Health Assessment Chapter 14 Eyes

Front 1

Snellen eye chart-

Back 1

20 ft from chart, cover one eye at a atime, read to smallest line reable on chart
Normal 20.20, 20/40 would be nearsighted

Front 2

Near vision – jagaer, rosenbaum, newspaper

Back 2

Hold 14 inches from the eyes
Prespyopia

Front 3

Confrontation test – test peripheral vision

Back 3

Sit at eye level, 2 ft. eye
Cover eye, bring finger midline
Client indications when able to see finger

Front 4

Extra ocular muslce function

Back 4

Corneal light reflex (Hirschberg test)
Look straight ahead with both eyes
Shine penlight to bridge of nose about 12-15 inches away
Light should reflect symmterically in both eyes

Front 5

Diagnositic positions tests

Back 5

6 cardinal fields of vision
Cranial nerves 3,4,6
About 10 inches away- should be symmetrical and smooth
Look for nystagmus – bouncing eye movement

Front 6

Pupillary light reflex

Back 6

Pupils should dilate (look across room) and constrict in light from side
accommodation

Front 7

Conjunctiva

Back 7

Bulbar
Covers and protects the anterior portion of the white sclera
Palpebral
Lines the eyelid

Front 8

Extraocular muscles

Back 8

Superior rectus
Inferior rectus
Lateral rectus
Medial rectus
Superior oblique
Inferior oblique

Front 9

Outer layer

Back 9

sclera

Front 10

middle layers: Choroid:

Back 10

Lines the recessed portion of the eyeball
Lies between the sclera and the retina
Contains blood vessels to provide blood supple to back of the eye

Front 11

middle layers Ciliary body

Back 11

Lies just beneath the iris
Has ligaments that controls the lens’ shape for close and distant vision
Produces aqueous humor: Clear, watery fluid in the front of the eye that fill the anterior and posterior chambers
Maintains the eye pressure

Front 12

middle layer

Back 12

iris
pupil

Front 13

Lens - middle layer

Back 13

Refracts and focuses light onto the retina
Located directly behind the iris at the pupillary opening

Front 14

Anterior chamber : - middle layer

Back 14

Filled with clear aqueous humor to maintain eye pressure

Front 15

middle layer

Back 15

choroiad
ciliary body
iris
pupil
lens
anterior chamber

Front 16

Inner layer

Back 16

Retina
Optic disc
Retinal vessels
Macula

Front 17

Visual pathways and visual fields

Back 17

Refraction of light rays
Crossing of fibers at optic nerve

Front 18

Visual reflexes

Back 18

Pupillary light reflexes
Fixation
Accommodation

Front 19

Equipment

Back 19

Snellen eye chart
Handheld visual screener
Opaque card or occluder
Penlight
Applicator stick
Ophthalmoscope

Front 20

Central visual acuity

Back 20

Snellen eye chart
Near vision

Front 21

Visual fields

Back 21

Confrontation test

Front 22

Extraocular muscle function—Inspect

Back 22

Corneal light reflex (Hirschberg test)
Cover test

Front 23

External ocular structures—Inspect

Back 23

General
Eyebrows
Eyelids and lashes
Eyeballs
Conjunctiva and sclera
Eversion of the upper lid
Lacrimal apparatus

Front 24

Iris and pupil
inspect

Back 24

Size and shape
Pupillary light reflex
Accommodation

Front 25

Red reflex

Back 25

Shine the light at the client’s pupil from a distance of about 4 inches and at a slight angle
Follow red in - follow vessels in

Front 26

Optic disc

Back 26

Color – creamy yellow or pink
Shape - round

Front 27

Retinal vessels – get bigger and meet in the middle of optic disc

Back 27

Color
A:V ratio
Caliber

Front 28

Strabismus – common in infants

Back 28

Esotropia: Inward, nasal drift of eyes
Exotropia: Outward, temporal drift of eyes

Front 29

Exophthalmos (protruding eyes) –

Back 29

eyelids look far back

Front 30

Ptosis

Back 30

(drooping upper lid)

Front 31

Pupils - miosis

Back 31

constricted and fixed; damage to pons of brain and drugs

Front 32

pupils - Mydriasis

Back 32

dilated and fixed; dead, brain injury, glaucoma

Front 33

Blepharitis:

Back 33

Inflammation of the eyelash follicles

Front 34

Chalazion:

Back 34

Nodule of meibomian gland in eyelid
Often follows conjunctivitis, blepharitis, or meibomian cyst.
Clinical findings
Firm, non-tender (can be tender if infected) nodule is observed in eyelid

Front 35

Hordeolum (stye):

Back 35

An acute infection originating in sebaceous gland of eyelid (Staphylococcus aureus).
Clinical findings
Affected area usually is painful, red, and edematous.

Front 36

anisocoria

Back 36

unequal pupil size

Front 37

Conjunctivitis

Back 37

Pink eye
Inflammation of palpebral or bulbar conjunctiva
Can be bacterial , usually not
Clinical manifestations – pruritic, mattery, gritty sensation, eye red with thick discharge

Front 38

subconjunctival hemorrhage – red in sclera of eye

Back 38

Increased ocular pressure, crying, gets better on its own

Front 39

Iritis (circumcorneal redness)

Back 39

Dark red halp around iris and cornea
Photopbobia, cilliary flushing (red vessels in squiggly pattern from iris), blurred vision, pain

Front 40

Acute glaucoma – increased ocular pressure

Back 40

Oval pupil, dilated pupil, cloudy vision, acute eye pain, halos around light

Front 41

Cataracts

Back 41

Opacity of crystalline lens from denaturation of lens protein

Front 42

Cataracts - causes

Back 42

aging
congenital
trauma

Front 43

Cataracts - clinical manifestations

Back 43

Cloudy or blurred vision, glare from headlights, lamps, or sunlight, and diplopia
may report poor night vision and frequent changes in glasses prescriptions
A cloudy lens can be observed on inspection
Red reflex is absent

Front 44

Microaneurysms

Back 44

Small, discrete, round, red dots localized dilations of a small vessel
Seen with diabetic retinopathy
Visual alteration with diabetes mellitus caused by changes in retinal capillaries
On examination, a network of new blood vessels is seen along retinal surface

Front 45

Vessel nicking

Back 45

localized narrowing in veins r/t arteriole crossing; HTN and arteriosclerosis