STUDENT STUDY GUIDE: CHAPTER 14 THE EYES

--------------------------------------------------------------SUBJECTIVE ASSESSMENT-----------------------------------------------------------

1. Ask questions that investigate:
Vision difficulty, including decreased acuity, blurring, and blind spots. Any difficulty seeing or any blurring? Any blind spots? Come on suddenly, or progress slowly? In one eye or both?
Eye pain
Strabismus or diplopia. Any history of crossed eyes? Now or in the past? Does this occur with eye fatigue?
Redness or swelling
Watering or discharge. Any discharge? Any matter in the eyes? Is it hard to open your eyes in the morning? What color is the discharge?
A history of ocular problems
Glaucoma
Use of glasses or contact lenses. Do you wear glasses or contact lenses? How do they work for you? If you wear contact lenses, are there any problems such as pain, photophobia, watering, or swelling?
Self-care behaviors. Any environmental conditions at home or at work that may affect your eyes? For example, flying sparks, metal bits, smoke, dust, chemical fumes? If so, do you wear goggles to protect your eyes? What medications are you taking? Systemic or topical? Do you take any medication specifically for the eyes?

---------------------------------------------------------------OBJECTIVE ASSESSMENT------------------------------------------------------------

1. Test visual acuity
Snellen eye chart
Near vision (those older than 40 years, or those having difficulty reading)
2. Test visual fields
Confrontation test
3. Inspect extraocular muscle function
Corneal light reflex (Hirschberg test)
Cover test
Diagnostic positions test
4. Inspect external eye structures
General
Eyebrows
Eyelids and lashes
Eyeball alignment
Conjunctiva and sclera
Lacrimal apparatus
5. Inspect anterior eyeball structures
Cornea and lens
Iris and pupil
Size, shape, and equality Pupillary light reflex Accommodation
6. Inspect the ocular fundus
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

--------------------------------------------------------------------ABNORMAL FINDINGS---------------------------------------------------------
Pseudostrabismus has the appearance of strabismus because of epicanthic fold but is normal for a young child.
Esotropia—inward turning of the eye.
Exotropia—outward turning of the eyes.
Periorbital Edema
Exophthalmos (Protruding Eyes)
Enophthalmos (Sunken Eyes)
Ptosis (Drooping Upper Lid)
Upward Palpebral Slant
Ectropion
Entropion
Blepharitis (Inflammation of the Eyelids)
Chalazion
Hordeolum (Stye)
Dacryocystitis (Inflammation of the Lacrimal Sac)
Anisocoria (Unequal Pupil Size)
Mydriasis (Dilated and Fixed Pupils)

--------------------------------------------------------------------HEALTH PROMOTION-----------------------------------------------------------

1. Annual comprehensive dilated eye exam – Many common eye diseases, such as glaucoma, diabetic eye disease, and age-related macular degeneration, often have no warning signs. A dilated eye exam is the only way to detect these diseases in their early stages. During a comprehensive dilated eye exam, your eye care professional places drops in your eyes to dilate, or