18.5  Examining the eyes and eyelids

18.5.1  Testing for corneal sensation

The surface of the eye is called the cornea. It is very sensitive to being touched in a healthy person, who will blink if something touches the cornea. Corneal sensitivity is lost in a person with leprosy. Observe the person’s blink when talking to him/her. If the blink is normal, corneal sensation will be normal and there is no need for the test. If there is no blink, the eye is at risk.

Look at Figure 18.8 and Box 18.4 to see how the corneal sensation test is done.

Figure 18.8  The corneal sensation test. (Source: Essential Action to Minimise Disability in Leprosy Patients, Jean M. Watson, second edition, 1994)

Box 18.4 Steps in the corneal sensation test

  1. You should wash your hands before testing. Then make a point out of a wisp of cotton wool and explain the test to the person.
  2. The person should look to the opposite side and upwards, away from you.
  3. You should:
    • Approach from the side
    • Touch the edge of the cornea with the cotton wisp
    • Observe the person’s reaction.
  4. Take note or record on the person’s record card: Write yes, if he/she blinks, which means corneal sensation is normal; write No if sensation is absent (no blink).

18.4.3  Examination of hands and feet for loss of sensation

18.5.2  Eyelid closure to test facial nerve function