Copyright 2002, Delmar, A division of Thomson Learning Chapter 12 Eyes

Copyright 2002, Delmar, A division of Thomson Learning Competencies Identify the structures of the eyes. Discuss the system-specific history for the eyes. Describe normal findings in the physical assessment of the eyes. (continues)

Copyright 2002, Delmar, A division of Thomson Learning Competencies Describe common abnormalities found in the physical assessment of the eyes. Explain the pathophysiology of common abnormalities of the eyes. Perform the physical assessment of the eyes.

Copyright 2002, Delmar, A division of Thomson Learning Anatomy and Physiology External structures  Conjunctiva  Palpebral  Bulbar  Canthus  Inner  Outer  Lacrimal apparatus  Extraocular muscles (continues)

Copyright 2002, Delmar, A division of Thomson Learning Anatomy and Physiology Internal structures  Outer layer  Sclera  Cornea  Middle layer  Choroid  Lens  Iris  Pupil Vitreous humor Anterior chamber Posterior chamber (continues)

Copyright 2002, Delmar, A division of Thomson Learning Anatomy and Physiology  Inner layer  Retina  Optic disc  Macula  Fovea centralis  Cones  Rods (continues)

Copyright 2002, Delmar, A division of Thomson Learning Anatomy and Physiology  Visual pathway  Sensory neurons in the retina  Optic disc  Optic nerve  Optic chiasm

Copyright 2002, Delmar, A division of Thomson Learning Health History Age  Middle age  Presbyopia  Retinopathy  Elderly  Cataract  Glaucoma  Macular degeneration  Entropion or ectropion  Dry eyes Race (continues)

Copyright 2002, Delmar, A division of Thomson Learning Health History Common chief complaints  Changes in visual acuity, drainage, itching, dryness Characteristics of chief complaints  Location, quality, associated manifestations, aggravating factors, alleviating factors, setting, timing

Copyright 2002, Delmar, A division of Thomson Learning Past Health History Medical: eye specific Surgical: eye specific Medications Allergies Injuries Special needs Childhood illnesses (continues)

Copyright 2002, Delmar, A division of Thomson Learning Past Health History Family Social  Work environment Health maintenance activities  Use of safety devices  Health checkups

Copyright 2002, Delmar, A division of Thomson Learning Assessment of the Eye Equipment  Ophthalmoscope  Penlight  Vision charts  Vision occluder General approach  Lighting  Environment

Copyright 2002, Delmar, A division of Thomson Learning Visual Acuity Cranial nerve II Distance vision  Myopia  Amblyopia Near vision  Hyperopia Color vision

Copyright 2002, Delmar, A division of Thomson Learning Visual Fields Confrontation technique Assess all fields Types of defects  Hemianopsia  Circumferential blindness  Unilateral blindness

Copyright 2002, Delmar, A division of Thomson Learning External Eye and Lacrimal Apparatus Eyelids  Abnormal findings  Ptosis  Exophthalmos  Entropion or Ectropion  Chalazion Lacrimal apparatus  Abnormal findings

Copyright 2002, Delmar, A division of Thomson Learning Extraocular Muscle Function Corneal light reflex (Hirschberg test)  Abnormal findings Cover/uncover test  Abnormal findings Cardinal fields of gaze  Abnormal findings

Copyright 2002, Delmar, A division of Thomson Learning Anterior Segment Structures Conjunctiva  Abnormal findings Sclera  Abnormal findings Cornea  Abnormal findings

Copyright 2002, Delmar, A division of Thomson Learning Anterior Chamber Assessment techniques Iris  Abnormal findings Pupil  Abnormal findings Lens  Abnormal findings

Copyright 2002, Delmar, A division of Thomson Learning Posterior Segment Structures Assessment techniques Retinal structures  Abnormal findings Macula  Abnormal findings

Copyright 2002, Delmar, A division of Thomson Learning Gerontological Variations Changes in visual acuity Presbyopia Cataracts Macular degeneration Glaucoma

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Visual acuity 20/20 Near vision acuity at 14 inches Able to identify all 6 colors Visual fields intact (continues)

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Eyelids symmetrical, no drooping, infections, or tumors No enlargement, swelling, or redness of the lacrimal apparatus Light reflex is symmetrical in the center of each cornea Eyes are aligned on cover/uncover test (continues)

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Extraocular eye movements intact in all 6 fields Bulbar conjunctiva is transparent Palpebral conjunctiva are pink and moist Sclera are white, without exudate, lesions, or foreign bodies Cornea is moist, shiny, without discharge, cloudiness, or opacities (continues)

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Entire iris is illuminated Color of iris is evenly distributed Pupils are deep, black, round, and of equal diameter Pupil size is between 2–6 mm Lens is transparent (continues)

Copyright 2002, Delmar, A division of Thomson Learning Normal Findings Red reflex is present Optic disc is pinkish to orange Macula is darker, avascular