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health assessment > eyes assessment - Sheet1 > Flashcards

eyes assessment - Sheet1 Flashcards

1
Q

What is the elliptical space between the upper and lower eyelids that exposes the eyeball?

A

Palpebral fissure

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2
Q

What is the translucent mucous membrane that covers the front of the eye and lines the inside of the eyelids?

A

Conjunctiva

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3
Q

What is the opening of the tear duct called?

A

Puncta

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4
Q

What is the hole located in the center of the iris that allows light to strike the retina?

A

Pupil

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5
Q

What structure behind the iris allows the eye to focus?

A

Lens

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6
Q

What is the tough, protective white covering of the eye?

A

Sclera

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7
Q

What flat, ring-shaped membrane provides eye color and is located behind the cornea?

A

Iris

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8
Q

What is the functional unit of the eye at the back of the eyeball that triggers nerve impulses to the brain?

A

Retina

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9
Q

What is the area on the nasal side of the retina where fibers converge to form the optic nerve?

A

Optic disc

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10
Q

Describe the optic disc’s appearance.

A

Creamy yellow-orange to pink, round or oval, with distinct margins

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11
Q

What is the thin, transparent, and touch-sensitive layer covering the front of the eye?

A

Cornea

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12
Q

What is the term for the normal constriction of pupils when light shines on the retina?

A

Pupillary light reflex

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13
Q

What is the constriction of the pupil in response to bright light exposure in the same eye?

A

Direct light reflex

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14
Q

What is the term for the simultaneous constriction of the opposite pupil when one eye is exposed to light?

A

Consensual light reflex

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15
Q

When observing the general ability of a patient in a room, what should they be able to do?

A

Avoid obstacles, respond to directions, and move around the room

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16
Q

What does a relaxed facial expression usually indicate?

A

Adequate vision

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17
Q

What could thin eyebrows indicate?

A

A potential thyroid issue

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18
Q

How should eyelashes appear on inspection?

A

Evenly distributed

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19
Q

What are the characteristics of normal eyeballs?

A

Moist and glossy

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20
Q

What should you check for in terms of eyeball position and discharge?

A

Protrusion, sunken appearance, discharge, symmetry, and symmetrical movement

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21
Q

How should the conjunctiva appear on inspection?

A

Clear

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22
Q

What is the normal color of the sclera?

A

White (may appear gray-blue in individuals with darker skin)

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23
Q

What color should the inside of the lower lid be?

A

Pink

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24
Q

How should the lids appear when closed?

A

They should completely approximate with the lower lid

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25
Q

How do you inspect the lacrimal apparatus?

A

Ask the patient to look down, then slide the outer part of the lid up to inspect for redness or swelling

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26
Q

What is conjunctivitis commonly known as?

A

Pink eye

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27
Q

What is a subconjunctival hemorrhage, and when can it occur?

A

A red patch on the sclera, often due to increased intraocular pressure from coughing, vomiting, weightlifting, etc.

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28
Q

What is periorbital edema, and what can cause it?

A

Swelling around the eyes; causes include local infections, crying, CHF, renal failure, and allergies

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29
Q

What is drusen, and is it normal?

A

Tiny yellow or white extracellular deposits on the retina; a few small drusen are normal with age

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30
Q

What should be asked regarding vision difficulty?

A

How long the difficulty has been present

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31
Q

What follow-up questions are needed if a patient reports eye pain?

A

Is it new or old?

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32
Q

What is strabismus?

A

A deviation in the parallel axes of the two eyes

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33
Q

What is diplopia?

A

Double vision

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34
Q

What is glaucoma?

A

Increased intraocular pressure (IOP)

35
Q

How often should people with diabetes have eye exams?

A

Every 6-12 months due to risk of retinopathy

36
Q

What might floaters in vision indicate?

A

Myopia (nearsightedness) or retinal detachment

37
Q

What does seeing a halo around lights potentially indicate?

A

Glaucoma

38
Q

What might blind spots (scotoma) suggest?

A

Glaucoma, migraine, or optic nerve disorders

39
Q

What conditions are associated with night blindness?

A

Optic atrophy, glaucoma, or decreased Vitamin A levels

40
Q

What does photophobia refer to?

A

An inability to tolerate light

41
Q

What condition could cause clouding of vision?

A

Cataracts

42
Q

What is presbyopia?

A

A condition where the lens becomes less flexible with age, reducing the ability to focus on close objects, often requiring reading glasses. By age 40, around 50% of people experience presbyopia.

43
Q

What is entropion, and why is it a concern?

A

Entropion is when the lower eyelid turns inward, which can cause the eyelashes to scratch the eye, potentially leading to irritation or damage.

44
Q

What is ectropion, and why is it a concern?

A

Ectropion is when the eyelids turn outward and drop away, leading to issues with eye dryness.

45
Q

What is assessed with the corneal light reflex?

A

Corneal light reflex assesses alignment of the eyes by shining a light toward them. Light reflection should be in the same spot on each eye. Displacement can indicate esotropia (eyes turned in) or exotropia (eyes turned out).

46
Q

What is the Diagnostic Positions Test used for?

A

To assess extraocular muscle function by observing the six cardinal positions of gaze, looking for parallel tracking. Abnormal findings may indicate muscle weakness or cranial nerve issues.

47
Q

What does failure to follow the Diagnostic Positions Test indicate?

A

Weakness of an extraocular muscle or a cranial nerve issue.

48
Q

What is nystagmus?

A

Involuntary oscillating eye movement, often seen best around the iris. Common in intoxication, thyroid issues, lack of sleep, and multiple sclerosis.

49
Q

What does the cover test detect?

A

Strabismus (eye misalignment). The test checks if the uncovered eye maintains its position when the other eye is covered. Movement of the uncovered eye may suggest amblyopia (lazy eye) or muscle weakness.

50
Q

Describe the Allen test for children’s visual acuity.

A

For children around age 2, using 7 picture cards of familiar objects from 15 ft away. Normal response is identifying 3 out of 7 cards in 3-5 trials.

51
Q

How is the ocular fundus inspected?

A

With an ophthalmoscope, starting 10 inches away at an angle, looking for the red reflex, moving steadily closer to check for any black dots or dark shadows. Both patient and examiner should remove glasses, and the room should be darkened.

52
Q

How is the red reflex seen, and what does it indicate?

A

The red reflex is the reflection of light off the retina, seen with an ophthalmoscope. Absence or interruption can indicate retinal issues like cataracts.

53
Q

How does ptosis appear, and what can it indicate?

A

Drooping of the upper eyelid, which may indicate cranial nerve damage or muscular issues.

54
Q

How should the examiner hold the ophthalmoscope for a fundoscopic exam?

A

Right hand for the examiner’s right eye and patient’s right eye, left hand on the patient’s brow.

55
Q

What could cause abnormalities in color vision testing?

A

Genetic colorblindness or optic nerve disorders.

56
Q

What does the Snellen chart measure, and at what distance?

A

Measures visual acuity at a distance, typically from 20 feet.

57
Q

What does the Rosenbaum chart measure, and at what distance?

A

Measures visual acuity for close reading, typically at 14-16 inches.

58
Q

What is the Ishihara test used for?

A

Detects color blindness, particularly red-green color deficiencies, using plates with colored dots forming numbers or patterns.

59
Q

What is the purpose of the handheld vision screener?

A

To assess near visual acuity, usually for close reading, similar to the Rosenbaum chart.

60
Q

What tool is used to cover one eye during a vision test?

A

Opaque card or occluder (often a stick with an eye patch shape).

61
Q

What tool is used to inspect the retina and other internal structures of the eye?

A

Ophthalmoscope.

62
Q

How is the cornea and lens inspected, and what should be noted?

A

Shine a light across the cornea to check for smoothness and clarity; cloudiness or scratches may indicate an issue.

63
Q

What are the normal characteristics of the iris?

A

Flat with a round, regular shape and even coloration.

64
Q

What is the typical resting size of the pupil?

A

3-5 mm.

65
Q

What is aniscoria, and what does it indicate?

A

Aniscoria is when pupils are asymmetrical in shape or size, with one pupil more oval-shaped, potentially indicating a neurological issue.

66
Q

How is the pupillary light reflex tested?

A

Shine a light into each pupil to observe constriction, ensuring both direct and consensual response.

67
Q

What does the accommodation test involve, and what is a normal response?

A

Shifting focus from a distant to a near object to observe pupil constriction and convergence. Normal response: close focus = constrict/converge, distant focus = dilate/diverge.

68
Q

What does PERRLA stand for?

A

Pupils Equal, Round, React to Light, and Accommodation.

69
Q

How does the Snellen chart differ from the Rosenbaum chart in terms of assessment distance?

A

Snellen is used at a distance (20 ft) for far visual acuity, while Rosenbaum is held close (14-16 in) for near visual acuity.

70
Q

What would you use if a patient has difficulty distinguishing between red and green?

A

Ishihara test, designed to assess red-green color blindness through colored plates.

71
Q

What is exophthalmos, and what is it associated with?

A

Exophthalmos is the bulging or protrusion of the eyes, with visible sclera above the iris, commonly associated with hyperthyroidism or thyrotoxicosis. Thyroid assessments, lab tests, and neck exams are recommended when exophthalmos is observed.

72
Q

Describe the Snellen chart visual acuity test procedure.

A

Stand 20 ft away, shield one eye at a time, and read the smallest line possible with glasses/contacts on. Test right eye (OD), left eye (OS), then both eyes (OU).

73
Q

What does 20/100 vision mean?

A

At 20 ft, the person sees what someone with normal vision sees at 100 ft (nearsighted).

74
Q

How is near vision tested?

A

Using a handheld vision screener held 14 inches away, especially for those over 40 or in bedside settings. Test each eye separately.

75
Q

What is the confrontation test, and what does it assess?

A

Screens for peripheral vision loss by comparing the person’s vision with the examiner’s. Each covers one eye and advances a flicking finger from the periphery.

76
Q

What is xanthelasma, and what causes it?

A

Xanthelasma consists of small (1-2 mm) yellowish plaques on the eyelids, caused by fat deposits in the skin, often related to high blood fat levels (hyperlipidemia). More common around age 50, especially in women.

77
Q

What is arcus senilis, and what does it indicate?

A

Arcus senilis is a gray ring around the cornea caused by lipid deposits. It has no effect on vision but can indicate a higher risk of heart disease.

78
Q

What pupil changes are associated with opioid use?

A

Opioids cause pupil constriction, and overdose can result in pinpoint pupils.

79
Q

What pupil changes are associated with stimulant use?

A

Stimulants, like cocaine and methamphetamines, cause pupil dilation.

80
Q

What does PERRLA stand for in an eye exam?

A

Pupils Equal, Round, React to Light, and Accommodation.

81
Q

How is the cover test performed, and what does it detect?

A

Checks for strabismus. The patient stares at a fixed point while one eye is covered; movement of the uncovered eye indicates muscle weakness or misalignment.

82
Q

What developmental considerations exist for the Snellen visual acuity test?

A

For young children, use the alphabet, E chart, or picture chart.

83
Q

What does 14/14 vision mean in a near-vision test?

A

The person can see clearly at a distance of 14 inches, which is considered normal.

84
Q

How does the accommodation test assess the eye’s focus ability?

A

By shifting focus between distant and near objects; pupils constrict and eyes converge for close objects and dilate/

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