Eye Assessment

Question 1

Eyelids

Answer 1

protects eye, filter out dust and dirt

Question 2

Palpebral Fissure

Answer 2

open space between the eyelids

Question 3

Limbus

Answer 3

border between cornea and sclera

Question 4

Canthus

Answer 4

corner of the eye

Question 5

Caruncle

Answer 5

small fleshy mass at inner corner containing sebaceous glands

Question 6

Tarsal Plates

Answer 6

strips of connective tissue, contain the meibomian glands, secrete oily lubricating material

Question 7

Conjunctiva

Answer 7

thin mucous membrane

Question 8

The conjunctiva includes

Answer 8

palpebral conjunctiva and bulbar conjunctiva

Question 9

palpebral conjunctiva

Answer 9

lines the lids

Question 10

bulbar conjunctiva

Answer 10

overlays the eyeball with the white sclera

Question 11

lacrimal apparatus

Answer 11

provides constant irrigation

Question 12

puncta

Answer 12

absorb tear drainage (upper and lower lids at the inner canthus)

Question 13

Extraocular Muscles

Answer 13

6 muscles attach to the eyeball and give the eye movement

Question 14

2 Types of Extraocular Muscles

Answer 14

rectus and oblique muscles

Question 15

Rectus Muscles

Answer 15

4 straight

Question 16

Oblique Muscles

Answer 16

2 slanting

Question 17

Internal Eye

Answer 17

sphere shaped, consists of 3 layers: sclera, choroid, and retina

Question 18

Sclera

Answer 18

outer fibrous, protective white covering

Question 19

Choroid

Answer 19

middle vascular, dark pigmented layer

delivers blood to the retina and prevents light from reflecting internally

Question 20

Choroid consists 3 parts

Answer 20

pupil, lens (focus) and anterior chamber

Question 21

anterior chamber of the choroid

Answer 21

continuous flow of fluid

serves to deliver nutrients to surrounding tissues and drains metabolic waste.

Question 22

Retina

Answer 22

visual receptive layer of the eye

light waves are changed into nerve impulses

Question 23

Retina includes 2 parts

Answer 23

optic disc, macula and retinal vessels

Question 24

optic disc

Answer 24

retina fibers converge to form the optic nerve

normal color is yellow-orange to pink

Question 25

macula

Answer 25

receives and transduces light from the center of the visual field

Question 26

Cultural Considerations include

Answer 26

palpebral fissures, glaucoma and cataracts

Question 27

Cultural Considerations: palpebral fissures

Answer 27

narrowed in asian population

Question 28

Cultural Considerations: glaucoma

Answer 28

more prevalent in african american population and more severe which can lead to blindness

Question 29

Cultural Considerations: cataracts

Answer 29

more prevalent in caucasians

Question 30

What information should you get during the history (subjective) portion of the interview?

Answer 30

A. Vision difficulty, decreased visual acuity, blurring, blind spots B. Eye pain C. Hx Strabismus, diplopia (double vision) D. Redness and/or swelling E. Watering and/or eye d/c F. Past hx of eye problems (ie.injury or surgery to eye) G. Hx glaucoma – also include family history of glaucoma H. Use of glasses and/or contacts I. Self care behaviors (date of last eye exam) J. Medications

Question 31

What information should the nurse assess for during a physical exam?

Answer 31

``` A. Snellen eye chart B. Near Vision C. Confrontation Test D. Corneal Light Reflex (Hirschberg Test) E. Cover Test F. Diagnostic Positions Test and 6 cardinal positions of gaze G. Inspection of External Eye H. Anterior Eyeball Structures I. Ocular Fundus - ophthalmoscope ```

Question 32

Snellen Eye Chart

Answer 32

tests visual acuity the larger the denominator, the poorer the vision (Normal 20/20)

Question 33

Normal 20/20

Answer 33

the top number (numerator) is the distance the person is standing from the eye chart, the bottom number (denominator) is the distance at which a normal eye could have read that line)

Question 34

Near vision

Answer 34

hand held vision card

Question 35

Confrontation Test

Answer 35

test visual fields, except the temporal visual field (flapping fingers, both pt and nurse cover 1 eye opposite of each other)

Question 36

Corneal Light Reflex (Hirschberg Test)

Answer 36

shine light from distance approx. 12-14" | –> at same spot both eyes

Question 37

Cover Test

Answer 37

test for lazy eye/strabismus normal response to the cover test is a steady fixed gaze. If muscle weakness is present, the covered eye will drift into a relaxed position

Question 38

Diagnostic Positions Test (H) and 6 cardinal positions of gaze

Answer 38

EOM function and test for nystagmus

Question 39

Inspection of External Eye includes

Answer 39

eyebrows, eyelids and eyelashes, eyeballs, conjunctiva and sclera, eversion of upper eyelid and lacrimal apparatus

Question 40

Assessing Inspection of External Eye: Eyebrows

Answer 40

symmetrical movement with facial expressions, no lesions, no scaling, etc.

Question 41

Assessing Inspection of External Eye: Eyelids and Eyelashes

Answer 41

upper lids overlap top of iris, skin intact without redness, swelling, d/c or lesions

Question 42

Assessing Inspection of External Eye: Eyeballs

Answer 42

alignment, note protrusion or sunken appearance

Question 43

Assessing Inspection of External Eye: Conjunctiva and Sclera

Answer 43

color, discharge

Question 44

Assessing Inspection of External Eye: Eversion of Upper Eyelid

Answer 44

not performed in lab

Question 45

Assessing Inspection of External Eye: Lacrimal Apparatus

Answer 45

palpate with thumb inner eye for lacrimal sac and brow area for lacrimal gland

Question 46

Anterior Eyeball Structures include

Answer 46

cornea and lens; iris and pupil

Question 47

Assessing Anterior Eyeball Structures: Cornea and Lens

Answer 47

smoothness and clarity

Question 48

Assessing Anterior Eyeball Structures: Iris and Pupil

Answer 48

shape, PERRLA

Question 49

accommodation

Answer 49

distant object, shift to close object - pupils should constrict

Question 50

Assessing Ocular Fundus

Answer 50

1. red reflex 2. optic disc 3. retinal vessels 4. general color/background, lesions 5. macula

Question 51

lens

Answer 51

refracting medium, keeping a viewed object in continuous focus on the retina

Question 52

iris

Answer 52

mediators of light

Question 53

Dark skinned people may normally have

Answer 53

small brown macules on the sclera