Ocular Effects of the Sympathetic Nervous System

Review of Techniques

Measuring Interpalpebral Distance

  1. Have the patient relax his eyelids and look at a distant, non-accommodative target
  2. Position your millimeter rule with the zero point at the right lower eyelid position
  3. The reading is the mark on the rule that corresponds to the upper eyelid position
  4. Repeat for left eye
  5. Document your results

Measuring Eyelid Position

  1. Have the patient relax his eyelids and look at a distant, non-accommodative target
  2. Observe the relative position between right and left upper eyelids; determine which is lower and estimate the distance
  3. Observe the relative position between right and left lower eyelids; determine which is higher and estimate the distance
  4. Document your results

Measuring Pupil Size

  1. Have the patient relax his eyelids and look at a distant, non-accommodative target
  2. Turn the room lights to their lowest setting that still allows visualization of the pupils
  3. Position your millimeter rule beside the patient’s right pupil, with the zero mark at the bottom edge of the pupil
  4. Measure the vertical size of the right pupil in dim light
  5. Repeat for the left pupil
  6. Repeat the procedure for both eyes, but in bright, direct illumination (can be obtained by use of your transilluminator)
  7. Document all findings

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