Lecture 3: Eyes Flashcards

Question

Testing Color Vision

Answer 1

Ishihara Test: Color blindness an inherited recessive X-linked trait affecting: 8% of White males 4% of African American males rare in females

Answer 2

Corneal Light Reflex Also known as Hirschberg test - shine light toward eyes from 12 inches, while they stare straight ahead - The reflection of the light should be seen same “clock location” in each eye If you look at this picture you see the reflection of light, in the two corneas, at the same exact spot or symmetrical, about clock position 12

Answer 3

Have patient stare at distant object Cover one eye with a card then uncover Normal: no moving When weaker eye is covered- it will drift to a relaxed position Once the eye is uncovered, it will quickly move back to reestablish fixation The uncovered eye is weaker- when the stronger eye is covered, the weaker eye moves to refocus

Answer 4

Diagnostic Position Test - AKA 6 cardinal positions of gaze - CN III, IV, VI *Focus on object 12 inches away *Coordination of movement & parallel *Nystagmus (fine oscillating movement) normal in newborn, abnormal in adult Draw the letter “H” in mid air and have client follow your finger Nystagmus at extreme lateral gaze normal but at other positions could indicate multiple sclerosis, brain lesion.

Answer 5

Eyebrows -Symmetrical -Evenly distributed Eyelids -Upper lids normally overlap superior part of iris -Lids should approximate when lids are closed Eyelashes -Evenly distributed along lid margins and curve outward Eyeballs -Aligned in sockets with no protrusion or sunken appearance Conjunctiva and sclera - Ask person to look up; using thumbs, slide lower lids down along orbital rim *Eyeball should look moist and glossy - Conjunctivae should be clear and white over sclera; pink over lower lids - Note any color change, swelling, or lesions Corena and Lens - Shine light from side across cornea - Normal: * clear, shiny, gray-blue in dark skin - There should be no opacities (cloudiness) in: *cornea, anterior chamber, lens behind the pupil Iris and Pupil Iris normally appears: - Flat, Round ,Even coloration Pupil normally appears - round - equal size in both eyes Pupillary Light Reflex: Darken room Ask person to gaze into distance this dilates pupils Advance a light in from side and note response Normal: constriction of same-sided pupil (direct light reflex) simultaneous constriction of the other pupil (consensual light reflex) Accommodation: Ask person to focus on a distant object This dilates pupils Have person shift gaze to near object, such as your finger held about 7 to 8 cm (3 inches) from nose Normal response includes Pupillary constriction Convergence of axes of eyes PERRLA Record expected response to all these maneuvers as PERRLA Pupils Equal Round Reactive to Light and Accommodation Ex. Documentation: PERRLA 4/3, react briskly

Answer 6

Lacrimal Apparatus - Normally puncta drain tears into lacrimal sac - Presence of excessive tearing may indicate blockage of nasolacrimal duct - Check by pressing index finger against sac - Pressure will slightly evert lower lid

Answer 7

pinpoint pupils, constricted and fixed, narcotic drugs or brain damage

Answer 8

dilated and fixed pupils, from CNS injury, injury

Answer 9

pupils of unequal size, could be normal or abnormal - Greater in bright light compared with dim light, cause could be trauma - Greater in dim light compared with bright light, cause could be Horner syndrome, caused by paralysis of the cervical sympathetic nerves

Answer 10

Refraction: bending of light rays Myopia, Hyperopia, Presbyopia, Astigmatism Most people have one or more of them Refractive errors can usually be corrected with eyeglasses or contact lenses

Answer 11

Nearsightnedness: - Can clearly see close objects, but distant objects are blurry - Light rays focus in front of the retina *clear near vision *blurry distance vision Causes: Globe is too long Cornea is too curved

Answer 12

Farsightedness: - Difficulty focusing on small print - Light focuses behind the retina *blurry vision up close *clear vision far away Causes: - Globe is too short - Cornea is too flat in relation to the length of the eye

Answer 13

Lens stiffens with age - becomes less flexible and unable to accommodate to near - ability to focus on small print becomes difficult Presbyopia will happen to 100% of the population sometime during midlife

Answer 14

Lens stiffens with age - becomes less flexible and unable to accommodate to near - ability to focus on small print becomes difficult Presbyopia will happen to 100% of the population sometime during midlife

Answer 15

When the cornea is shaped more like a football than a basketball, it causes distortion and blurry vision as light enters the eye Instead of one focus point, there are multiple focus points when light enter the eye

Answer 16

“Drooping eye” Occurs from neuromuscular weakness (Myasthenia Gravis), oculomotor (CN III) damage, or sympathetic nerve damage (Horner’s Syndrome) Gives the person a “sleepy” appearance and impairs vision

Answer 17

Strabismus is disparity of the eye axes Constant malalignment of the eye axis - Esotropia: eye turns in - Exotropia: eye turns out - Hypertropia: eye turns up - Hypotropia: eye turns down These need to be identified early in life sometimes children can wear eye patches to make the eye stronger or there are surgical procedures available.

Answer 18

“Protruding Eyes” Forward displacement of the eyeballs and widened palpebral fissures Upper lid rests well above the limbus (border between the cornea and sclera and white sclera is visible Associated with thyroid disease with hyperthyroidism or an overactive thyroid Forward displacement and widened palpebral fissures (the distance and shape between the two corners of the opening of the eye)

Answer 19

Outwardly turned lower lid The lower lid is loose and rolls out. Puncta cannot siphon tears effectively, so excess tearing results. Eyes feel dry and itchy because tears do not drain correctly.

Answer 20

Outwardly turned lower lid The lower lid is loose and rolls out. Puncta cannot siphon tears effectively, so excess tearing results. Eyes feel dry and itchy because tears do not drain correctly.

Answer 21

Inwardly turned lower eyelid Lower lid rolls in because of spasm of lids or scar tissue contracting. Constant rubbing of lashes may irritate the cornea The person feels a “foreign body” sensation

Answer 22

Upper and lower lids are swollen and puffy. Lid tissues are loosely connected so excess fluid is easily apparent. Occurs with: Crying CHF Renal failure Allergies Hypothyroidism

Answer 23

5/15/23 1120AM- Snellen 20/20 both eyes with glasses. Near 14/14 right, left, and both c ̅ glasses. Peripheral fields intact bilateral per confrontation, equal to examiner. PERRLA 4/3. EOMs intact bilateral. R eye dark brown, L eye hazel. Corneas clear. Sclera white. Conjunctiva pink. Brows and lashes dark brown full bilateral. Lid coverage symmetrical bilateral. --------------------------Signature UANS

Lecture 3: Eyes Flashcards

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