II. Exam: Observation

  1. Blank stare
  2. Glazing (film over Cornea)
  3. Excessive Lacrimation (Marijuana)
  4. Red Sclera (Marijuana, inhalant)
  5. Walleye or Bug-eye appearance (Exophthalmos)
    1. Ptosis (Heroin)
    2. Swelling of Eyelids (Phencyclidine or Marijuana)
    3. Retracted upper lid (Phencyclidine)

IV. Exam: Abnormal Extraocular Movements

  1. Fails to hold gaze
  2. Nystagmus
    1. Phencyclidine (PCP) - Vertical Nystagmus may occur
    2. Alcohol
    3. Benzodiazepine
    4. Marijuana
  3. Abnormal Convergence (unable to hold crossed eyes)
    1. Alcohol
    2. Benzodiazepines

V. Exam: Abnormal Corneal Reflex (Decreased rate of blinking)

VI. Exam: Abnormal Retinal Exam

  1. Talc retinopathy (talc used to cut IV drugs)
    1. Peri-Macular vessels show white retractile spots

VII. Exam: Corneal defects

  1. Keratopathy or Corneal Ulcers
    1. Associated with crack Cocaine smoking
    2. Sachs (1993) Ophthalmology 100:187-91 [PubMed]

VIII. Contributors

  1. Paul Rock, OD at Outer Banks Eye Care
    1. http://www.obeyecare.com/eyelinks.html

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