Eye Examination Heather Nelson, RN

Inspection of the Eye eyebrows---size, extension, and texture of hair eyelids---color, edema, lesions, adequate muscle control, eyelashes, ability to close completely and open widely sclera---color, vascular pattern, should be white

Inspection of the Eye Cornea---examine for clarity by shining a light on it. Blood vessels should not be present. Iris---Should be round, regular, and equal in size. Note color. Conjunctiva---usually free of erythema and exudate. Only inspect upper when foreign object may be present.

Eyes need Snellen eye chart or Rosenbaum pocket vision card need opthalmoscope check for color blindness check visual acquity---far at 20 feet, near at 14 inches

Pupils size, shape, symmetry reaction to light accommodation

Visual Fields by Confrontation do both eyes together wiggle fingers at side of patient’s head repeat 2-3 times to test both temporal fields test eyes separately if abnormality is suspected

Extraocular Muscles Have patient watch your finger as it moves through the six cardinal fields of gaze. Test for convergence. Observe for sustained nystagmus.

Opthalmoscopic Exam Darken room. Start at 0 diopters. Use plain white circle of light. Ask pt to focus on spot on wall. Find red reflex from 2 feet away. Caused by light illuminating the retina. Follow in on 15 degrees. Adjust diopters to focus. Look at vascular supply of the retina. Follow blood vessels to optic disc. Disc margin should be sharp and well- defined.

What does 20/20 mean? Visual acuity is recorded as a fraction in which the numerator indicates the distance of the patient from the chart and the denominator indicates the distance at which the average eye can read the line. Thus 20/20 means that the patient can read at 20 feet what the average person can read at 20 feet. Vision not correctable to better than 20/200 is considered legal blindness.