PATIENT’S NAME: ______________________________________________________ DATE OF ASSESSMENT: __________________________________

PATIENT AGE: ______________ BIRTHDAY: ________________________________ TIME OF ASSESSMENT: __________________________________

ASSESSMENT OF THE EYES

PERFORMING PHYSICAL ASSESSMENT
Use the following Physical Assessment Checklist to examine the eye of a peer, friend, or family
member. Column 1 can be used by you to guide your physical assessment. Column 2 may be
used for your documentation.

Physical Assessment Checklist

Physical Assessment Guide to Collect Objective Client Data

Assessment Skill
1. Gather equipment (Snellen chart,
handheld Snellen chart or near-vision
screener, penlight, opaque card, and
ophthalmoscope).
2. Explain procedures to client.
Perform Vision Tests
1. Distant visual acuity

2. Near visual acuity

3. Visual fields
Perform Extraocular Muscle Function Tests
1. Corneal light reflex

2. Cover test

3. Positions test
External Eye Structures
1. Inspect eyelids and lashes (width and
position of palpebral fissures, ability to
close eyelids, direction of eyelids in
comparison with eyeballs, color, swelling,
lesions, or discharge)
2. Inspect positioning of eyeballs (alignment
in sockets, protruding or sunken)
3. Inspect positioning of eyeballs (alignment
in sockets, protruding
4. Inspect the palpebral conjunctiva
(eversion of upper eyelid is usually

______________________________________
NAME AND SIGNATURE OF EXAMINER
PATIENT’S NAME: ______________________________________________________ DATE OF ASSESSMENT: __________________________________
PATIENT AGE: ______________ BIRTHDAY: ________________________________ TIME OF ASSESSMENT: __________________________________

performed only with complaints of eye

pain or sensation of something in eye).
5. Inspect the lacrimal apparatus over the
lacrimal glands (lateral aspect eyelid).
Observe for swelling, redness, or
drainage.
6. Palpate the lacrimal apparatus, noting
drainage from the puncta when palpating
the nasolacrimal duct
7. Inspect the cornea and lens by shining a
light to determine transparency.
8. Inspect the iris and pupil for shape and
color of the iris and size and shape of the
pupil.
9. Test pupillary reaction to light (in a
darkened room, have client focus on a
distant object, shine a light obliquely into
the pupil, and observe the pupil’s
reaction to light—normally, pupils
constrict).
10. Test accommodation of pupils by shifting
gaze from far to near (normally, pupils
constrict).
Internal Eye Structures
1. Inspect the fundus for:
• Optic disk
• Retinal vessels
• Fovea and macula
• Anterior chamber
Analysis of Data

1. Formulate a Nursing Diagnosis

2. Formulate collaborative problems

3. Make necessary referrals

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NAME AND SIGNATURE OF EXAMINER