Eye exam learning guides
Each guide starts with a short answer, walks through the technique and interpretation step by step, and ends with a link that opens the matching case on Pupilla's virtual patient so you can practice straight away.
Pupils
Strabismus and eye movements
- The cover test: cover–uncover, alternate cover and prism cover test Tell a tropia from a phoria and measure the angle with prisms, step by step.
- Hirschberg and Krimsky tests: measuring strabismus with the corneal light reflex Read the corneal light reflex, convert millimeters to prism dioptres and neutralize with prisms.
- Ocular motility and the H-test: ductions, versions and the nine positions of gaze Trace the H, know which muscle each gaze position tests and interpret limited movements.
- Third, fourth and sixth cranial nerve palsies and the three-step test Recognize each ocular motor palsy, run the three-step test and spot the red flags.
- Internuclear ophthalmoplegia (INO), one-and-a-half syndrome and gaze palsies Localize INO, one-and-a-half syndrome, gaze palsies and Parinaud syndrome from eye movements.
- Types of nystagmus: gaze-evoked, downbeat, upbeat, see-saw and pendular Describe nystagmus properly and know what downbeat, upbeat, see-saw and pendular patterns suggest.
- Extraocular muscles: anatomy, actions and nerve supply Origins, insertions, actions and nerve supply of the six eye muscles — and why actions change with gaze.
Optics and refraction
- Streak retinoscopy: with motion, against motion and neutralization Read with and against motion, neutralize both meridians and correct for working distance.
- Refractive errors and astigmatism: myopia, hyperopia and Sturm's conoid Understand myopia, hyperopia and astigmatism, read a prescription and correct for vertex distance.
Visual pathway
Free simulators
- Eye Exam Simulator A virtual patient with 43 conditions: penlight pupil exam and RAPD, cover tests, Hirschberg and Krimsky, ductions and versions, cranial nerve palsies, INO, gaze palsies and nystagmus.
- Streak Retinoscopy Simulator Read with and against motion, find the principal meridians and neutralize the reflex for myopia, hyperopia and astigmatism.
- Refraction Simulator Change axial length, corneal curvature and astigmatism, then correct them with sphere, cylinder and axis trial lenses and watch Sturm's conoid collapse onto the retina.
- Visual Pathway Simulator Place a lesion anywhere from the optic nerve to the occipital cortex and see the visual field defect, with lessons and a case quiz.
- 3D Eye Muscle Anatomy Contract each extraocular muscle, see its action in the nine gaze positions and follow Hering's and Sherrington's laws.
- Clinical Repertoire Condition summaries with presentation, signature findings, red flags, workup, treatment and differentials (English).