What are Cataracts
Clouding of the eyes lens, common in older people
What is muscular degeneration
Loss of central vision
How are neonates vision when born and how long does it take for them to fix it?
Far sighted and 3-4 months
What are some critical findings of eye
Red eye
Sudden vision change
Pupil irregularity: sluggish reaction: not equal sizes
How do you measure the fundus structure?
Measuring the diameter of the disc
What is a pigment crescent?
Accumulation of black pigment between retina and sclera called choroid
Is pigment crescent variation normal?
Yes, more common in african american
What is sclera crescent?
No pigment in choroid layer, Grey-White, New moon shaped, normal
what are two variation that may happen near optic disc?
sclera crescent
Pigment crescent
Structures of the oculus fundus?
Retina vessels
Macula and inside fovea
optic disc and nerves
What is myopia?
Nearsightedness - can see nearby things but not far things
What is hyperopia?
Farsightedness - can see far things but not nearby things
What is Presbyopia?
gradual loss to focus on nearby objects, happens around 40
What is amblypoia
Lazy eye - reduced vision in one eye
What is Diplopia
Double Vision
What is Palpebral Fissure
Space between the eyelids
What is the limbus of the eyes
Border between sclera and cornea
What is the lateral and medial canthus of the eyes
Inner corner and the outter corner of the eyes
Where does lacrimal gland drain?
Nasolacrimal Duct
What are the 6 muscles that helps the eyes to orbit?
4 rectus - Superior(up), Inferior(down), Lateral(out), Medial(in)
2 Oblique - Superior(rotating eye downwards towards the nose) and Inferior(rotating the eye inwards away from the nose)
What 3 nerves control the extra-ocular(movement of the eyes) muscles?
3 III - Oculomotor
4 IV - Trochlear
6 VI - Abducen
What movements does cranial 3 innervates?
Oculomotor
Rectus - Superior, Inferior and Medial.
Oblique - Inferior
What movements does cranial 4 innervates?
Trochlear
Oblique - Superior
What movements does cranial 6 innervates?
Abducen
Rectus - Lateral
What is Conjugate movement?
Parallel movement of the eyes
What are the 3 concentric coats of the eye?
Sclera, choroid and Retina
what is the choroid
Heavily vascularized so its dark doesn’t let any light in.
Supplies blood to the Retina
Which side of the brain looks at which side of the world?
Left looks at right and vice versa
What is strabismus
Cross Eyed
What is glaucoma?
Increased intra-ocular pressure from blocked drainage. Results in vision loss
How to use snellen eye chart?
Well lit spot.
At client eye level.
Remove reading glasses only.
Make client stand 20FT from chart
Use a opaque card to test one eye at a time.
Ask to read as small as possible and encourage to next smallest.
What does the snellen eye chart test?
Central Visual Acuity. Optic nerve
How to test for near vision?
Put glasses on if applicable
Hold the card about 14 inches away.
One eye at a time start reading the chart
Record findings
How to record findings on snellen chart
20/50 - means what normal person sees in 50 ft is what the client sees on 20 feet.
minus scores on the board of they make mistakes.
How to do a diagnostic position test?
Ask the client to follow the finger steady flow.
Hold back about 12 inches
Go to first position, Hold then back to centre.
Move to all 6 positions clockwise.
NOTE IF THERES PARARELL MOVEMENT
What is nsytagmus?
Involuntary movement of the eye
What is corneal reflex test and how is it done?
Shining light into patients’ eyes.
Check for the reflection on both eyes and it should be around the same spot.
What is Phoria?
Sometimes miss-alignment of the eyes
What is Tropia?
Permanent miss-alignment of the eyes
Absence of lateral 3rd of brow
Hyperthyroidism
Unequal or no movement of the eyebrows mean?
Nerve damage
What is Ptosis?
Dropping of the upper eyelid
What is exophthalmos
Bulging eyes
What is enothalmos?
Sunken eyes, eyes going in
How do you asses for conjunctiva and sclera?
Patient looks up and you pull the eyelid down
What color is sclera in black people?
Muddy, Grey blue
Small brown macula in eyes, is it normal?
Yes is they are dark skinned
What is scleral Icterus?
Yellow eyes
Dark skin people may have yellow deposits?
Yes, its normal and its not juandice
How do you inspect cornea and lenses?
Shine light from sideways and there should be no opacities
What is arcus senilis?
White ring around the Iris, Normal in older people
What is aniscoria?
Unequal Pupil size
PERRLA
Pupils Equal Round & Reactive to Light and Accommodation
What is red reflex?
Red glow over the patients pupil, illuminating the retina
What is a ophthalmoscope?
helps we see the back
How to use an ophthalmoscope?
Darken the room.
Remove glasses.
Ask the patient to look at a set point to look.
25 cm away and 15 degrees angle
Note the red reflex
+6 Dioptres, check for opaqueness
Go until ur foreheads touch
Adjust for focus
What to do if you cant find the optic vessel in an ophthalmoscope?
Track the blood vessel
ophthalmoscope, if u and the patient have same vision, what should be dioptre setting be?
0
Negative dioptre
Myopia
Positive dioptre
Hyperopia
What are the structure of the oculus fundus
Optic disc
Macula
Vessels