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Health Assessment Chapter 14
Terms in this set (80)
unequal pupil size
-gray white arc or circle around the limbus of the iris that is common with aging
- due to deposition of lipid material
- indicates high cholesterol
argyll robertson pupil
pupil does not react to light, does not constrict with accommodation
refractive error of vision due to difference in curvature in refractive surfaces of the eye (cornea and lens)
crossing paths of an artery and vein in the ocular fundus
loss of both temporal visual fields
inflammation of the glands and eyelash follicles along the margin of the eyelids
infection or retention cuts of a meibomian gland, showing as a beady nodule on the eyelid
cotton- wool area
abnormal soft exudates visible as gray white areas on the ocular fundus
unit of strength of the lens setting on the ophthalmoscope that changes focus on the eye structures
-benign deposits on the ocular fundus that show as round yellow dots and occur commonly with aging
- usually symmetrically place in both eyes
- drusen in macular area suggests macular degeneration
lower eyelid loose and rolling outward
lower eyelid rolling inward
abnormal finding of round red dots on the ocular fundus that are localized dilations of small vessels
nearsighted, can see better near than far
stasis of blow flow out of the ocular fundus; sign of increased intracranial pressure
drooping of upper eyelid over iris and possibly covering pupil
-soft , raised yellow plaques occurring on the skin at the inner corners of the eyes
- occur more frequently in women
-indicates high cholesterol
The palpebral fissure is
the open space between the eyelids
Corneal reflex is mediated by Cranial Nerves
V and VII
The retinal structures view through the ophthalmoscope are
The examiner records " positive consensual light reflex". This is
simultaneous constriction of the other pupil when one eye is exposed to bright light.
Several changes occur in the eye with the aging process. The thickening and yellowing of the lens is referred to as:
Be alert to symptoms that may constitute an eye emergency. What symptoms should be referred immediately.
sudden onset of vision change
Visual acuity is assessed with
the snellen eye chart
cover test is used to assess for:
When using the ophthalmoscope, you would:
remove your own glasses and approach the patient's left eye with your left eye
the six muscles that control eye movements are innvervated by cranial nerves:
3,4, and 6
Conjunctivitis is always associated with
a reddened conjunctiva
A patient has blurred peripheral vision. You suspect glaucoma, and test the visual fields. A person with normal vision would see your finger temporally at
A person is know to be blind in the left eye. What happens to the pupils when the right eye is illuminated by a penlight beam?
Both Pupils constrict
Use of the ophthalmoscope: an interruption of the red reflex occurs when
there is an opacity in the cornea or lens
One cause of visual impairment in aging adults is:
What is the cause of the red reflex?
light reflecting from the retina
transparent protective layer
tough, protective, white covering of eyes.
Pupillary light Reflex
is the normal constriction of the pupils when bright light shines on the retina
Direct light reflex vs consensual light reflex
DLR- constriction of pupil when light hits it
CLR- simulataneous constriction of the other pupil
a reflex direction of they eye towards an object attracting a persons attention. image is fixed in the center of the visual field
- consists of rapid eye movements to put target back into center of visual field
adaptation of the eye for near vision
When does the macula develop in a new born child?
develops by 4 months and is mature by 8 months
What percentage of neonates are born farsighted?
-this gradually decreases after ages 7 to 8 years
When does eyeball reach adult size?
8 years old
Eyes of the aging adult
- pupil size decreases
- lens becomes hard and glasslike affecting accommodation (presbyopia)
- Presbyopia is in 50% of people by age 40
- by age 70, lens begins to thicken and yellow, beginning senile cataracts
Most common causes of decrease visual function in older adults
1) cataract formation (lens opacity)
2) glaucoma (increased intraocular pressure)
3) macular degeneration (breakdown of cells in the macula of retina)
What is the most common cause of blindness in whites
Glaucoma affects what race?
3 to 6 times more often than whites and is 6 times more likely to cause blindness in blacks than whites
If a patient complains of halos around light, what should you suspect?
acute narrow - angle glaucoma
-a blind spot surrounded by an area of normal or decreased vision
-occurs with glaucoma or optic nerve disorders
What should you do if patient complains of eye pain, floaters, blind spots, loss of peripheral vision?
this is an emergency, refer immediately
is the inability to tolerate light
What do you expect to see if a patient has irritants or obstruction in drainage of an eye?
epiphora (excessive tearing)
is thick yellow discharge and crusts that form at night
If a mother had genital herpes or gonorrhea while giving birth, what should we be worried about with the newborns eyes?
ocular sequelae (eye disease developed from a previous disease, in this case the mothers STD)
What happens to tear production with aging?
Snellen eye chart
- is the most commonly used and accurate measure of visual acuity
-has lines of letters arranged in decreasing size
- person stands exactly 20 feet away from chart with card over one eye
-you should note hesitancy, squinting, leaning forward, and misreading of the letters.
-top number indicates distance the person is standing from the chart
-bottom number indicates the distance a normal eye could have read that particular line
- 20/30 means you read at 20 ft what a normal eye could have read at 30 feet
-larger the denominator the poorer the vision
decrease in power of accommodation with aging
- test for peripheral vision field loss
-corneal light reflex
- hold light 12 inches away and ask patient to look straight ahead
- reflect of light on cornea should be in same place on both eyes
- if not in same place, this indicates a deviation in the alignment from eyes muscle weakness or paralysis
constant malalignment of they eyes
if lacrimal gland is swollen, what would you see?
visible bulge in the outer part of upper eyelid
what 2 things do you look for with pupillary light reflex
1) constriction of the same-sided pupil
2) simultaneous constriction of the other pupil
0 = normal vision
- = nearsighted
How do you test for visual acuity on neonates?
using penlight, assess for blink reflex.
- absent blinking and absent pupillary light reflex especially after 3 weeks indicate blindness
Behaviors of children to light
birth to 2 weeks-- refusal to reopen eyes after light exposure
2 to 4 weeks-- infant can fixate on object
1 month -- can fixate and follow a light or bright toy
3 to 4 months -- can fixate, follow, and reach for toy
6 to 10 months -- can fixate and follow the toy in all directions
National Society for Prevention of Blindness refferal guidelines
1) vision 20/50 or less in either eye at age 3
2) vision 20/40 or less in either eye at age 4 or older
3) difference between two eyes is one line or more
4) child shows other signs of vision impairment, regardless of acuity.
Colorblindness is more prominent in males or females?
-roughly 8% in white males and 4% of black males
test for color blindness using polychromatic cards
-color blind person can not see the letter against the color field
if a child has brush field's spot, we suspect:
What visual acuity rating is associated with increased risk of falls and fractures in aging adults?
20/25 or greater
Study abnormal findings starting on page 311
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