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Health Assessment > Eye Assessment > Flashcards

Eye Assessment Flashcards

1
Q

What do the six muscles that attach to the eye do?

A

They serve to direct eye to points of the person’s interest.

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2
Q

What kind of movements do the muscles that attach to the eye provide?

A

Straight and rotary

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3
Q

Describe the sclera of the eye.

A

Tough, protective white coat that is continuous with transparent cornea which covers the iris and pupil.

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4
Q

What is the cornea?

A

Is a part of the refraction of the eye which bends incoming rays.

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5
Q

Describe the cornea.

A
  • Sensitive to touch
  • Cotton ball causes blink reflex called ‘corneal reflex’.
  • Innervation by Trigeminal Cranial Nerve (CN V), by afferent sensation to brain (Discuss afferent and efferent).
  • Facial Cranial Nerve (CN Vll) carries efferent message and actually causes the ‘blink reflex’.
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6
Q

What is the choroid?

A

Is dark pigmentation which prevents light from reflecting internally.

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7
Q

What is fixation?

A

Ability of center of eye to track an object

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8
Q

What is accommodation?

A
  • Adaptation of the eye for near vision
  • Increase curvature of lens
  • Observe when pupils converge and constrict
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9
Q

Infant and Children Vision

A
  • Peripheral vision intact, central vision clear by 3-4 months
  • Will start tracking
  • Eyeball reaches adult size by age 8
  • Light iris and small pupil at birth
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10
Q

What are problems older adults can face with vision?

A
  • Presybyopia
  • Loss of structural tissue, elasticity
  • Involution of lacrimal glands:
  • Debris in vitreous: floaters
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11
Q

What is presybyopia?

A
  • Loss of flexibility in lens
  • Loss of accommodation/near vision
  • Difficulty reading
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12
Q

What does loss of structural tissue cause?

A

Sunken eyes

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13
Q

What does involution of lacrimal glands cause?

A

Less tear production

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14
Q

What are the guidelines for eye care?

A
  • Every 10 years until 40
  • Every 5 years to 55
  • Every 3 years to 65
  • Every 2 older than 65, diabetes, or eye disease
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15
Q

Subjective Data:

A
  • Vision difficulties (, color changes, floaters, blurring, blind spots)
  • Eye pain
  • Strabismus (crossed eyes)
  • Diplopia (double vision)
  • Redness, swelling
  • Watering, discharge
  • History of ocular problems
  • Glaucoma
  • Use of glasses/contacts
  • Self-care-testing, environmental exposure, safety
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16
Q

Inspect External Ocular Structures: General, eyebrows, eyelids and lashes, and eyeballs

A

-General: groping, squinting, struggling to see
Eyebrows: bilateral, move symmetrically, no scaling or lesions
Eyelids and lashes: approximate, no swelling, redness, discharge, lesions
Eyeballs
Aligned, not sunken or protruding

17
Q

Assessment of Conjunctiva and Sclera

A
  • Pink conjunctiva, white sclera
  • Moist, glossy eyeball
  • No drainage, lesions, color changes
18
Q

inspection of Lacrimal Apparatus

A
  • Patient looks down
  • Slide outer part of upper eyelid up along bony ridge with your thumbs
  • Inspect for redness, swelling
  • Press index finger gently along lacrimal sac (not nose)
  • Redness, fluid indicates swelling
19
Q

Assessment of the Cornea and lens

A
  • Shine light from the side across the patients cornea

- No cloudiness or irregularities in cornea, anterior chamber or lens

20
Q

Hoe do you assess the Iris and pupils?

A
  • Iris has regular shape, uniformity
  • Pupils equal in size (3-5 mm)

Check pupillary light reflex

  • Darken room
  • Request patient to look into distance
  • Advance the light from the SIDE about 4-6” from eye
  • Check same side (direct response)
  • Check opposite eye (indirect response)
  • Repeat for other eye
21
Q

How do you assess accommodation?

A
  • Patient focuses on distant object (dilates pupil)
  • Shift gaze to near object (finger 7-8cm from nose)
  • Pupils should constrict and converge
22
Q

What does PERRLA stand for?

A

Pupils equal, round, reactive to light, accommodating

23
Q

What tests can be used to assess Extraoccular Muscle Function?

A
  • Corneal light reflex
  • Cover-uncover test
  • Diagnostic positions test
24
Q

How do you perform a corneal light reflex test?

A
  • Examiner 30 cm away
  • Patient staring straight ahead
  • Shine light on cornea
  • Should be in exact same spot
  • Asymmetry indicates muscle weakness or paralysis
25
Q

How do you perform the cover-uncover test?

A
  • Patient to stare at your nose
  • Cover one eye with opaque card
  • Uncovered eye should remain steady
  • Remove cover and watch –if muscle weakness exists the covered eye will have drifted away and you will see it come back to center
26
Q

Eye muscle function : 6 cardinal positions

A
  • Patient tracks your fingers through all 6 cardinal directions
  • Finger about 30 cm away
  • No head movement, only eye movement
  • Both eyes should move together through all six directions
  • Follow clockwise procedure
  • Evaluates cranial nerves and muscle function
27
Q

What does confrontation measure?

A

Peripheral vision

28
Q

How do you assess confrontation?

A

-Compared with the testers vision, eye level, 60 cm apart
-Patient covers one with card, looks directly at you with other eye
-Tester covers same eye
-Testing the uncovered eye bring stimulus in from peripheral field
-Patient states “now” when they see the stimulus
s

29
Q

Visual Acuity: Snellen

A

-Patient at 20 ft from chart
-Glasses/contacts on (not reading glasses)
-Cover one eye with card
-Top to bottom, left to right
-Record last line successfully read
Eg. L eye 20/40 -1

30
Q

Visual acuity: Written

A
  • Test in those over 40 or reporting difficulties reading
  • Card at 14 inches
  • Test each eye separately and with glasses
31
Q

Newborn (infant): visual development

A

Newborns

  • Test visual reflexes and attending behaviors
  • Blink with exposure to bright light
  • Check pupil response
  • 2-4 wks fixates on objects
  • 3-4 months –follows and reaches for toy

Visual acuity testable at 42 months

  • Snellen E chart
  • Corneal light reflex at 6 mos
32
Q

Children: visual development

A
  • Visual acuity every 2 years
  • Visual fields when able to hold head still, follow directions
Colour blindness (inherited in about 8% of males with european descent)
-Test boys once age 4-8 years

Check for strabismus

  • Corneal light reflex
  • Cover-uncover test

Health Assessment (10 decks)

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