Normal Ophthalmic Values
Visual Acuity
- Normal: 6/60
Near Vision
- Normal: N6
Intraocular Pressure (NCT)
- Normal: 10–21 mmHg
- Suspicious: 22–24 mmHg
- High: >21 mmHg with disc changes
Cup Disc Ratio
- Normal: ≤0.3
- Suspicious: >0.5
- Glaucoma: ≥0.7
Central Corneal Thickness
- 520–550 μm
Schirmer Test
- Normal: >10 mm/5 min
- Mild: 5–10 mm
- Severe: <5 li="" mm="">
TBUT (Tear Break-up Time)
- Normal: >10 sec
Colour Vision
- 14/14 Ishihara plates
Pupil Size
- 2–4 mm in bright light
- 4–8 mm in dim light
Normal Fundus
- Pink optic disc
- Sharp margins
- Foveal reflex present
- Attached retina
Common Ophthalmology OPD Cases
Allergic Conjunctivitis
Clinical Features
- Itching
- Redness
- Watering
- Stringy discharge
First line management
- Olopatadine 0.1% eye drops – 1 drop BD × 2–4 weeks
- Carboxymethylcellulose 0.5% eye drops 4–6 times/day
Advice
- Cold compresses
- Avoid allergens and eye rubbing
Viral Conjunctivitis
Clinical Features
- Red eye
- Watering
- Follicles
- Preauricular lymphadenopathy
First line management
- Carboxymethylcellulose eye drops 4–6 times/day
Advice
- Cold compresses
- Usually resolves in 1–3 weeks
Bacterial Conjunctivitis
Clinical Features
- Purulent discharge
- Sticky eyelids
- Red eye
First line management
- Moxifloxacin 0.5% eye drops QID × 7 days
Advice
- Lid hygiene
Stye (Hordeolum)
Clinical Features
- Painful eyelid swelling
- Tender lump
First line management
- Warm compresses 10–15 min QID
- Moxifloxacin eye ointment TDS × 5–7 days
Advice
- Avoid squeezing
Chalazion
Clinical Features
- Painless eyelid lump
First line management
- Warm compresses
- Lid massage
Advice
- Incision and curettage if persistent
Blepharitis
Clinical Features
- Lid crusting
- Burning
- Foreign body sensation
First line management
- Erythromycin ointment HS × 2 weeks
- Azithromycin drops as prescribed
Advice
- Lid hygiene
Dry Eye Disease
Clinical Features
- Burning
- Foreign body sensation
- Intermittent blurring
First line management
- CMC 0.5% drops 4–6 times/day
- Cyclosporine 0.05% BD × 3–6 months
Advice
- Frequent blinking
Corneal Abrasion
Clinical Features
- Pain
- Photophobia
- Watering
First line management
- Moxifloxacin 0.5% QID × 5–7 days
- Paracetamol 500 mg SOS
Advice
- Avoid rubbing eye
Corneal Foreign Body
Clinical Features
- Foreign body sensation
- Pain
- Watering
First line management
- Removal under slit lamp
- Moxifloxacin QID × 5–7 days
Advice
- Follow-up examination
Cataract
Clinical Features
- Painless progressive diminution of vision
- Glare
First line management
- Phacoemulsification + IOL implantation
Advice
- Regular follow-up
Primary Open Angle Glaucoma
Clinical Features
- Raised IOP
- Peripheral field loss
- Optic disc cupping
First line management
- Timolol 0.5% BD
- Latanoprost 0.005% HS
Advice
- Regular visual field testing
Acute Angle Closure Glaucoma
Clinical Features
- Severe eye pain
- Headache
- Vomiting
- Mid dilated pupil
First line management
- Acetazolamide 500 mg stat then 250 mg QID
- Pilocarpine 2% QID
Advice
- Emergency ophthalmology referral
Diabetic Retinopathy
Clinical Features
- Visual impairment
- Retinal hemorrhages
First line management
- Anti-VEGF injections
- Laser photocoagulation
Advice
- Strict glycemic control
Hypertensive Retinopathy
Clinical Features
- Retinal vascular changes
First line management
- Blood pressure control
Advice
- Regular fundus examination
Episcleritis
Clinical Features
- Sectoral redness
- Mild discomfort
First line management
- Lubricants
- Ibuprofen 400 mg TDS × 5–7 days
Advice
- Usually self-limiting
Pterygium
Clinical Features
- Triangular fibrovascular growth
First line management
- Lubricants
Advice
- Surgery if visual axis threatened
Trichiasis
Clinical Features
- Inwards misdirection of eyelashes towards the cornea
First line management
- Epilation (removing of misdirected eyelashes
