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47 Cards in this Set
- Front
- Back
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External structures of eye
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cornea-transparent, avascular outer layer of the eyeball
anterior chamber- filled with aqueous humor pupil- the aperture of the iris |
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Internal Structures
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optic disc & physiological cup- area where the optic nerve and the bl vessel enter the eye
retinal blood vessels-blood supply to eye |
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Aging Adults
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pseudoptosis-elongated upper lid
pingueculae-yellowish nodules @ 3 & 9 o'clock **arcus senilis- cloudy cornea from lipids ectropion-eyelids turn outwards entropion-eyelids turn inwards |
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Symptoms signaling problem c eye
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redness, pain, swelling, change/loss of vision
diploplia-double vision tearing/drainage dry eyes |
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physical assessment
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approach-inspection, palpation, ophthalmoscopy
position-sitting tools-visual acuity charts (Snellen), penlight, opnthalmoscope General survey & head-to-toe scan |
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Visual Acuity
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Far vision-Snellen
Near-read newsprint 13-15" away Color-Ischera test Peripheral-examiner comes in from periphery c fingers in all fields and pt reports "cuts" |
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Extraocular Muscles
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Parallel alignment
Corneal light reflex test- symmetry 6 cardinal fields of gaze-"EOMs are intact" Accommodation-finger test 4" away, focus on that then on distant object, do pupils adjust equally? |
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Cover-Uncover Test
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Eye moves to inner canthus near lacrimal duct when the "strong" L eye is covered; indicates phoria-weakness
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Lids & Lashes
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color, lesions, edema, symmetry, position & distribution of lashes
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Lacrimal glands & ducts
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color, edema, excessive tearing or drainage
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Conjunctiva
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color, moisture, lesions, and foreign bodies
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Sclera
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color, moisture, lesions, tears
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Cornea
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clarity and abrasions, corneal reflex-both eyes close together with light touch
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anterior chamber
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clarity, bulging iris, and blood
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Iris
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color, size, shape, symmetry
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Pupils
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size, shape, reaction to light-direct and consensual, test accommodation
PERRLA-pupils equal, round, reaction to light and accommodation |
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Optic disc and physiologic cup
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color, size, shape, borders, cup-disc ratio; nasal side; macula- is temporal side
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ptosis
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drooping of upper eyelid
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Nystagmus
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fine oscillating movement best seen around the iris
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lid lag
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white rim of sclera seen all around iris; occurs c hyperthyroidism
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anisocoria
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different sized pupils; 5% of population have this normally
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esotropia & exotropia
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eso-inward turn of eye
exo-outward turn of eye |
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periorbital edema
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swollen, puffy lids c CHF, renal failure, allergy, hypothyroidism (myxedema)
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Exophthalmos
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protruding eyes c thyrotoxicosis
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miosis
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constricted, fixed pupils; tx for glaucoma, narcotics, iritis, and damaged pons of brain
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cranial nerve III damage
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unilateral dilated pupil c no reaction, oculomotor nerve damage; may have ptosis down and lateral too
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horner's syndrome
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unilateral, small, regular pupil reacts to L & A, lesion of sympathetic nerve; ptosis and absence of sweat (anhidrosis) on same side
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conjunctivitis
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pink eye, purulent discharge; more peripheral redness
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subconjunctival hemorrhage
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red patch on sclera, not serious
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iritis
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circumcorneal redness
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acute glaucoma
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dilated pupil, circumcorneal redness, sudden increase in intraocular pressure from blocked outflow, cloudy vision, pain, halos
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pterygium
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opaque wing of bulbar conjunctiva overgrowing toward center of cornea; usually starts as pinguecula and is stimulated and grows
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shallow anterior chamber
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from increased intraocular pressure; "shadow sign" when temporal part of iris is illuminated-may mean acute glaucoma
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cataracts
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1. central gray opacity- forms in center of lens "nuclear cataract"
2. star shaped opacity-asymmetrical, radial, white spokes, cortical cataract |
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Optic atrophy
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disc pallor, partial or complete death of optic nerve; decreased visual acuity, decreased color vision, and contrast sensitivity
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what test for near vision? |
jaegar card |
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color test |
ishihara; identify all 6 colors |
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normal adult size of pupil |
3 to 5 mm |
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anisorcoria |
pupils of 2 diff sizes |
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accommodation |
test for pupils ability to adjust or accommodate to diff distances. |
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PERRLA |
Pupils Equal Round, React to Light and Accommodation |
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corneal light reflex |
hirschberg; reflection of light on corneas should be in exactly the same spot in each eye. |
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cover test |
steady fixed gaze |
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six cardinal position of gaze |
eom Normal response is parallel tracking of object with both eyes. Mild nystagmus at extreme lateral gaze is normal. |
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inspection of ocular fundus |
light off inner retina |
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color of fundus |
light red to dark brown red |
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optic disc: color, shape and margins |
creamy yellow orange to pink shape: round or oval margins: distinct and sharply demarcated, nasal edge might be slightly fuzzy |
