HEALTH ASSESSMENT

EYES

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 HEALTH ASSESSMENT
EYES
- Is the sensory organ of vision and has many critical
components including several cranial nerves
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 HEALTH ASSESSMENT
EYES

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 HEALTH ASSESSMENT
EYES

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VISUAL PATHWAYS

Cranial nerve II
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PUPILLARY REACTIONS

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Oculomotor
Cranial Nerve III
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EXTRAOCULAR MOVEMENTS

Oculomotor (CN III)

 (CN IV)
Trochlear

Abducens (CN VI)

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HEALTH HISTORY
- Difficulty when looking something up close or a distance
- Blurred vision
- Visual field defect
- Double vision
- Eye pain and discomfort
- History of eye diseases
- Use of eyeglass or contact lens
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INSPECTION OF THE EYE
- Check for difficulty looking at something up close or at a
distance
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- Check for blurring of vision
- Check for eye pain
- Check if experience: excessive tearing / discharge /
crusting / redness
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EYE: REDNESS
- Conjunctivitis
Inflammation of conjunctiva
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EYE: REDNESS
- Subconjunctival Hemorrhage
Leakage of blood outside of the vessels
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EYE: REDNESS
- Corneal Injury or Infection
Dilation of deeper vessels due to abrasions or viral/bacterial
infections.
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EYE: REDNESS
- Acute Iritis
Inflammation of iris
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EYE: REDNESS
- Glaucoma
Progressive eye disease caused by damage to the optic
nerve.
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VISION TESTS
1. Visual Acuity Tests: Snellen Test
To test the acuity of central vision and the patient’s ability to
see at a distance.
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VISION TESTS
2. Peripheral Vision / Visual Field Test
To screen for visual field defects by confrontation.
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EXTERNAL EYE
Position and Alignment of the Eyes

- Stand in front of the patient and survey the eyes for

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position and alignment
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EXTERNAL EYE
Position and Alignment of the Eyes
- Assess for inward or outward deviation of the eyes
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- An abnormal protrusion of the eye may indicate Grave
Disease or ocular tumors
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EYELIDS
- Note the position of the lids in relation to the eyeballs
- Inspect for edema, color and lesions
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EYELIDS
- Note the position of the lids in relation to the eyeballs
- Inspect for edema, color and lesions: Blepharitis
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EYELIDS
- Note the position of the lids in relation to the eyeballs
- Inspect for edema, color and lesions: Ptosis
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LACRIMAL APPARATUS
- Briefly inspect the regions of the lacrimal gland and
lacrimal sac for swelling.
- Look for excessive tearing, dryness or crusting of the eyes.
 HEALTH ASSESSMENT
LACRIMAL APPARATUS
- Briefly inspect the regions of the lacrimal gland and
lacrimal sac for swelling.
- Look for excessive tearing, dryness or crusting of the eyes.
- Sty (Hordeolum)
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LACRIMAL APPARATUS
- Briefly inspect the regions of the lacrimal gland and
lacrimal sac for swelling.
- Look for excessive tearing, dryness or crusting of the eyes.
- Dacryocystitis
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CONJUNCTIVA AND SCLERA
- Inspect the sclera and palpebral conjunctiva for color.
- Look for any nodules or swelling
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 HEALTH ASSESSMENT
CONJUNCTIVA AND SCLERA
- Inspect the sclera and palpebral conjunctiva for color.
- Look for any nodules or swelling
- Redness
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CONJUNCTIVA AND SCLERA
- Inspect the sclera and palpebral conjunctiva for color.
- Look for any nodules or swelling
- Jaundice
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CORNEA AND LENS
- With oblique lighting, inspect the cornea of each eye for
opacities.
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 HEALTH ASSESSMENT
CORNEA AND LENS
- With oblique lighting, inspect the cornea of each eye for
opacities.
- Corneal Scar
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CORNEA AND LENS
- With oblique lighting, inspect the cornea of each eye for
opacities.
- Pterygium
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CORNEA AND LENS
- With oblique lighting, inspect the cornea of each eye for
opacities.
- Cataracts
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IRIS
- At the same time, inspect each iris. Note color.
- The markings should be clearly defined.
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IRIS
- At the same time, inspect each iris. Note color
- The markings should be clearly defined.
- Acute Iritis
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PUPILS
- In dim light, inspect the size, shape and symmetry of each
pupil.
- Measure the pupils with a guide such as a card or
flashlight with black circles of various sizes to facilitate
measurement.
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PUPILS
- In dim light, inspect the size, shape and symmetry of each
pupil.
- Measure the pupils with a guide such as a card or
flashlight with black circles of various sizes to facilitate
measurement.
- Anisocoria
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EXTRAOCULAR MUSCLES
- Test the six extraocular movements.

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 HEALTH ASSESSMENT
TEST FOR EXTRAOCULAR MOVEMENTS

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TEST FOR EXTRAOCULAR MOVEMENTS
1. Ask the patient to follow your finger or pencil as you
sweep through the six cardinal directions of gaze.
2. Making a wide “H” direction in the air, lead the patient’s
gaze in the direction:
a. To the patient’s extreme right
b. To the right and upward
c. Down and to the right
d. Without pausing in the middle, to the extreme left
e. To the left and upward
f. Down and to the left
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EXTRAOCULAR MUSCLES
- Deviation in movements can signal a brain tumor or injury.
- Repetitive uncontrolled movement Nystagmus
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OPHTHALMOSCOPE EXAMINATION
- Examine the eyes and view the posterior structure of the
retina.
- Using the ophthalmoscope.
- With proper lighting and positioning.
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SUMMARY OF ASSESSMENT:
Part Assessment Normal Abnormal
Inspect: note position and misalignment (strabismus)
External Eye maintained alignment
alignment of the eyes protrusion (exopthalmos)
Edema; lesions;
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Eyelids Inspect: color, edema and lesions no edema/lesions inflammation (blepharitis);
drooping of the upper lid (ptosis)
Inspect: lacrimal gland & sac for inflammation of lacrimal sac
no swelling/excessive
Lacrimal Apparatus swelling, excessive tearing or (dacryocystitis);
tearing/crust
crusting of the eyes excessive tearing and crust
Conjunctiva redness (conjunctivitis);
Inspect: color, swelling and nodules white in color
& Sclera Yellowish (jaundice)
scarring (corneal scar);
Cornea & Lens Inspect: opacities clear
opaque (cataract)
Iris Inspect: markings clearly defined markings inflammation (iritis)
large (>5mm); small (<3mm);
Inspect: size, shape and symmetry normal (2-4mm);
Pupil unequal pupils (anisocoria);
of each pupil brisk response
slow response
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