Assessment of the eyes Flashcards
palpebral fissure
the opening between the eyelids
conjunctivae
two thin, transparent mucous membranes, between eyelids and eyeball
bulbar conjunctiva
covers sclera surface of the eyeball
palpebral conjunctiva
lines eyelids and contains blood vessels, nerves, hair follicles, and sebaceous glands
scotoma
blind spot in visual feild surrounded by an area of normal vision.
- occurs with disorders of the optic nerve and glaucoma
diplopia
double vision
strabismus
deviation in the anterior-posterior axis of the eye
glaucoma
- increased interocular pressure
- second most common cause of vision loss in older adults
eyelids expected findings
- upper eyelids overlap superior iris and meet lower eyelids when closed
- skin intact, no redness, swelling, discharge, lesions
eyelids unexpected
- ptosis, edema, unable to completely close
ptosis
dropping of the upper eyelid
what is the leading cause of blindness
age related macular degeneration (AMD)
what is the leading cause of visual impairment in people younger than 65
diabetic retinopathy
scelera expected
white; grey blue (darker skin individuals)
scleral icterus
- yellowing of the sclera
- indicative of jaundice
epiphora
excessive tearing
macular degeneration causes
a loss in central vision acuity
what is used to measure visual acuity
snellen eye chart
what is normal visual acuity
20/20
the numerator of the swellen chart indicates
how far the patient was standing from the chart
what is the demominator of the swellen chart indicate
distance at which the normal coudl have read
hirschberg’s test asseses
corneal light reflex
- symmetrical
what does the cover-uncover test find
small degress of deviated alignment
what is nystagmus
fine oscillating movement best seen around the iris
nystagmus occurs with
disease of the semi-circular canals in the ears, a paretic eye muscle, MS, or brain leasions
lid lag occurs with
hyperthyroidism
exophthalmos
protruding eyes
enophthalmos
sunken eyeballs
pallor near the outer canthus of the lower eyelid may occur with
anemia
anisocoria
small number of people (5%) who normally have pupils of two diffrent sizes
pupil expected findings
3-5mm, equal bilaterally
- anisocoria
what does PERRLA stand for
Pupils
Equal
Round
Reactive to
Light
Accommodation
Pupillary Light Reflex direct reaction
constriction of the same size pupil with light
Pupillary Light Reflex consensual reaction
simultaneous constriction of the other pupil
how to asses peripheral vision
confrontation
hwo to asses alignment
cover/uncover test
how to asses extra-ocular movement
cardinal directions
fundus expected findings
light red to dark brown
optic disk expected findings
- round oval defined margins, physiologic cup bright yellow-white and less then 1/2 disc diameter
retinal vessels
- paired artery and vein in each quadrant; artery lighter and narrower than veins
macula expected findings
- darker compaired to fundus
- fovea light reflex (ophthalmoscope)
develomental considerations at birth
- macula is not fully developed
developmental considerations at 3-4 months
infants can fixate on a single image with both eyes simultaneously
most neonates are
farsighted (changes over time)
the eyeball reaches full size at what age
8
drusen
- normal development on the retinal surface
- small, yellow dots that are scattered haphazardly on the retina
fundi
red reflex has central dark spot, both eyes. Disc flat with sharp margins
