Eye Lab

Question 1

You get an eye problem. what is the steps?

Answer 1

SIS Wiggled Her COStume

1) sanitize hands
2) inspection of the eye and verbalize findings (no lesions, droop, etc)
3) snellen eye chart for CN2
4) evaluate visual field (using finger wiggle test)
5) evaluate extra ocular movement (H test)
6) Evaluate pupillary reactions (direct constriction, indirect constriction, accommodation
7) fundoscopic exam
8) cover and uncover test to check for strabismus

Question 2

How do you inspect the eyes?

Answer 2

Pull down the lower eyelids, ask the patient to look upward.. this is for the sclera

ask the patient to look downward as upper lids are pulled superior… looking at the sclera

have them look both right and left

if necessary, invert the upper eyelid to look at the palpebral conjunctiva

mention that you’re looking for swelling, abnormal color, or nodules

Question 3

How do you use the snellen chart?

Answer 3

hold the chart 14 inches away and ask them to read the smallest line they can read with one eye closed, then the other, then both open.

Question 4

How do you evaluate the visual field?

Answer 4

ask a patient to look directly at you as you stand about an arms length away

this is estimating the extent of the visual field by wiggling your hands outside the visual field until they can see it.

repeat with the other eye

if you suspect a problem, have them cover one eye that you think is affected and try it again to have the boundary. in that case you would have them cover the opposite eye and you would cover your own ipsilateral eye to their covered one.

Question 5

How do you do the H test?

Answer 5

This is testing extra ocular movements.

Go to the patients extreme right, then upward, then downward, then up and back to their extreme left side, then upward, then downward

Question 6

How do you evaluate pupillary function?

what are the tests to do?

Answer 6

1) direct –> pupil exposed to light source constricts
2) consensual –> when one pupil is exposed to light source, other eye constricts
3) convergence/accomodation –> pupil constriction as object becomes close to eyes

Question 7

How would you perform a fundoscopic exam?

Answer 7

start lateral to midline to identify red reflex

set the ophthalmoscope to 0 and have them look over your shoulder at a fixed point in the room

when looking at the right eye, make sure the scope is in your right hand, on your right eye, looking in their right eye.

have your thumb of your other hand across the patients eyebrow to keep steady.

shine on the pupil and located the red reflex which is an orange glow

while holding the red reflex, move in on the 15 degree angle towards the pupil till it’s almost touching your thumb

note optic disk, then bring optic disc into sharp focus, look at the arteries

then change it to setting 10 to look at the vitreous humor.

Question 8

How do you check for strabismus?

Answer 8

just see if the eyes are of the same alignment. misalignment is strabismus when looking at an object.