eyes

• Cross-section of the eye

  • Choroid
  • Vitreous Humor
  • Cornea
  • Pupil
  • Lens
  • Retina
  • Sclera

  
• Extraocular Structures


  • Eyelids
  • Eye lashes
  • Conjunctiva
  • Lacrimal apparatus
  • Lacrimal muscles

  
• Extraocular Muscles


  • Superior rectus
  • Superior oblique
  • Lateral rectus
  • Inferior oblique
  • Inferior rectus
  • Medial rectus
• Eye Brows


  • Hair distribution
  • Symmetrical alignment
  • Equal movement
• Eye Lashes


  • Distribution
  • Inversion
  • Eversion

  
• Everting the Upper Eyelid

  1. Push approximately 1 cm above the eyelid margin

  2. Ask the client to blink

  
• Eye Lids


  • Edema
  • Lesions
  • Asymmetry
  • Ptosis
  • Myasthenia gravis
  • Lesions of eyeballs
  • Basal cell carcinoma
  • Squamous cell carcinoma
  • Xanthelasma
  • Chalazion
  • Hordeolum/stye

  
• Snellen Chart


  • 20/20 - normal vision in adults and children age 6 and older
  • 20/50 - normal vision for children age 3 and younger
  • 20/40 - normal vision for children age 4
  • 20/30 - normal vision for children age 5

  
• Rosenbaum Card


  • Developed to assess or test the vision of a patient from cataract surgery
  • Used to evaluate near-vision

  
• Jaegers Card


  • An eye chart used in testing near vision acuity
  • Hyperopia - farsightedness
  • Myopia - nearsightedness
  • Presbyopia - farsightedness because of aging process

  
• Ishihara Test


  A color perception test for red-green color deficiencies
• Allen Card Test


  • Done at a distance of 3 meters or 15 feet
  • Usually used for 2 years old children and older
• Tests


  • Snellen Chart
  • Rosenbaum Card
  • Jaegers Card
  • Ishihara Test
  • Allen Card Test
• Cornea


  • Clear outer layer at the front of the eye
  • Helps your eye to focus light so you can see clearly

  
• Cornea Inspection


  • Bulbar Conjunctiva
  • Palpebral Conjunctiva
  • Lacrimal Apparatus
  • Clarity and Texture
  • Corneal Light Reflex
  • Blink Reflex
• Common Cornea Abnormalities


  • Conjunctivitis
  • Conjunctival pallor
  • Pterygium or pinguecula
  • Subconjunctival hemorrhage
  • Nevus
  • Papilloma
• Strabismus


  • A condition where eyes do not line up with one other (cross-eyed or duling)
  • Caused by weakening of intraocular muscles or damage/lesions in oculomotor nerve

  
• Types of Strabismus


  • Esotropia
  • Exotropia
  • Hypertropia
  • Hypotropia
• Intraocular Structures


  • Sclera
  • Cornea
  • Iris
  • Lens
  • Pupil
  • Choroid
  • Retina
  • Optic disc
  • Retinal vessels

  
• Red Reflex Test


  Used to screen for abnormalities of the back of the eye (posterior segment) and opacities in the visual axis

  
• Common Intraocular Abnormalities


  • Cloudy cornea
  • Corneal abrasions and ulcers
  • Kayser-Fleischer ring
  • Corneal scar
  • Early pterygium
  • Negative corneal reflex
• Sclera


  The white outer layer of the eyeball
• Sclera Inspection


  • Color
  • Texture
• Common Sclera Abnormalities


  • Diffuse Episcleritis
  • Bluish Sclera
  • Icteric Sclera
• Pupil


  • The dark-colored openings at the center of the eyes that let light in
  • 2 to 4 mm in diameter in bright light
  • 4 to 8 mm in the dark

  
• Pupil Inspection


  • Size
  • Equality
  • Reaction to light
• Miosis


  Small fixated pupils, usually associated with brain damage
• Mydriasis


  Big pupils, usually associated with cranial nerve damage
• Common Pupil Abnormalities


  • Tonic pupil
• Blink


  Diminished in people wearing contact lenses due to damage in cranial nerve V and VII

  
• INSPECTION


  • Normal
  • Deviation
• SCLERA - Normal


  • Smooth, white, shiny
• SCLERA - Deviation


  • Muddy sclera
  • Jaundice
• COMMON ABNORMALITIES


  • Diffuse Episcleritis – inflammation of the episcleral
  • Bluish Sclera – osteogenesis imperfecta
  • Icteric Sclera – at the limbus; due to elevated bilirubin (jaundice)
• PUPIL


  The dark-colored openings at the center of the eyes that let light in
• PUPIL - Normal


  • 2 to 4 mm in diameter in bright light
  • 4 to 8 mm in the dark
• PUPIL - Deviation


  • No reaction, anisocoria
  • Constriction
  • No reaction
• Miosis


  Small fixated pupils and usually associated with brain damage
• Mydriasis


  Big pupils and usually associated with cranial nerve damage
• COMMON ABNORMALITIES


  • Tonic pupil – unilateral large pupil that reacts to light slowly (benign)
  • Horner's Syndrome – unequal pupils; affected pupil small but reacts to light and has ptosis on affected eye related to sympathetic nerve lesion
  • Argyll Robertson pupils – small and irregular with no reaction to light or accommodation, associated with neurosyphilis
  • Oval pupils – irregularly shaped pupils may be caused by certain eye surgeries; may indicate a trans tentorial herniation with third nerve compression
  • Sluggish or fixed pupil – reaction to light; lack of oxygen to optic nerve or brain or tropical or systematic drug effects
  • Absence of consensual response – seen in conditions that compress or deprive those areas or oxygen
  • Absent light reflex – but no change in power of contraction during accommodation (Argyll Robertson pupil); paralysis and locomotor ataxia caused by syphilis