Eye Flashcards
Organ of vision, transmitting visual stimuli to the brain for interpretation
eye
The eye is located in ______ (round, bony hollow formed by several bones) surrounded by cushion of ____ for protection
eye orbit; fat
Light rays strike _____
Retina transforms into ______
_____ nerve transmits impulses to brain
______interprets
retina; nerve impulses; optic; brain
open space between eyelids
palpebral fissure
border between cornea & sclera
limbus
secrete oily lubrication onto lids
Meibomian Glands
transparent protective covering
conjunctiva
keep cornea moist
lacrimal apparatus
give eye straight & rotary movement
extra ocular muscles
Extraocular muscles are stimulated by what 3 nerves?
Cranial nerve III, IV, and VI
oculomotor nerve- all the rest
Cranial nerve III
trochlear nerve-innervates superior oblique muscle- able to look down and inward
Cranial nerve IV
abducens nerve- innervates lateral rectus muscle able to look outward to the side
Cranial nerve VI
Normal constriction of the pupil when bright light shines on it is a ______
Direct reflex
Shine light on eye- _______ (afferent) takes it to the brain(synapses with both sides) and _______(efferent) takes it back to the pupil and the pupil constricts
cranial nerve II; cranial nerve III
When both pupils constrict it is a ___________
consensual light reflex
_______ is when a person looks at a far object and then a near object and the eyes converge and constrict. (The Near Reaction)
Accommodation
Common/concerning symptoms include:
Changes in Vision
Double Vision or Diplopia
Strabismus Tearing
Blurring Edema
Redness Lesions
Itching Visual Disturbances
Discharge Photophobia
Pain
When eyes don’t look in same direction at same time
Strabismus
Subjective Data of health history includes (3)____:
Past Eye History of Client
Family History
Lifestyle Habits
Equipment needed for the objective physical exam includes (5)____
Snellen eye chart Handheld visual screener Opaque card Penlight Ophthalmoscope
Used to test distant visual acuity, the_____ chart consists of lines of different letters stacked one above the other
Snellen
If the client cannot read or has a handicap that prevents verbal communication, the______ is used. It is configured just like the Snellen chart but the characters on it are only Es, which face in all directions.
E chart
Position the client 20 ft from the Snellen or E chart and ask to read each line until she cannot decipher the letters or their direction. This tests for _____
distant visual acuity
_____ (impaired far vision) is present when the second number in the test result is larger than the first (20/40). The higher the second number, the ____ the vision.
Myopia; poorer
Normal distant visual acuity is _____ with or without corrective lenses.
20/20
Give the client a hand-held vision chart to hold 14 in from the eyes. Have the client cover one eye with an opaque card before reading from top (largest print) to bottom (smallest print). This tests for _______
near visual acuity
Near vision is assessed in clients over 40 years of age by holding the pocket screener _______or newspaper print 14 in from the eye
Jaeger test
________(impaired near vision) is indicated when the client moves the chart away from the eyes to focus on the print. It is caused by decreased accommodation.
Presbyopia
Normal near visual acuity is ____ (with or without corrective lenses).
14/14
Position yourself approximately 2 ft away from the client at eye level. Have the client cover the left eye while you cover your right eye. Look directly at each other with your uncovered eyes. Next, fully extend your left arm at midline and slowly move one finger (or a pencil) upward from below until the client sees your finger (or pencil). Test the remaining three visual fields of the client’s right eye (i.e., superior, temporal, and nasal). Repeat the test for the opposite eye. This tests for _____
gross peripheral vision/confrontation test
Test where you hold a grid 14 to 16 inches from eyes, focus on dot in center and answer questions.
Amsler Grid
The _______ test assesses parallel alignment of the eyes. Hold a penlight approximately 12 in from the client’s face. Shine the light toward the bridge of the nose while the client stares straight ahead. Note the light reflected on the corneas.
Corneal light reflex test
_________detects deviation in alignment or strength and slight deviations in eye movement by interrupting the fusion reflex that normally keeps the eyes parallel.
cover test
Ask the client to stare straight ahead and focus on a distant object. Cover one of the client’s eyes with an opaque card. As you cover the eye, observe the uncovered eye for movement. Now remove the opaque card and observe the previously covered eye for any movement. This is what you do in the _____
cover test
The reflection of light on the corneas should be in the exact same spot on each eye, which indicates ____alignment.
parallel
The uncovered eye should remain fixed straight ahead. The covered eye should remain______straight ahead after being uncovered.
fixed
The ______assesses eye muscle strength and cranial nerve function.
cardinal fields of gaze test (EOM’s)
Instruct the client to focus on an object you are holding (approximately 12 in from the client’s face). Move the object through the six cardinal positions of gaze in a clockwise direction, and observe the client’s eye movements. This is the _____
cardinal fields of gaze test
Eye movement should be smooth and symmetric throughout all _____ directions.
6
You can test for Extraocular muscle Functions
Corneal Light Reflex
Cover Test
Cardinal Fields of Gaze (EOMs)
You inspect and ______ and _____by pulling down the lower eyelid
conjunctiva; sclera
Sclera should be _______; _______is free of swelling, foreign bodies, or trauma.
white; palpebral conjunctiva
Used to Inspect the internal eye and observe the red reflex
opthalmoscope
The optic disk should be:
oval, creamy yellow-orange
Retinal vessels should have:
bright red, thin lines
The retinal background should be:
red orange in color
Macula should be:
small darkened area-temporal to disk
Look at ____ last
macula
Refers to a false appearance of eye misalignment caused by an optical illusion
pseudostrabismus
Turning inward of eye
esotropia
Turning outward of eye
exotropia
The margin of the lower lid is turned outward exposing the palpebral conjunctiva
ectropion
Drooping of the upper lid, with causes like Myasthenia Gravis and Horner’s syndrome
Ptosis
Appears as a white arc around the limbus. The condition has no effect on vision.
Arcus senilis
Swelling around the eyes
Periorbital Edema
Bleeding underneath the conjunctiva
Subconjunctival Hemmorrhage
________ is when the lens loses its ability to adjust for vision changes to look closely- decreased ability to read
Presbyopia
During aging, you need more light to read and visualize, have increased sensitivity to _____, decreased in _____ vision, produce fewer _______ secretions, ____ smaller
glare; peripheral; lacrimal; pupils
Clouding of the normally clear lens of the eye
Cataracts
A group of eye conditions that cause blindness
Glaucoma
Causes loss in the center of field of vision
Macular Degeneration
Inward turning of the lid margin
Entropion
A wide eyed stare suggests _____
lid retraction
When the eyeball protrudes forward
Exophthalmos
A thin grayish white arc or circle not quite at the edge of the cornea
Corneal Arcus
A superficial grayish white opacity in the cornea, secondary to an old injury or inflammation
Corneal scar
A triangular thickening of the bulbar conjunctiva that grows slowly across the outer surface of the cornea, usually from the nasal side; reddening may occur too.
Pterygium
Opacities of the lenses visible through the pupil; most common in old age
Cataracts
Looks gray when seen with a flashlight; through an ophthalmoscope it will look black against the red reflux
Nuclear cataract
Produces spoke-like shadows that point inward; gray against black when seen with a flashlight or black against red with an ophthalmoscope
peripheral cataract
Pupil is large, regular, and usually unilateral. Reaction to light is severely reduced and slowed, or even absent
Tonic Pupil/Adie’s Pupil
The dilated pupil is fixed to light and near effort; Ptosis of upper eyelid and lateral devotion of eye almost always present
Oculomotor Nerve Paralysis (CN III)
Affected pupil reacts briskly to light and near effort. Ptosis present, perhaps with loss of sweating on forehead.
Horner’s Syndrome
Condition where pupils accommodate but do not react to light
Small, irregular pupils
A light directed into a seeing eye produces a direct reaction in that eye and a _____ reaction in the blind eye
consensual
A light directed in the blind eye causes _____ response in either eye
no
Unequal pupils
Aniscoria
When aniscoria is greater in bright light than dim light, the ______ pupil cannot _____ properly
larger; constrict
When aniscoria is greater in dim light, the _____ pupil cannot _____ properly
smaller; dilate
Unilateral blindness does not cause aniscoria as long as _____ and ____ innervation to both irises is normal
sympathetic; parasympathetic
Eye strain that develops after reading, computer work etc
Asthenopia
Abnormal football shaped curvature of cornea that prevents light from focusing on the retina; images appear blurred
Astigmatism
Nearsightedness; can only see objects up close but not far
Myopia
Farsightedness; Can only see distant objects clearly but not up close
Hyperopia
Farsightedness caused by loss of elasticity not the lens of the eye
Presbyopia
Pupils that are in the _____ or slightly dilated (4-6mm) and are ______ to light suggest structural damage in midbrain
mid position; fixed
A pupil that is _____ and ____warns of herniation of the temporal lobe, causing compression of the oculomotor nerve and midbrain.
fixed; dilated
Bilaterally _____ and ____ pupils may be due to severe anoxia snd its effects after cardiac arrest.
fixed and dilated
Bilaterally _______ pupils may be due to cocaine, LSD or other sympathetic nervous system agonists.
large reactive
Bilaterally ____ pupils (1-2.5mm) suggest damage to sympathetic pathways in the hypothalamus or metabolic encephalopathy
small
______ pupils (<1mm) suggest hemorrhage in pons or effect of morphine, heroine or other narcotics
pinpoint
