Copyright 2002, Delmar, A division of Thomson Learning Chapter 12 Eyes

Copyright 2002, Delmar, A division of Thomson Learning

Chapter 12

Eyes


Competencies Identify the structures of the

eyes. Discuss the system-specific

history for the eyes. Describe normal findings in the

physical assessment of the eyes.

(continues)


Competencies Describe common abnormalities

found in the physical assessment of the eyes.

Explain the pathophysiology of common abnormalities of the eyes.

Perform the physical assessment of the eyes.


Anatomy and Physiology External structures

Conjunctiva Palpebral Bulbar

Canthus Inner Outer

Lacrimal apparatus Extraocular muscles

(continues)


Anatomy and Physiology Internal structures

Outer layer Sclera Cornea

Middle layer Choroid Lens Iris Pupil

Vitreous humorAnterior chamberPosterior chamber

(continues)


Anatomy and Physiology

Inner layer Retina Optic disc Macula Fovea centralis Cones Rods

(continues)


Anatomy and Physiology

Visual pathway Sensory neurons in the retina Optic disc Optic nerve Optic chiasm


Health History Age

Middle age Presbyopia Retinopathy

Elderly Cataract Glaucoma Macular degeneration Entropion or ectropion Dry eyes

Race

(continues)


Health History Common chief complaints

Changes in visual acuity, drainage, itching, dryness

Characteristics of chief complaints Location, quality, associated

manifestations, aggravating factors, alleviating factors, setting, timing


Past Health History Medical: eye specific Surgical: eye specific Medications Allergies Injuries Special needs Childhood illnesses

(continues)


Past Health History Family Social

Work environment Health maintenance activities

Use of safety devices Health checkups


Assessment of the Eye Equipment

Ophthalmoscope Penlight Vision charts Vision occluder

General approach Lighting Environment


Visual Acuity Cranial nerve II Distance vision

Myopia Amblyopia

Near vision Hyperopia

Color vision


Visual Fields Confrontation technique Assess all fields Types of defects

Hemianopsia Circumferential blindness Unilateral blindness


External Eye and Lacrimal Apparatus Eyelids

Abnormal findings Ptosis Exophthalmos Entropion or Ectropion Chalazion

Lacrimal apparatus Abnormal findings


Extraocular Muscle Function Corneal light reflex (Hirschberg

test) Abnormal findings

Cover/uncover test Abnormal findings

Cardinal fields of gaze Abnormal findings


Anterior Segment Structures Conjunctiva

Abnormal findings Sclera

Abnormal findings Cornea

Abnormal findings


Anterior Chamber Assessment techniques Iris

Abnormal findings Pupil

Abnormal findings Lens

Abnormal findings


Posterior Segment Structures Assessment techniques Retinal structures

Abnormal findings Macula

Abnormal findings


Gerontological Variations Changes in visual acuity Presbyopia Cataracts Macular degeneration Glaucoma


Normal Findings Visual acuity 20/20 Near vision acuity at 14 inches Able to identify all 6 colors Visual fields intact

(continues)


Normal Findings Eyelids symmetrical, no drooping,

infections, or tumors No enlargement, swelling, or

redness of the lacrimal apparatus Light reflex is symmetrical in the

center of each cornea Eyes are aligned on

cover/uncover test(continues)


Normal Findings Extraocular eye movements intact in

all 6 fields Bulbar conjunctiva is transparent Palpebral conjunctiva are pink and

moist Sclera are white, without exudate,

lesions, or foreign bodies Cornea is moist, shiny, without

discharge, cloudiness, or opacities(continues)


Normal Findings Entire iris is illuminated Color of iris is evenly distributed Pupils are deep, black, round, and of

equal diameter Pupil size is between 2–6 mm Lens is transparent

(continues)


Normal Findings Red reflex is present Optic disc is pinkish to orange Macula is darker, avascular

Documents

Copyright 2002, Delmar, A division of Thomson Learning Chapter 12 Eyes