Eye assessments Assessment Notes PDF

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Notes on How to do your assessment for the practicum...

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Equipment:  Penlight  Cotton wisps and cotton tip applicators  Opthalmoscope  Snellen chart  Jaeger chart  Occlusive covers  Ishihara plates Eye Assessment Distance Vision Test  Assess distance visual acuity by having patient read SNELLEN CHART  Pt stands 20ft. away and covers one eye at a time reading down to smallest line of letters then switches to other eye (you stand by chart) Near Vision Text  Used to assess if having difficulty reading  Patient will hold chart 14 inches away and perform same steps for SNELLEN CHART Visual Fields Test  Perform static and kinetic confrontation test Static confrontation Test  Stand 2-3 ft. in front of patient having them cover one eye at a time.  Hold 1-4 fingers up midway between ya’ll.  Ask how many you are holding up without looking directly at the fingers.  Do this in all 4 quadrants then repeat with other eye  Pt will accurately report the correct numbers in all four quadrants Kinetic Confrontation Test  Same technique as the static test except you will hold fingers outside of each quadrant wiggling them into view.  Have patient tell you when they see your fingers Cover Test  Assessment of ocular alignment  Stand in front of your pt and have them focus on bridge of your nose.  Cover one eye at a time inspecting for any movement of uncovered eye  Uncover other eye and inspect for any movement Corneal light test  Stand in front of patient and have them stare straight ahead at bridge of your nose  Use penlight and shine at their bridge of nose

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Note where the light reflects on the cornea of each eye Light reflection is in the exactly same spot in both eyes

Diagnostic positions test Cranial Nerves III, IV, VI Oculomotor, Trochlear, abducens   

Further testing of the extra ocular muscles assessing for symmetrical movements of the eys using the CARDINAL FIELDS OF GAZE TEST PT holds head steady and follows penlight with their eyes. Hold penlight 12- 14 inches away and move through positions 2- 9 slowly

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Eyes move smoothly and symmetrical in all nine cardinal fields of gaze

Accommodation Test  Patient stares at distant object for 30 seconds.  Hold penlight 14 inches in front of nose  Have them focus on it as you move it forward to nose  Pupils constrict (accommodate) and eyes cross (convergence) Pupillary Light Test  Room darkened  Patient gaze into distance to dilate pupil.  Bring light in from side quickly observing reaction  Repeat with other eye  Eyes PERRLA  Checking cornea and lens (Glossy and Transparent)

Inspect external eye structures  Eyebrows, lashes, eyelids, eye shape and symmetry  No hair loss on eyebrows, eyelashes curve outward, eyes distributed evenly, eyelids open and close Inspect anterior eyeball structures  Lacrimal apparatus, Bulbar conjunctiva, sclera, cornea and lens, Iris and pupil Lacrimal ApparatusGently palpate by pressing inside corner of eyes (Free from tenderness) Bulbar conjunctivaGently lift upper eyelid having pt. looking down then left and right Then gently stretch down lower lids having patient looking up then left and right **NORMALLY TRANSPARENT WITH VISIBLESMALL BLOOD VESSELS ScleraWhen inspecting bulbar conjunctiva you can view sclera **CLEAR, SMOOTH, WHITE, FREE OF EXUDATE, LESIONS OR FOREIGN BODIES Cornea and lensShine penlight in each eye moving laterally toward bridge of nose **CORNEA GLOSSY AND LENS TRANSPARENT IrisInspect for color, nodules and vascularity **COLOR SHOULD BE EVENLY DISTRIBUTED, SMOOTH WITHOUT VASCULARITYS PupilsUse penlight to observe the shape and size **Black, round and equal in diameter Inspect Ocular Fundus using Opthalmoscope  Hold pt. head and move inwards about 10 inches away from forehead Red Reflex

Optic Disc- Should be round with arteries Retinal Blood Vessels Macula- Dark with no blood vessels...