Things to check:
1) Position and alignment of eyes, inspect globes for proptosis, enophthalmos
2) Lacerations
3) Subconjunctival hemorrhage
4) Pupillary reflex – equal and reactive? Should be tested directly and indirectly
5) Range of eye movements/presence of restriction in a H pattern
6) Diplopia
7) Palpate orbital rim for step deformities
8) Palpate peri-orbital tissues for surgical emphysema
9) Visual acuity – Snellen chart
10) Retrobulbar haemorrhage – decreased vision, orbital pain, proptosis, inability to discern colour red, increased intra-ocular pressure, tense hard globe. Note this is an emergency and the on-call ophthalmologist should be contacted immediately to perform a lateral canthotomy. A delay in surgery can result in permanent vision loss. For more information on retrobulblar haemorrhages, please click here.
If you are ever in doubt regarding your eye assessment, obtain an ophthalmology assessment