Neuro-ophthalmic examination: eye movements, fundoscopy and visual testing
How to test and record acuity, colour vision, pupils, fields, fundi and eye movements, what each abnormal finding localises to, worked examples, the accuracy of bedside tests against perimetry and photography, and the Austroads vision thresholds.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Examine in the same order every time: acuity, colour, pupils, fields, fundi, eye movements. Each answers a different localising question.
- Low acuity with an RAPD and poor colour is optic nerve until proven otherwise. Normal acuity doesn't exclude a field defect.
- Confrontation fields miss many defects. Formal perimetry is needed for any suspected field loss and for driving.
Loading the rest of the note…
Finished reading?
Sources
- Therapeutic Guidelines: OphthalmologyAU/NZTherapeutic Guidelines Limited, current online version, accessed November 2026
- Assessing Fitness to Drive (AP-G56), Vision and eye disordersAU/NZAustroads and National Transport Commission, 2022 (NTC review consulted mid-2026; 2022 standards apply until replaced)
- Assessing fitness to drive: visual standards and general practitioner responsibilities (Moshegov S et al. Aust J Gen Pract 2026;55:425-30)AU/NZAustralian Journal of General Practice (RACGP), 2026
- Diagnostic accuracy of confrontation visual field tests (Kerr NM et al. Neurology 2010;74:1184-90)Neurology, 2010
- Nonmydriatic ocular fundus photography in the emergency department (Bruce BB et al. N Engl J Med 2011;364:387-9)New England Journal of Medicine, 2011
- HINTS to diagnose stroke in the acute vestibular syndrome (Kattah JC et al. Stroke 2009;40:3504-10)Stroke, 2009
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Turnstile bot check on sign-in and signed-out feedback