1. Palpebral Fissure
    open space between the eyelids
  2. Limbus
    border between cornea and sclera
  3. Canthus
    corner of the eye
  4. Caruncle
    small fleshy mass at inner corner containing sebaceous glands
  5. Tarsal Plates
    strips of connective tissue, contain the meibomian glands, secrete oily lubricating material
  6. Conjunctiva
    • thin mucous membrane
    • a. Palpebral Conjunctiva - lines the lids
    • b. Bulbar Conjunctiva - overlays the eyeball with the white sclera showing through
  7. Lacrimal Apparatus
    provides constant irrigation
  8. Puncta
    absorb tear drainage (upper and lower lids at the inner canthus)
  9. Extraocular Muscles
    • 6 muscles attach to the eyeball and give the eye
    • movement
    • a. Rectus Muscles - 4 straight
    • b. Oblique Muscles - 2 slanting
  10. Internal Eye
    • 1. Sclera - outer fibrous, protective white covering
    • 2. Choroid - middle vascular, dark pigmented layer, delivers blood to the retina, prevents light from reflecting internally
    • a. Pupil
    • b. Lens - focus
    • c. Anterior Chamber - continuous flow of fluid, serves to deliver, nutrients to surrounding tissues and drains metabolic waste
    • 3. Retina - visual receptive layer of the eye, light waves are changed into nerve impulses (includes optic disc, retinal vessels)
    • a. Optic Disc - retina fibers converge to form the optic nerve
    • b. Macula - receives and transduces light from the center of the visual
    • field
  11. Cultural Considerations
    • A. Palpebral Fissures - narrowed in Asian population
    • B. Glaucoma - more prevalent in African American population, and more severe
    • which can lead to blindness
  12. History (Subjective)
    • A. Vision difficulty, decreased visual acuity, blurring, blind spots
    • B. Eye pain
    • C. Hx Strabismus, diplopia (double vision)
    • D. Redness and/or swelling
    • E. Watering and/or eye d/c
    • F. Past hx of eye problems (ie.injury or surgery to eye)
    • G. Hx glaucoma
    • H. Use of glasses and/or contacts
    • I. Self care behaviors (date of last eye exam)
    • J. Medications
  13. Physical Exam/Assessment (Objective)
    • A. Snellen eye chart
    • B. Near Vision
    • C. Confrontation Test
    • D. Corneal Light Reflex (Hirschberg Test) - shine light from distance approx. 12-14"
    • –> at same spot both eyes
    • E. Cover Test - test for lazy eye/strabismus
    • F. Diagnostic Positions Test (H) and 6 cardinal positions of gaze - EOM function and test for nystagmus
    • G. Inspection of External Eye
    • 1. Eyebrows - symmetrical movement with facial expressions, no lesions, no scaling, etc.
    • 2. Eyelids and Eye Lashes - upper lids overlap top of iris, skin intact without redness, swelling, d/c or lesions
    • 3. Eyeballs - alignment
    • 4. Conjunctiva and Sclera - color, discharge
    • 5. Eversion of Upper Eyelid (not performed in lab)
    • 6. Lacrimal Apparatus - palpate with thumb inner eye for lacrimal sac and brow area for lacrimal gland
    • H. Anterior Eyeball Structures
    • 1. Cornea and Lens - smoothness and clarity
    • 2. Iris and Pupil - shape, PERRLA
    • a. Pupillary light reflex
    • b. Accommodation - distant object, shift to close object - pupils should constrict
    • I. Ocular Fundus - ophthalmaloscope
    • 1. Red Reflex
    • 2. Optic disc
    • 3. Retinal Vessels
    • 4. General Color/Background, Lesions
    • 5. Macula
  14. Esotropia
    inward turning of eye
  15. Exotropia
    outward turning of the eye
  16. Strabismus
    eyes crossed (pseudostabismus - eyes look crossed secondary to epicanthal folds - normal for young children)
  17. Periorbital Edema
    lids swollen, red, and puffy
  18. Ptosis
    drooping upper eyelid
  19. Blepharitis
    red scaly, flakey crusted lid margins (seborrhea)
  20. Hordeolum
    (stye) - infection of the hair follicle
  21. Chalazion
    (internal stye) - infection of internal glands of the eye
  22. Dacryocyctitis/Dacryoadenitis
    inflammation of the lacrimal sac/gland
  23. Conjunctivitis
    infection of the conjunctiva, “pink eye”
  24. Subconjunctival Hemorrhage
    secondary to increased intraocular pressure
  25. Iritis
    increased redness around iris only, usually need immediate referral
  26. Corneal Abrasion
    scratch, irregular ridges, spot noted with fluorescein
  27. Anisocoria
    unequal pupil
  28. Mydriasis
    dilated and fixed pupils
  29. Miosis
    constricted and fixed pupils
  30. Myopia
  31. Hyperopia
  32. Diabetic Retinopathy
    multiple microaneurysms or small red dots or dilations of the vessels noted on the fundiscopic exam
Card Set
Nursing 307