a.

Vision and Eye Movement Assessment

 PERRLA assessment.
 Visual Fields.
 Extraocular muscle tests.
 Visual Acuity.

Nursing Responsibilities
Before
 Explain the procedure to the patient, ensuring they understand what to expect.
 Gather necessary equipment such as a Snellen chart, penlight, occluder, and
visual acuity chart.
 Ensure proper lighting and a quiet environment for optimal testing conditions.
 Advocate for the patient's needs and preferences, ensuring they receive
appropriate care and understanding.

During
 Assist the patient as needed during testing, such as guiding them to the
appropriate position for visual acuity testing.
 For visual acuity tests, assess distant and near visual acuity using a Snellen
chart and near vision chart respectively.
 For eye movement examination, evaluate eye movements by observing pursuits,
saccades, convergence, and divergence.
 For pupil examination, check pupil size, shape, and reactivity to light using a
penlight.
 For visual field tests, perform confrontation visual field testing to assess
peripheral vision.
 For color vision tests, conduct Ishihara color vision testing to evaluate color
perception.

After
 Document nursing interventions, patient responses, and any observed
abnormalities during the assessment accurately for continuity of care.
 Communicate any significant findings to the attending physician for further
evaluation and management.
 Clean and disinfect any equipment used during the assessment according to
infection control protocols.