HA part 2

• Visual Field


  A person sees with one eye. Can be divided into four quadrants: upper temporal, lower temporal, upper nasal, and lower nasal.
• Visual Reflexes


  the pupillary light reflex causes pupils immediately to constrict

  when exposed to bright light. Can be seen as Direct Reflex and Indirect or Consensual Reflex.
• Direct Reflex 


  which constriction occurs in the eye exposed to the light
• PERRLA 


  Pupils

  Equally

  Round

  Reflective

  Light

  Accomodation
• Test Result


  Acuity results are recorded somewhat like blood pressure readings

  in a manner that resembles a fraction.
• The top, or first, number is always 20, indicating the distance from the client to the chart. The bottom, or second number refers to the last full line the client could read
• Hyperopic (farsighted)


  Black numbers indicate a positive diopter and are used for
• Turn the ophthalmoscope "on'' and select the aperture with the large round beam of white light - the small round beam of white light may be used if the client has smaller pupils
• Myopia 


  Impaired far vision. Present when the second number in the test result is larger than the first (20/40).
• • The higher the second number, the poorer the vision.
  • A client is considered legally blind when vision in the better eye with corrective lenses is 20/20 or less.
• Test visual fields for gross peripheral vision


  Perform the confrontation test, position yourself -2 ft away from the client at eye level. Using pencil
• Normal Findings


  • Inferior: 70 degrees
  • Superior: 50 degrees
  • Temporal: 90 degrees
  • Nasal: 60 degrees
• Perform corneal light reflex test


  Assesses parallel alignment of the eyes. Hold a penlight approximately 12 inches from the client's face Shine the light toward the bridge of the nose while the client stares straight ahead.
• Perform cover test


  Cover test detects deviation in alignment or strength and slight deviations in eye movement.
• Phoria


  A term used to describe misalignment that occurs only when the fusion reflex is blocked.
• Strabismus


  a constant malalignment of the eyes.
• Tropia


  a specific type of misalignment: esotropia is an inward turn of the eye, and exotropía is an outward turn of the eye
• Perform the positions test


  which assesses eye muscle strength and cranial nerve function. Clockwise direstion
• Nystagmus


  an oscillating (shaking) movement of the eye
• Inspect the eyelids and eyelashes


  width and position of palpebral fissures. Assess ability of eyelids to dose. Note the position of the eyelids in comparison with the eyeballs.
• Xanthelasma 


  • Raised yellow plaques located most often near the inner canthus.
  • Skin on both eyelids is without redness, swelling, or lesions
• Ptosis


  Drooping of the upper lid
• Entropion


  Inverted lower lid condition which may caused pain and injure the cornea.
• Ectropion


  Everted lower eyelid, result in exposure and drying of the conjunctiva.
• Redness and crusting along the lid margins suggest seborrhea or blepharitis, an infection caused by Staphylococcus aureus.
• Hordeolum (style)


  a hair follicle infection, causes local redness, swelling, and pain.
• Protrusion


  Eyeballs accompanied by retracted eyelid margins is termed exophthalmos and is characteristic of Graves disease (a type of

  hyperthyroidism)
• Sunken Eyeballs


  A sunken appearance of the eyes may be seen with severe dehydration or chronic wasting illnesses
• Inspect the bulbar conjunctiva and sclera


  Have the client keep the head straight while looking from side to side then up toward the ceiling. Observe clarity, color, and texture.
• Bulbar Conjuctiva


  clear, moist, and smooth. Underlying structures are clearly visible.

  Sclera is white.
• Pinguecula


  yellowish nodules on the bulbar conjunctiva. Harmless nodules and common in older client. Appear first on the medial side of the iris
• Redness of the conjunctiva suggests conjunctivitis (pink eye).
• Areas of dryness are associated with allergies or trauma.
• Episcleritis


  a local, noninfectious inflammation of the sclera. The condition is

  usually characterized by either a nodular appearance or by redness with dilated vessels.
• Palpebral conjunctiva.


  a tree of swelling foreign bodies or truma
• Cyanosis of the lower lid suggests a heart or lung disorder.
• Inspect the lacrimal apparatus


  assess the areas over the lacrimal glands (lateral aspect of upper eyelid) and the puncta (medial aspect of lower eyelid)
• Abnormal Findings


  Swelling of the lacrimal gland may be visible in the lateral aspect of the upper eyelid. This may be caused by blockage, infection, or an

  inflammatory condition.
• Palpate the lacrimal apparatus


  put on disposable gloves to palpate the nasolacrimal duct to assess for blockage. Use one finger and palpate just inside the lower orbital rim.
• Inspect the cornea and lens


  shine a light from the side of the eye for an oblique view.

  Look through the pupil to inspect the lens.