Test: Conjunctiva - Visual Inspection

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Background/Purpose

Procedure

The conjunctiva is examined by direct inspection. The bulbar conjunctiva is directly visible between the eyelids; the palpebral conjunctiva can only be examined by everting the upper or lower eyelid. The normal conjunctiva is smooth, shiny, and moist. The examiner should be alert to any reddening, secretion, thickening, scars, or foreign bodies.

Eversion of the lower eyelid. The patient looks up while the examiner pulls the eyelid downward close to the anterior margin. This exposes the conjunctiva and the posterior surface of the lower eyelid.

The lower eyelid must be everted for this examination of eyeball scleritis. The patient looks up while the examiner pulls the eyelid downward close to the anterior margin.
Eversion of the upper eyelid is simple eversion. The patient is asked to look down. The patient should repeatedly be told to relax and to avoid tightly shutting the opposite eye. This relaxes the levator palpebrae superioris and orbicularis oculi muscles. The examiner grasps the eyelashes of the upper eyelid between the thumb and forefinger and everts the eyelid against a glass rod or swab used as a fulcrum. Eversion should be performed with a quick levering motion while applying slight traction. The palpebral conjunctiva can then be inspected and cleaned if necessary.
Performed: Unilaterally

Dialog

Evaluation of the palpebral and bulbar conjunctiva.

Criteria

• Smooth, shinny surface
• No redness, secretion, thickening or scars

Measurement

LOINC Code

Scale/Grading

selection range; grade - LOINC ID
Option - Value option selection range; grade - LOINC IDPass ; Pass - Fail ; Fail -