Eyes

Question 1

Eyes Subjective Data

Answer 1

1. Vision difficulty (decreased acuity, blurring, blind spots)
2. Pain
3. Strabismus, diplopia
4. Redness, swelling
5. Watering, discharge
6. History of ocular problems
7. Glaucoma
8. Use of glasses or contact lenses
9. Patient-centered care

Question 2

Eyes Objective Data

Answer 2

1. Test visual acuity
   - Snellen eye chart (OD –LE, OS–RE, OU–Both eyes)
   - Near vision (those older than 40 years or having difficulty reading)
2. Test visual fields
   - Confrontation test - screens for loss of peripheral vision
3. Inspect extraocular muscular function
   - Corneal light reflex (Hirschberg test) - assess parallel alignment of the eye axes
   - Cover test (if indicated
   - Diagnostics positions test - leading the eyes through a six cardinal gaze
4. Inspect external eye structures
   - General
   - Eyebrows
   - Eyelids and lashes
   - Eyeball Alignment
   - Conjunctiva and sclera
   - Lacrimal apparatus
5. Inspect interior eyeball structures
   - Cornea and lens
   - Iris and pupil
   - Size, shape, and equality
   - Pupillary light reflex
   - Accommodation
6. Inspect ocularfundus
   - Optic disc (color, shape, margins, cup-disc ratio)
   - Retinal vessels (number, color, artery-vein [ A : V ] ratio, caliber, arteriovenous crossings, tortuosity, pulsations)
   - General background (color, integrity)
   - Macula

Question 3

Developmental competence Infants and Children

Answer 3

• peripheral vision is intact in newborn infants
• by 3-4 months of age, infant establishes binocularity
• leans is nearly spherical at birth
• consistency changes from that of soft plastic at birth to rigid glass in old age

Question 4

Developmental Competence: Aging Adults

Answer 4

• Pupil size decreases
• Presbyopia
• By age 70, normally transparent fibers of lens begin to thicken and yellow, the beginning of cataracts
• Visual acuity may diminish gradually after age 50, and more so after age 80
• Most common causes of decreased visual functioning:
  1. Cataract formation - lens opacity, resulting from a clumping of proteins in lens

2. Glaucoma - increased intraocular pressure; chronic open-angle glaucoma is most common type
3. Age-related macular degeneration (AMD) - breakdown of cells in macula of retina; loss of central vision
4. Diabetic retinopathy - leading cause of blindness in adults ages 25 - 74

Question 5

Equipment

Answer 5

• Snellen eye chart
• Handheld visual scanner
• Opaque card or occluder
• Penlight
• opthalmascope
• Applicator stick

Question 6

Common problems of the Aging Adult

Answer 6

1. Cataracts - a clouding of the crystalline lens partially due to UV radiation
2. Glaucoma - an optic nerve neuropathy characterized by loss of peripheral vision, caused by increased increased extra ocular pressure
3. Age-related macular degeneration (AMD) - a loss of central vision caused by yellow deposits (drusen) and neovascularity in the macula
4. Diabetes retinopathy