Spangdahlem Air Base, Germany, Nov. 7, 2014. The screenings are held once a year to assess the weight, height, eyesight and hearing of students. (U.S. Air Force photo by Staff Sgt. Christopher Ruano/Released)
Image by U.S. Air Force photo by Staff Sgt. Christopher Ruano/Released
B&L Retinoscope
Janee
4:43
Retinoscopy of the eye (Ophthalmology)
Tim Root/YouTube
Performing a Retinoscopy
National Eye Institute
Determining Eyeglass Prescription
National Eye Institute
Refractive Error Fact Sheet
National Eye Institute
Nearsightedness Fact Sheet
National Eye Institute
Pediatric Eye Exam
National Eye Institute
Pediatric Eye Exam
National Eye Institute
Retinoscopy
CDC/ Amanda Mills
Retinoscopy
CDC/ Amanda Mills
Retinoscopy
CDC/ Amanda Mills
Eye exam
CDC/ Amanda Mills
Retinoscopy
CDC/ Amanda Mills
Retinoscopy
CDC/ Amanda Mills
Retinoscopy
CDC/ Amanda Mills
Retinoscopy
CDC/ Amanda Mills
Middle schoolers receive health screenings
U.S. Air Force photo by Staff Sgt. Christopher Ruano/Released
Dilated Eye Exam
Dilated Eye Exam
Also called: Comprehensive Dilated Eye Exam, Dilated Fundus Exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss. Learn what happens during and after a dilated eye exam and how often you need one.
Dilated Eye Exam
Also called: Comprehensive Dilated Eye Exam, Dilated Fundus Exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss. Learn what happens during and after a dilated eye exam and how often you need one.
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Use the slider below to see how your results affect your
health.
ratio
0.02
0.04
0.125
0.32
0.8
Your result is Normal vision.
US: 20/25 to 20/12 (Metric: 6/7.5 to 6/4)
Visual acuity is expressed as a decimal or a fraction. 1 = US 20/20 or metric 6/6 is considered optimal vision.
The top number refers to the distance you stand from the chart. This is often 20 feet (6 meters).
The bottom number indicates the distance at which a person with normal eyesight could read the same line you correctly read.
Related conditions
{"label":"Visual field reference range","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"The peripheral vision is normal.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"Abnormal results may be due to diseases or central nervous system (CNS) disorders, such as tumors that damage or press on (compress) the parts of the brain that deal with vision.","conditions":["Diabetes","Glaucoma","High blood pressure","Macular degeneration","Multiple sclerosis","Optic glioma","Overactive thyroid","Pituitary gland disorders","Retinal detachment","Stroke","Temporal arteritis"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
The peripheral vision is normal.
Related conditions
{"label":"Eye muscle function reference range","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result indicates normal movement of the eyes in all directions.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal result reveals restricted or abnormal eye movement, such as shaking of the eyes, misalignment, saccadic dysfunction (overshooting or undershooting of the eye movements), mechanical restrictions, or double vision.","conditions":["Amblyopia","Diplopia","Duane retraction syndrome","Eye injury","Nystagmus","Strabismus","Myasthenia gravis","Thyroid eye disease"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result indicates normal movement of the eyes in all directions.
Related conditions
{"label":"Pupil dilation reference range","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result means the status of your optic nerve and retina is in good shape.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"An abnormal result may reveal various problems with your optic nerve and retina, including inflammation or injury, a retinal tear or detachment, clouding of the lens or an ocular tumor.","conditions":["Diabetic retinopathy","Macular degeneration","Cataract","Glaucoma","Eye cancer"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means the status of your optic nerve and retina is in good shape.
Related conditions
{"label":"Pupil response reference range","scale":"lin","step":0.25,"items":[{"flag":"normal","label":{"short":"Pass","long":"Pass","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A pass or normal result means that the pupils dilate (get larger) when room light is dimmed; the pupils are round and equal in size, in both bright and dim light; and the pupils quickly and symmetrically constrict to a bright light directed into either of the eyes and when the bright light swings between the two eyes.","conditions":[]},{"flag":"abnormal","label":{"short":"Refer","long":"Refer","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"A refer or non-pass result means that the test revealed unequal or sluggish response to light or that the pupils are unequal in size or not round. Further testing may be needed.","conditions":["Anisocoria (unequal pupil size)","Relative afferent pupillary defect","Adie syndrome","Argyll Robertson pupil","Horner syndrome"]}],"hideunits":true,"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Pass.
A pass or normal result means that the pupils dilate (get larger) when room light is dimmed; the pupils are round and equal in size, in both bright and dim light; and the pupils quickly and symmetrically constrict to a bright light directed into either of the eyes and when the bright light swings between the two eyes.
Related conditions
{"label":"Eye pressure reference range","scale":"lin","step":0.1,"items":[{"flag":"abnormal","label":{"short":"Low","long":"Low","orientation":"horizontal"},"values":{"min":0,"max":10},"text":"In general, the eye can see fine at a low pressure, though the risk of blurred vision increases significantly with eye pressure under 6 mm Hg.","conditions":[]},{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":10,"max":21},"text":"A normal result means your eye pressure is within the normal range. However, the thickness of your cornea can affect measurements. A corneal thickness measurement (pachymetry) is needed to get a correct pressure measurement.","conditions":[]},{"flag":"abnormal","label":{"short":"High","long":"High","orientation":"horizontal"},"values":{"min":21,"max":50},"text":"Elevated eye pressure with no other symptoms is ocular hypertension. Left untreated, high eye pressure may cause glaucoma and permanent vision loss in some individuals.","conditions":["Glaucoma","Hyphema (blood in the front chamber of the eye)","Inflammation in the eye","Injury to the eye or head"]}],"units":[{"printSymbol":"mm\u00a0Hg","code":"mm[Hg]","name":"millimeter of mercury"}],"hideunits":false,"value":15.5}[{"abnormal":0},{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
mm Hg
10
21
Your result is Normal.
A normal result means your eye pressure is within the normal range. However, the thickness of your cornea can affect measurements. A corneal thickness measurement (pachymetry) is needed to get a correct pressure measurement.
Related conditions
A dilated eye exam is the best thing you can do for your eye health! It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
The exam is simple and painless. Your eye doctor will check for vision problems that make it hard to see clearly, like being nearsighted or farsighted. Then your doctor will give you some eye drops to dilate (widen) your pupil and check for eye diseases.
Since many eye diseases have no symptoms or warning signs, you could have a problem and not know it. Even if you think your eyes are healthy, getting a dilated eye exam is the only way to know for sure.
How often you need a dilated eye exam depends on your risk for eye disease. Talk to your doctor about what’s right for you.
Get a dilated eye exam every 1 to 2 years if you:
Are over age 60
Are African American and over age 40
Have a family history of glaucoma
If you have diabetes or high blood pressure, ask your doctor how often you need an exam. Most people with diabetes or high blood pressure need to get a dilated eye exam at least once a year.
The exam includes:
A visual acuity test to check how clearly you see. Your doctor will ask you to read letters that are up close and far away.
A visual field test to check your peripheral (side) vision. Your doctor will test how well you can see objects off to the sides of your vision without moving your eyes.
An eye muscle function test to check for problems with the muscles around your eyeballs. Your doctor will move an object around and ask you to follow it with your eyes.
A pupil response test to check how light enters your eyes. Your doctor will shine a small flashlight into your eyes and check how your pupils react to the light.
A tonometry test to measure the pressure in your eyes. Your doctor will use a machine to blow a quick puff of air onto your eye, or gently touch your eye with a special tool. Don’t worry — it doesn’t hurt!
Dilation to check for problems with the inner parts of your eye. Your doctor will give you some eye drops to dilate (widen) your pupil. This helps the doctor see inside your eye.
Depending on your needs, your doctor may include other tests too. Ask your doctor if you have questions.
Dilating your pupil lets more light into your eye — just like opening a door lets light into a dark room. Dilation helps your eye doctor check for many common eye problems, including diabetic retinopathy, glaucoma, and age-related macular degeneration (AMD).
For a few hours after a dilated eye exam, your vision may be blurry and you may be sensitive to light. Ask a friend or family member to drive you home from your appointment.
If your eye doctor finds refractive errors in your vision, you may get a prescription for eyeglasses or contact lenses to help you see more clearly.
Bring your sunglasses!
Your eyes may be sensitive to light for a few hours after your exam. Sunglasses can help, so bring them if you have them! Your eye doctor may also have disposable sunglasses they can give you.
If your eye doctor finds signs of an eye disease, you can talk about treatment options and decide what’s right for you. Learn more about these common eye diseases:
Diabetic eye disease
Age-related macular degeneration
Cataract
Glaucoma
If you’re seeing clearly and there are no signs of eye disease, you’re all set until your next exam. Make an appointment for your next dilated eye exam before you leave the office — that way, you won’t forget!
Additional Materials (50)
Comprehensive Dilated Eye Exam
Video by National Eye Institute, NIH/YouTube
Animation: Detecting age-related macular degeneration through a dilated eye exam.
Video by National Eye Institute, NIH/YouTube
Animation: Detecting diabetic retinopathy through a dilated eye exam
Video by National Eye Institute, NIH/YouTube
What are dilating eye drops?
Video by EyeSmart — American Academy of Ophthalmology/YouTube
Dilated fundus examination
Diagram of the Eye Before and After Dilated Eye Exam
Image by National Eye Institute (NEI), National Institutes of Health (NIH)
Pupillary response
Pupillary response : Animation that illustrates the pupillary light reflex. When the light is turned on, the pupil reacts by constricting.
Image by Greyson Orlando
Right Eyeball
3D visualization based on scanned human data of the right eyeball.
Image by TheVisualMD
Tangier disease
Diffuse hazy opacity of the right cornea in the patient with Tangier disease
Image by National Eye Institute
Pupil
The pupil is the central transparent area (showing as black). The grey/blue area surrounding it is the iris. The white outer area is the sclera, the central transparent part of which is the cornea.
Image by ROTFLOLEB
Mydriasis
Mydriasis, pupillary response
Image by OpenStax College
Intraocular lens
Cataract surgery performed, IOL inserted. Note incision right of dilated pupil.
Image by Janke
Drawing of a woman having her eyes examined by a doctor using a machine
See your eye doctor for a dilated eye exam every year. Early treatment of eye problems can help save your sight.
Image by NIDDK Image Library
Two-sided Adie's pupils of unknown etiology identified by an ophthalmologist
Two-sided Adie's pupils of unknown etiology identified by an ophthalmologist
Image by Casper
Ehlers-Danlos Syndrome
The patient was a four-year-old female who was first seen three months before with a two day history of swelling of the upper lid of the left eye and lower lid of the right eye. This was apparently due to some skin eruption. The patient was also thought to have congenital glaucoma and the sclerae were noted to be blue. The corneas also protruded anteriorly and it was thought the patient might possibly have keratoconus. The patient was thought to have the syndrome of blue sclerotics with a high myopic astigmatism. Incidentally, the parents were first cousins. Generally, the patient had a brachycephaly, there was no nystagmus and the heart was normal. The patient was thought to possibly have osteogenesis imperfecta. She was also thought to have the typical physique of Marfan's, but the lenses were not dislocated. She had blue sclerae ([1], [2]) and keratoconus and she was -6.00 to -8.00 diopters myopic. It appeared that the patient had type VI Ehler's Danlos syndrome on the basis of the blue sclera, high myopia and keratoconus.
Image by National Eye Institute
Sensitive content
This media may include sensitive content
Slit Lamp Exam
Maj. Ivy Madson, 99th Air Base Squadron optometry flight commander, uses a Slit Lamp to examine the interior of the eye during an exam for Airman 1st Class Hunter, 18th Reconnaissance Squadron Airman, Jan. 13, 2015, at Creech Air Force Base, Nevada. The Creech Medical Aid Station now offers optometry services to all personnel assigned to Creech AFB Tuesdays from 7:30 a.m. to 3 p.m. (Last names have been withheld for security purposes). (U.S. Air Force photo by Staff Sgt. Adawn Kelsey/Released)
Image by U.S. Air Force photo by Staff Sgt. Adawn Kelsey/Released
Mydriasis
Mydriasis, pupillary response. Dilated pupils after an optometrist appointment.
Image by Nutschig at en.wikipedia
Drawing of an eye with a dilated pupil
None
Image by NIDDK Image Library
Child's Eye Exam
Lenses placed in a trial frame help determine eyeglass prescription.
Image by National Eye Institute, National Institutes of Health
Sensitive content
This media may include sensitive content
Eye exam
Capt. Luanne Danes uses a light to check the anterior segment of Master Sgt. Timothy Vanderhoff's eye during his visit to the Optometry Clinic Nov. 19, 2009, Eielson Air Force Base, Alaska. Captain Danes is looking for healthy structure of the eye and ensuring no corneal disease is present. Captain Danes, officer in charge of Optometry, is assigned to the 354th Medical Operation Squadron. Sergeant Vanderhoff, crew chief, is assigned to the 168th Aircraft Maintenance Squadron. (U.S. Air Force photo/Staff Sgt. Christopher Boitz)
Image by U.S. Air Force photo/Staff Sgt. Christopher Boitz
Eye exam
U.S. Navy Lt. Patricia Salazar examines a patient's eyes at a Continuing Promise medical clinic set up by staff assigned to the hospital ship USNS Comfort in Paita, Peru
Image by Petty Officer 1st Class Brian A. Goyak, U.S. Navy
Dilated fundus examination - Before
The same eye as File:Result of Dilated fundus examination.JPG, but before examination
Image by Nicko va
Pupil
Dilated and Undilated Pupil - Portions of the retina that can be seen through an undilated versus a dilated pupil.
Image by National Eye Institute, National Institutes of Health
Dilated fundus examination - After
Result of Dilated fundus examination
Image by Nicko va
Dilated fundus examination
This is my dilated pupil, an hour or two after getting drops put in them so the optometrist could examine my retinas. Pupil dilated using the anticholinergic drug tropicamide.
Image by grendel|khan and Lady Byron
Baby Eye Exam
Maj. Renee Vincent shows Taylor, 1, an ophthalmoscope during an exam. The 341st Medical Group has a total of 21 technicians and 24 nurses serving approximately 10,000 beneficiaries at Malmstrom. Major Vincent is the 341st Missile Wing’s pediatric advisor, commander of the 341st Medical Operations Squadron’s Maternal Child Flight, and a certified pediatric nurse practitioner for the 341st MDG. (U.S. Air Force photo/Staff Sgt. Marcus McDonald)
Image by U.S. Air Force photo/Staff Sgt. Marcus McDonald
Optical Coherence Tomography
A detailed cross-sectional image of the back of the eye is obtained using an optical coherence tomography (OCT).
Image by National Eye Institute, National Institutes of Health
Iris (anatomy)
Image by Shanon
Fundus Photography
An eye care professional takes fundus autofluorescence photographs to study the retina.
Image by National Eye Institute, National Institutes of Health
Drawing of an eye with a dilated pupil
Dilated eye
Image by NIDDK Image Library
An undilated pupil and dilated pupil
Dilating your pupil lets more light into your eye — just like opening a door lets light into a dark room. Dilation helps your eye doctor check for many common eye problems, including diabetic retinopathy, glaucoma, and age-related macular degeneration (AMD).
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
Woman checking her glasses
Image by National Eye Institute (NEI)
Vision with age-related macular degeneration
Image by National Eye Institute (NEI)
Vision with cataract
Image by National Eye Institute (NEI)
Vision with diabetic rethinopathy
Image by National Eye Institute (NEI)
Vision with glaucoma
Vision with glaucoma
Image by National Eye Institute (NEI)
Healthy Eyes
Image by National Eye Institute (NEI)
Healthy Eyes
Image by National Eye Institute (NEI)
Healthy Eyes
Image by National Eye Institute (NEI)
Healthy Eyes
Image by National Eye Institute (NEI)
Healthy Eyes
Image by National Eye Institute (NEI)
Get a dilated eye exam
A dilated eye exam is the best thing you can do for your eye health. It’s the only way to check for eye diseases early on, when they’re easier to treat — and before they cause vision loss.
Image by National Eye Institute (NEI)
2:19
Comprehensive Dilated Eye Exam
National Eye Institute, NIH/YouTube
1:56
Animation: Detecting age-related macular degeneration through a dilated eye exam.
National Eye Institute, NIH/YouTube
1:53
Animation: Detecting diabetic retinopathy through a dilated eye exam
National Eye Institute, NIH/YouTube
1:12
What are dilating eye drops?
EyeSmart — American Academy of Ophthalmology/YouTube
Dilated fundus examination
National Eye Institute (NEI), National Institutes of Health (NIH)
Pupillary response
Greyson Orlando
Right Eyeball
TheVisualMD
Tangier disease
National Eye Institute
Pupil
ROTFLOLEB
Mydriasis
OpenStax College
Intraocular lens
Janke
Drawing of a woman having her eyes examined by a doctor using a machine
NIDDK Image Library
Two-sided Adie's pupils of unknown etiology identified by an ophthalmologist
Casper
Ehlers-Danlos Syndrome
National Eye Institute
Sensitive content
This media may include sensitive content
Slit Lamp Exam
U.S. Air Force photo by Staff Sgt. Adawn Kelsey/Released
Mydriasis
Nutschig at en.wikipedia
Drawing of an eye with a dilated pupil
NIDDK Image Library
Child's Eye Exam
National Eye Institute, National Institutes of Health
Sensitive content
This media may include sensitive content
Eye exam
U.S. Air Force photo/Staff Sgt. Christopher Boitz
Eye exam
Petty Officer 1st Class Brian A. Goyak, U.S. Navy
Dilated fundus examination - Before
Nicko va
Pupil
National Eye Institute, National Institutes of Health
Dilated fundus examination - After
Nicko va
Dilated fundus examination
grendel|khan and Lady Byron
Baby Eye Exam
U.S. Air Force photo/Staff Sgt. Marcus McDonald
Optical Coherence Tomography
National Eye Institute, National Institutes of Health
Iris (anatomy)
Shanon
Fundus Photography
National Eye Institute, National Institutes of Health
Drawing of an eye with a dilated pupil
NIDDK Image Library
An undilated pupil and dilated pupil
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Woman checking her glasses
National Eye Institute (NEI)
Vision with age-related macular degeneration
National Eye Institute (NEI)
Vision with cataract
National Eye Institute (NEI)
Vision with diabetic rethinopathy
National Eye Institute (NEI)
Vision with glaucoma
National Eye Institute (NEI)
Healthy Eyes
National Eye Institute (NEI)
Healthy Eyes
National Eye Institute (NEI)
Healthy Eyes
National Eye Institute (NEI)
Healthy Eyes
National Eye Institute (NEI)
Healthy Eyes
National Eye Institute (NEI)
Get a dilated eye exam
National Eye Institute (NEI)
Fluorescein Angiography
Fluorescein Angiography
Also called: Fluorescein Eye Angiogram, Fundus Fluorescence Photography
Fluorescein eye angiography is a diagnostic procedure that uses orange fluorescent dye (fluorescein) and a special camera to look at blood vessels and the flow of blood inside the eye. The test is particularly useful in the management of diabetic retinopathy and macular degeneration.
Fluorescein Angiography
Also called: Fluorescein Eye Angiogram, Fundus Fluorescence Photography
Fluorescein eye angiography is a diagnostic procedure that uses orange fluorescent dye (fluorescein) and a special camera to look at blood vessels and the flow of blood inside the eye. The test is particularly useful in the management of diabetic retinopathy and macular degeneration.
{"label":"Fluorescein Angiography Reference Range","scale":"lin","step":0.25,"hideunits":true,"items":[{"flag":"normal","label":{"short":"Normal","long":"Normal","orientation":"horizontal"},"values":{"min":0,"max":1},"text":"A normal result means the vessels appear a normal size, there are no new abnormal vessels, and there are no blockages or leakages.","conditions":[]},{"flag":"abnormal","label":{"short":"Abnormal","long":"Abnormal","orientation":"horizontal"},"values":{"min":1,"max":2},"text":"If blockage or leakage is present, the pictures will map the location for possible treatment.","conditions":["Blood flow (circulatory) problems, such as blockage of the arteries or veins","Cancer","Diabetic or other retinopathy","High blood pressure","Inflammation or edema","Macular degeneration","Microaneurysms -- enlargement of capillaries in the retina","Tumors","Swelling of the optic disc"]}],"value":0.5}[{"normal":0},{"abnormal":0}]
Use the slider below to see how your results affect your
health.
Your result is Normal.
A normal result means the vessels appear a normal size, there are no new abnormal vessels, and there are no blockages or leakages.
Related conditions
A fluorescein eye angiography is a test that helps the doctor diagnosis or monitor problems with your eye.
The test involves taking pictures of the blood vessels in your eye with the help of a special dye. This dye is called contrast. Contrast helps the blood vessels show up better in the pictures. The test lets your doctor see the blood vessels in your eye and how blood flows to two parts of your eyes:
The choroid (the middle layer of the eye).
The retina (the back of the eye).
The test usually takes about 2 hours.
The nurse or technician will put drops in your eyes to dilate (enlarge) your pupils.
The nurse will insert an IV (intravenous) catheter (small tube) into a vein in your arm.
You may feel some pain when the catheter is inserted.
The nurse will inject contrast into the IV catheter. The contrast travels up to your eye within a few seconds and “lights up” the blood vessels for the camera.
You may feel some pain if any contrast leaks out of the catheter and into your vein.
The camera technician will take several pictures as the contrast passes through the blood vessels of your eye.
After the test is done, the nurse will remove the IV catheter.
Drink plenty of water and other fluids for 36 hours after the test to flush the contrast out of your body. You can resume your normal activities once the test is done.
You may eat and drink fluids before the test unless your doctor tells you not to.
If you wear contacts, take them out before the test.
Make a plan have someone drive you home after. Your vision may be blurred for about 12 hours after the test so you may not be able to drive.
Let your doctor know if you:
Might be pregnant or are pregnant or breastfeeding.
Have ever had a bad reaction to contrast.
Have an allergy to iodine, penicillin, or sulfa drugs.
Feel dizzy or lightheaded when you get blood drawn.
It’s normal to have:
Some pain when the catheter is inserted.
Burning where the catheter is inserted.
Mild nausea.
Vomiting.
A feeling of warmth.
A headache.
A metallic taste after the contrast is injected.
A yellow color to the skin for about 12 hours after the test.
A bright yellow color to the urine for up to 36 hours after the test.
Call the doctor or nurse if:
You itch or have hives.
You start sneezing.
Your heart feels like it’s beating fast or racing.
Your face or hands begin to swell.
You feel lightheaded or dizzy.
You notice these changes where the catheter was:
Pain.
Redness.
https://cc.nih.gov/ccc/patient_education/pepubs/fluorescein.pdf [accessed on Dec 12, 2018]
Fluorescein Angiogram | National Eye Institute [accessed on Dec 12, 2018]
Fluorescein angiography: MedlinePlus Medical Encyclopedia [accessed on Dec 12, 2018]
Normal reference ranges can vary depending on the laboratory and the method used for testing. You must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
Additional Materials (20)
Fluorescein angiography
Fluorescein retinography of a 33 years old patient (right eye), showing the optical disc at the inferior right quadrant and the macula lutea at the inferior left quadrant (darker spot). No anomalies detected.
Image by Mekhahertz
Choroid folds in high hypermetropia (fluorescein angiography)
Choroid folds in high hypermetropia (fluorescein angiography)
Image by Maria Sieglinda von Nudeldorf
diabetic retinopathy (fluorescein angiography)
Emptied retinal venules due to arterial branch occlusion in diabetic retinopathy (fluorescein angiography)
Image by Maria Sieglinda von Nudeldorf
Epiretinal Membrane using fluorescein angiography
Epiretinal Membrane using fluorescein angiography
Image by basherkit
American Academy of Ophthalmology-Fluorescein Angiography
Video by retina/YouTube
Can Screens Damage Your Eyes?
Video by SciShow/YouTube
Fluorescein Angiography
Video by Bigsease30/YouTube
Real-Time Fluorescein Angiography
Video by JAMA Network/YouTube
Central retinal vein occlusion
Comparison of foveal avascular zone between optical coherence tomography angiography and fluorescein angiography in patients with retinal vein occlusion.
Image by Werner JU, Böhm F, Lang GE, Dreyhaupt J, Lang GK, Enders C
retinal vein occlusion
Comparison of foveal avascular zone between optical coherence tomography angiography and fluorescein angiography in patients with retinal vein occlusion.
Image by Werner JU, Böhm F, Lang GE, Dreyhaupt J, Lang GK, Enders C
Dendritic corneal ulcer after fluorescein staining
Dendritic corneal ulcer after fluorescein staining
Image by Imrankabirhossain
Keratitis
Dendritic corneal ulcer after fluorescein staining under cobalt blue illumination
Image by Imrankabirhossain
The eye uses many layers of nerve cells to convert light into sight
This image captures the many layers of nerve cells in the retina. The top layer (green) is made up of cells called photoreceptors that convert light into electrical signals to relay to the brain. The two best-known types of photoreceptor cells are rod- and cone-shaped. Rods help us see under low-light conditions but can't help us distinguish colors. Cones don't function well in the dark but allow us to see vibrant colors in daylight.
This image is part of the Life: Magnified collection, which was displayed in the Gateway Gallery at Washington Dulles International Airport June 3, 2014, to January 21, 2015. To see all 46 images in this exhibit, go to https://www.nigms.nih.gov/education/life-magnified/Pages/default.aspx.
Image by Wei Li, National Eye Institute, National Institutes of Health
diagnosis of Stargardt's disease
Optical coherence tomography is used for diagnosis of Stargardt's disease.
Image by medOCT-group, Dept of Med. Physics, Med. Univ. Vienna
Retina close-up
A picture of a patient’s retina is displayed at the optometry clinic March 11, 2016, at Malmstrom Air Force Base, Mont. The clinic is the only one in Montana that has a retinal imagining device called an Optos, used to look at the retina without diluting it. (U.S. Air Force photo/Senior Airman Jaeda Tookes)
Image by U.S. Air Force photo/Senior Airman Jaeda Tookes
Retinal mapping of the eye
Patients can watch the retinal mapping of their eye as the image slowly rotates, giving a 200-degree view immediately after scanning with the new ophthalmoscope.
Image by Air Force photo by Margo Wright
Chloroquine retinopathy
Chloroquine retinopathy in the left eye of a 55-year-old woman who had taken chloroquine for rheumatoid arthritis for more than 4 years, with an estimated total dose of 365 gr (250 mg daily). She first presented with a history of gradually decreasing visual acuity without any other symptoms approximately two years earlier. The latest examination revealed that her visual acuity was 30/200 right eye and 60/200 left eye. Left image shows typical bull's eye sign and right image is the fluorescien angiogram of the same eye showing increased fluorescence in the macular area and round-shaped blocked fluorescence in the central fovea.
Image by Doctors:Xiaoyun Ma, Liang Yan, Linping He Dongyi He, Hao Lu from Shanghai, China
Optical coherence tomography
The healthy optic disc (optic nerve head) of a 24 year old male (cross-section view). This image is released to Wikimedia with patient consent. Imaged in-vivo with an Optovue iVue Spectral Domain Optical Coherence Tomographer (SD-OCT) at the office of Drs. Harry Wiessner, Steven Davis, Daniel Wiessner, and Eric Wiessner in Walla Walla, WA, USA.
Image by Wies6014/Wikimedia
Fluorescein Angiography
Fluorescein Angiography
Image by Litev / https://commons.wikimedia.org/wiki/File:%D0%9D%D0%94%D0%A0-%D0%9C%D0%9B%D0%A6.JPG
Fluorescein Angiography
Fluorescein Angiography
Image by Litev / https://commons.wikimedia.org/wiki/File:%D0%9F%D0%94%D0%A0-%D0%9D%D0%92%D0%95.JPG
Fluorescein angiography
Mekhahertz
Choroid folds in high hypermetropia (fluorescein angiography)
Maria Sieglinda von Nudeldorf
diabetic retinopathy (fluorescein angiography)
Maria Sieglinda von Nudeldorf
Epiretinal Membrane using fluorescein angiography
basherkit
7:45
American Academy of Ophthalmology-Fluorescein Angiography
retina/YouTube
3:45
Can Screens Damage Your Eyes?
SciShow/YouTube
1:44
Fluorescein Angiography
Bigsease30/YouTube
1:40
Real-Time Fluorescein Angiography
JAMA Network/YouTube
Central retinal vein occlusion
Werner JU, Böhm F, Lang GE, Dreyhaupt J, Lang GK, Enders C
retinal vein occlusion
Werner JU, Böhm F, Lang GE, Dreyhaupt J, Lang GK, Enders C
Dendritic corneal ulcer after fluorescein staining
Imrankabirhossain
Keratitis
Imrankabirhossain
The eye uses many layers of nerve cells to convert light into sight
Wei Li, National Eye Institute, National Institutes of Health
diagnosis of Stargardt's disease
medOCT-group, Dept of Med. Physics, Med. Univ. Vienna
Retina close-up
U.S. Air Force photo/Senior Airman Jaeda Tookes
Retinal mapping of the eye
Air Force photo by Margo Wright
Chloroquine retinopathy
Doctors:Xiaoyun Ma, Liang Yan, Linping He Dongyi He, Hao Lu from Shanghai, China
Indocyanine green (ICG) angiography is a diagnostic procedure that uses green dye (indocyanine green) and a special camera to look at blood vessels in the choroid layer of the eye. The most common application of the test is the detection of choroidal neovascularization, a common component of age related macular degeneration.
Indocyanine Green Angiography
Also called: ICG Angiography
Indocyanine green (ICG) angiography is a diagnostic procedure that uses green dye (indocyanine green) and a special camera to look at blood vessels in the choroid layer of the eye. The most common application of the test is the detection of choroidal neovascularization, a common component of age related macular degeneration.
An indocyanine green contrast eye angiography will help the doctor diagnosis or monitor problems with your eye. The test involves taking pictures of the blood vessels in your eye with the help of a special dye. This dye is called contrast. Contrast helps the blood vessels show up better in the pictures.
The test usually takes about 1 - 2 hours.
The nurse or technician will put drops in your eyes to dilate (enlarge) your pupils.
The camera technician will take a few pictures of your eye with a special camera.
The nurse will insert an IV (intravenous) catheter (small tube) into a vein in your arm.
You may feel some pain when the catheter is inserted.
The nurse will inject contrast into the IV catheter. The contrast travels up to your eye within a few seconds and “lights up” the blood vessels for the camera.
The camera technician will take several more pictures of your eye.
After the test is done, the nurse will remove the IV catheter.
Drink plenty of water and other fluids for 36 hours after the test to flush the contrast out of your body. You can resume your normal activities once the test is done.
You may eat and drink fluids before the test unless your doctor tells you not to.
If you wear contacts, take them out before the test.
Make a plan have someone drive you home after. Your vision may be blurred for about 12 hours so you may not be able to drive.
Let your doctor know if you:
Might be pregnant or are pregnant or breastfeeding.
Have ever had a bad reaction to contrast.
Have an allergy to iodine, penicillin, or sulfa drugs.
Have an allergy to shellfish (such as shrimp, lobster, or crabs).
Feel dizzy or lightheaded when you get blood drawn.
It’s normal to have:
Some pain when the catheter is inserted.
Burning where the catheter is inserted.
Mild nausea.
A feeling of warmth.
A headache.
A metallic taste after the contrast is injected.
A greenish color to the skin for about 6-12 hours after the test.
A greenish color to the urine for up to 36 hours after the test.
Call the doctor or nurse if:
You itch or have hives.
You start sneezing.
Your heart feels like it’s beating fast or racing.
Your face or hands begin to swell.
You feel lightheaded or dizzy.
You notice these changes where the catheter was:
Pain.
Redness.
https://cc.nih.gov/ccc/patient_education/pepubs/indocyanine.pdf [accessed on Dec 12, 2018]
Indocyanine Green Angiography | Department of Ophthalmology and Visual Sciences [accessed on Dec 12, 2018]
Indocyanine Green Angiography | Department of Ophthalmology [accessed on Dec 12, 2018]
Additional Materials (7)
Fluorescein Angiography for AMD
Video by EyeSmart — American Academy of Ophthalmology/YouTube
Fluorescein and Indocyanine Green Angiography of Chorioretinal Anastomosis
Video by JAMA Network/YouTube
ICG Angiography
Video by Heidelberg Engineering/YouTube
A look at the smallest blood vessels in the eye
Video by National Eye Institute, NIH/YouTube
Fluorescein Angiography
Emptied retinal venules due to arterial branch occlusion in diabetic retinopathy (fluorescein angiography)
Image by Maria Sieglinda von Nudeldorf
Epiretinal Membrane using fluorescein angiography
Epiretinal Membrane using fluorescein angiography
Image by basherkit
Fluorescein angiography
Fluorescein retinography of a 33 years old patient (right eye), showing the optical disc at the inferior right quadrant and the macula lutea at the inferior left quadrant (darker spot). No anomalies detected.
Image by Mekhahertz
0:21
Fluorescein Angiography for AMD
EyeSmart — American Academy of Ophthalmology/YouTube
0:55
Fluorescein and Indocyanine Green Angiography of Chorioretinal Anastomosis
JAMA Network/YouTube
20:28
ICG Angiography
Heidelberg Engineering/YouTube
0:10
A look at the smallest blood vessels in the eye
National Eye Institute, NIH/YouTube
Fluorescein Angiography
Maria Sieglinda von Nudeldorf
Epiretinal Membrane using fluorescein angiography
basherkit
Fluorescein angiography
Mekhahertz
Staging
Sensitive content
This media may include sensitive content
Stages of Melanoma
Image by Cancer Research UK / Wikimedia Commons
Sensitive content
This media may include sensitive content
Stages of Melanoma
Diagram showing the T stages of melanoma.
Image by Cancer Research UK / Wikimedia Commons
What Are the Stages of Intraocular (Uveal) Melanoma?
KEY POINTS
After intraocular melanoma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.
The following sizes are used to describe intraocular melanoma and plan treatment:
Small
Medium
Large
There are three ways that cancer spreads in the body.
Cancer may spread from where it began to other parts of the body.
The following stages are used for intraocular melanoma of the ciliary body and choroid:
Stage I
Stage II
Stage III
Stage IV
There is no staging system for intraocular melanoma of the iris.
Intraocular melanoma can recur (come back) after it has been treated.
After intraocular melanoma has been diagnosed, tests are done to find out if cancer cells have spread to other parts of the body.
The process used to find out if cancer has spread to other parts of the body is called staging. The information gathered from the staging process determines the stage of the disease. It is important to know the stage in order to plan treatment.
The following tests and procedures may be used in the staging process:
Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
Liver function tests: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by the liver. A higher than normal amount of a substance can be a sign the cancer has spread to the liver.
Ultrasound exam: A procedure in which high-energy sound waves (ultrasound) are bounced off internal tissues or organs, such as the liver, and make echoes. The echoes form a picture of body tissues called a sonogram.
Chest x-ray: An x-ray of the organs and bones inside the chest. An x-ray is a type of energy beam that can go through the body and onto film, making a picture of areas inside the body.
MRI (magnetic resonance imaging): A procedure that uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas inside the body, such as the liver. This procedure is also called nuclear magnetic resonance imaging (NMRI).
CT scan (CAT scan): A procedure that makes a series of detailed pictures of areas inside the body, such as the chest, abdomen, or pelvis, taken from different angles. The pictures are made by a computer linked to an x-ray machine. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography.
PET scan (positron emission tomography scan): A procedure to find malignant tumor cells in the body. A very small amount of radioactive glucose (sugar) is injected into a vein. The PET scanner rotates around the body and makes a picture of where glucose is being used in the body. Malignant tumor cells show up brighter in the picture because they are more active and take up more glucose than normal cells do. Sometimes a PET scan and a CT scan are done at the same time. If there is any cancer, this increases the chance that it will be found.
The following sizes are used to describe intraocular melanoma and plan treatment:
Small
The tumor is 5 to 16 millimeters in diameter and from 1 to 3 millimeters thick.
Millimeters (mm). A sharp pencil point is about 1 mm, a new crayon point is about 2 mm, and a new pencil eraser is about 5 mm.
Medium
The tumor is 16 millimeters or smaller in diameter and from 3.1 to 8 millimeters thick.
Large
The tumor is:
more than 8 millimeters thick and any diameter; or
at least 2 millimeters thick and more than 16 millimeters in diameter.
Though most intraocular melanoma tumors are raised, some are flat. These diffuse tumors grow widely across the uvea.
There are three ways that cancer spreads in the body.
Cancer can spread through tissue, the lymph system, and the blood:
Tissue. The cancer spreads from where it began by growing into nearby areas.
Lymph system. The cancer spreads from where it began by getting into the lymph system. The cancer travels through the lymph vessels to other parts of the body.
Blood. The cancer spreads from where it began by getting into the blood. The cancer travels through the blood vessels to other parts of the body.
If intraocular melanoma spreads to the optic nerve or nearby tissue of the eye socket, it is called extraocular extension.
Cancer may spread from where it began to other parts of the body.
When cancer spreads to another part of the body, it is called metastasis. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.
Lymph system. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.
Blood. The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.
The metastatic tumor is the same type of cancer as the primary tumor. For example, if intraocular melanoma spreads to the liver, the cancer cells in the liver are actually intraocular melanoma cells. The disease is metastatic intraocular melanoma, not liver cancer.
The following stages are used for intraocular melanoma of the ciliary body and choroid:
Intraocular melanoma of the ciliary body and choroid has four size categories. The category depends on how wide and thick the tumor is. Category 1 tumors are the smallest and category 4 tumors are the largest.
Category 1:
The tumor is not more than 12 millimeters wide and not more than 3 millimeters thick; or
the tumor is not more than 9 millimeters wide and 3.1 to 6 millimeters thick.
Category 2:
The tumor is 12.1 to 18 millimeters wide and not more than 3 millimeters thick; or
the tumor is 9.1 to 15 millimeters wide and 3.1 to 6 millimeters thick; or
the tumor is not more than 12 millimeters wide and 6.1 to 9 millimeters thick.
Category 3:
The tumor is 15.1 to 18 millimeters wide and 3.1 to 6 millimeters thick; or
the tumor is 12.1 to 18 millimeters wide and 6.1 to 9 millimeters thick; or
the tumor is not more than 18 millimeters wide and 9.1 to 12 millimeters thick; or
the tumor is not more than 15 millimeters wide and 12.1 to 15 millimeters thick.
Category 4:
The tumor is more than 18 millimeters wide and may be any thickness; or
the tumor is 15.1 to 18 millimeters wide and more than 12 millimeters thick; or
the tumor is not more than 15 millimeters wide and more than 15 millimeters thick.
Stage I
In stage I, the tumor is size category 1 and is in the choroid only.
Stage II
Stage II is divided into stages IIA and IIB.
In stage IIA, the tumor:
is size category 1 and has spread to the ciliary body; or
is size category 1 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor may have spread to the ciliary body; or
is size category 2 and is in the choroid only.
In stage IIB, the tumor:
is size category 2 and has spread to the ciliary body; or
is size category 3 and is in the choroid only.
Stage III
Stage III is divided into stages IIIA, IIIB, and IIIC.
In stage IIIA, the tumor:
is size category 2 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor may have spread to the ciliary body; or
is size category 3 and has spread to the ciliary body; or
is size category 3 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has not spread to the ciliary body; or
is size category 4 and is in the choroid only.
In stage IIIB, the tumor:
is size category 3 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has spread to the ciliary body; or
is size category 4 and has spread to the ciliary body; or
is size category 4 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has not spread to the ciliary body.
In stage IIIC, the tumor:
is size category 4 and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is not more than 5 millimeters thick. The tumor has spread to the ciliary body; or
may be any size and has spread through the sclera to the outside of the eyeball. The part of the tumor outside the eyeball is more than 5 millimeters thick.
Stage IV
In stage IV, the tumor may be any size and has spread:
to one or more nearby lymph nodes or to the eye socket separate from the primary tumor; or
to other parts of the body, such as the liver, lung, bone, brain, or tissue under the skin.
There is no staging system for intraocular melanoma of the iris.
Intraocular melanoma can recur (come back) after it has been treated.
The melanoma may come back in the eye or in other parts of the body.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (8)
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
3D medical animation TNM Staging System
3D medical illustration depicting the Tumor (left), Node (middle) and Metastasis (right) staging system for cancer
Image by https://www.scientificanimations.com
Malignant melanoma of the choroid
Malignant melanoma of the choroid
Image by Wellcome Trust
Ocular Melanoma - See Your Eye Professional Today
Video by Ocular Melanoma Foundation/YouTube
Ocular Melanoma: What You Need to Know | Tara McCannel, MD | UCLAMDChat
Video by UCLA Health/YouTube
Stages of Morphology
Stages of Morphology - A flow chart summarizing the stages in morphology of the embryo
Image by Farah Mohd Zaki
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
Cancer staging, that is, determining the extent and spread of cancer in the body, is used by doctors to plan treatment and to arrive at a prognosis (estimate of future course and outcome) for the disease.
Image by TheVisualMD
Staging Cancer
TheVisualMD
3D medical animation TNM Staging System
https://www.scientificanimations.com
Malignant melanoma of the choroid
Wellcome Trust
2:44
Ocular Melanoma - See Your Eye Professional Today
Ocular Melanoma Foundation/YouTube
33:01
Ocular Melanoma: What You Need to Know | Tara McCannel, MD | UCLAMDChat
UCLA Health/YouTube
Stages of Morphology
Farah Mohd Zaki
Staging Cancer
TheVisualMD
Staging Cancer
TheVisualMD
Treatment
Photocoagulation
Image by BruceBlaus
Photocoagulation
A medical illustration depicting a photocoagulation surgery.
Image by BruceBlaus
How Is Intraocular (Uveal) Melanoma Treated?
Treatment Option Overview
KEY POINTS
There are different types of treatments for patients with intraocular melanoma.
Five types of standard treatment are used:
Surgery
Watchful Waiting
Radiation therapy
Photocoagulation
Thermotherapy
New types of treatment are being tested in clinical trials.
Treatment for intraocular (uveal) melanoma may cause side effects.
Patients may want to think about taking part in a clinical trial.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Follow-up tests may be needed.
There are different types of treatments for patients with intraocular melanoma.
Different types of treatments are available for patients with intraocular melanoma. Some treatments are standard (the currently used treatment), and some are being tested in clinical trials. A treatment clinical trial is a research study meant to help improve current treatments or obtain information on new treatments for patients with cancer. When clinical trials show that a new treatment is better than the standard treatment, the new treatment may become the standard treatment. Patients may want to think about taking part in a clinical trial. Some clinical trials are open only to patients who have not started treatment.
Five types of standard treatment are used:
Surgery
Surgery is the most common treatment for intraocular melanoma. The following types of surgery may be used:
Resection: Surgery to remove the tumor and a small amount of healthy tissue around it.
Enucleation: Surgery to remove the eye and part of the optic nerve. This is done if vision cannot be saved and the tumor is large, has spread to the optic nerve, or causes high pressure inside the eye. After surgery, the patient is usually fitted for an artificial eye to match the size and color of the other eye.
Exenteration: Surgery to remove the eye and eyelid, and muscles, nerves, and fat in the eye socket. After surgery, the patient may be fitted for an artificial eye to match the size and color of the other eye or a facial prosthesis.
Watchful Waiting
Watchful waiting is closely monitoring a patient’s condition without giving any treatment until signs or symptoms appear or change. Pictures are taken over time to keep track of changes in the size of the tumor and how fast it is growing.
Watchful waiting is used for patients who do not have signs or symptoms and the tumor is not growing. It is also used when the tumor is in the only eye with useful vision.
Radiation therapy
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. There are two types of radiation therapy:
External radiation therapy uses a machine outside the body to send radiation toward the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging nearby healthy tissue. These types of external radiation therapy include the following:
Charged-particle external beam radiation therapy is a type of external-beam radiation therapy. A special radiation therapy machine aims tiny, invisible particles, called protons or helium ions, at the cancer cells to kill them with little damage to nearby normal tissues. Charged-particle radiation therapy uses a different type of radiation than the x-ray type of radiation therapy.
Gamma Knife therapy is a type of stereotactic radiosurgery used for some melanomas. This treatment can be given in one treatment. It aims tightly focused gamma rays directly at the tumor so there is little damage to healthy tissue. Gamma Knife therapy does not use a knife to remove the tumor and is not an operation.
Internal radiation therapy uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer. Certain ways of giving radiation therapy can help keep radiation from damaging healthy tissue. This type of internal radiation therapy may include the following:
Localized plaque radiation therapy is a type of internal radiation therapy that may be used for tumors of the eye. Radioactive seeds are attached to one side of a disk, called a plaque, and placed directly on the outside wall of the eye near the tumor. The side of the plaque with the seeds on it faces the eyeball, aiming radiation at the tumor. The plaque helps protect other nearby tissue from the radiation.
Plaque radiotherapy of the eye. A type of radiation therapy used to treat eye tumors. Radioactive seeds are placed on one side of a thin piece of metal (usually gold) called a plaque. The plaque is sewn onto the outside wall of the eye. The seeds give off radiation which kills the cancer. The plaque is removed at the end of treatment, which usually lasts for several days.
The way the radiation therapy is given depends on the type and stage of the cancer being treated. External and internal radiation therapy are used to treat intraocular melanoma.
Photocoagulation
Photocoagulation is a procedure that uses laser light to destroy blood vessels that bring nutrients to the tumor, causing the tumor cells to die. Photocoagulation may be used to treat small tumors. This is also called light coagulation.
Thermotherapy
Thermotherapy is the use of heat from a laser to destroy cancer cells and shrink the tumor.
Treatment for intraocular (uveal) melanoma may cause side effects.
Patients may want to think about taking part in a clinical trial.
For some patients, taking part in a clinical trial may be the best treatment choice. Clinical trials are part of the cancer research process. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.
Many of today's standard treatments for cancer are based on earlier clinical trials. Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.
Patients who take part in clinical trials also help improve the way cancer will be treated in the future. Even when clinical trials do not lead to effective new treatments, they often answer important questions and help move research forward.
Patients can enter clinical trials before, during, or after starting their cancer treatment.
Some clinical trials only include patients who have not yet received treatment. Other trials test treatments for patients whose cancer has not gotten better. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.
Clinical trials are taking place in many parts of the country. Information about clinical trials supported by NCI can be found on NCI’s clinical trials search webpage. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.
Follow-up tests may be needed.
Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Some tests will be repeated in order to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.
Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your condition has changed or if the cancer has recurred (come back). These tests are sometimes called follow-up tests or check-ups.
Treatment of Intraocular (Uveal) Melanoma
Iris Melanoma
Treatment of iris melanoma may include the following:
Watchful waiting.
Surgery (resection or enucleation).
Plaque radiation therapy, for tumors that cannot be removed by surgery.
Ciliary Body Melanoma
Treatment of ciliary body melanoma may include the following:
Plaque radiation therapy.
Charged-particle external-beam radiation therapy.
Surgery (resection or enucleation).
Choroid Melanoma
Treatment of small choroid melanoma may include the following:
Watchful waiting.
Plaque radiation therapy.
Charged-particle external-beam radiation therapy.
Gamma Knife therapy.
Thermotherapy.
Surgery (resection or enucleation).
Treatment of medium choroid melanoma may include the following:
Plaque radiation therapy with or without photocoagulation or thermotherapy.
Charged-particle external-beam radiation therapy.
Surgery (resection or enucleation).
Treatment of large choroid melanoma may include the following:
Enucleation when the tumor is too large for treatments that save the eye.
Extraocular Extension Melanoma and Metastatic Intraocular (Uveal) Melanoma
Treatment of extraocular extension melanoma that has spread to the bone around the eye may include the following:
Surgery (exenteration).
A clinical trial.
An effective treatment for metastatic intraocular melanoma has not been found. A clinical trial may be a treatment option. Talk with your doctor about your treatment options.
Recurrent Intraocular (Uveal) Melanoma
An effective treatment for recurrent intraocular melanoma has not been found. A clinical trial may be a treatment option. Talk with your doctor about your treatment options.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
Additional Materials (4)
laser photocoagulation surgery
Laser photocoagulation
Image by MarkPanin
Ocular Melanoma Treatment
Video by Cure Melanoma/YouTube
Overview of Uveal Melanoma, Dr. Prithvi Mruthyunjaya
Video by Ocular Melanoma Foundation/YouTube
Ocular Melanoma: What You Need to Know | Tara McCannel, MD | UCLAMDChat
Video by UCLA Health/YouTube
laser photocoagulation surgery
MarkPanin
34:21
Ocular Melanoma Treatment
Cure Melanoma/YouTube
35:18
Overview of Uveal Melanoma, Dr. Prithvi Mruthyunjaya
Ocular Melanoma Foundation/YouTube
33:01
Ocular Melanoma: What You Need to Know | Tara McCannel, MD | UCLAMDChat
UCLA Health/YouTube
Prognosis
Malignant melanoma of the choroid
Image by Wellcome Trust
Malignant melanoma of the choroid
Malignant melanoma of the choroid
Image by Wellcome Trust
What Is the Prognosis for Adults with Intraocular (Uveal) Melanoma?
Certain factors affect prognosis (chance of recovery) and treatment options.
The prognosis and treatment options depend on the following:
How the melanoma cells look under a microscope.
The size and thickness of the tumor.
The part of the eye the tumor is in (the iris, ciliary body, or choroid).
Whether the tumor has spread within the eye or to other places in the body.
Whether there are certain changes in the genes linked to intraocular melanoma.
The patient's age and general health.
Whether the tumor has recurred (come back) after treatment.
Source: PDQ® Adult Treatment Editorial Board. PDQ Intraocular (Uveal) Melanoma Treatment. Bethesda, MD: National Cancer Institute.
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Intraocular (Uveal) Melanoma
Intraocular (uveal) melanoma is a rare cancer that forms in the eye. It usually has no early signs or symptoms. As with melanoma of the skin, risk factors include having fair skin and light-colored eyes. Learn about the signs and symptoms of intraocular melanoma and find out how it can be treated.