Assessi

ng eyes
 1.
Vision charts
 Snellen Chart

Used to test distant visual acuity, the Snellen chart consists of

lines of different letters stacked one above the other. The
letters are large at the top and decrease in size from top to
bottom. The chart is placed on a wall or door at eye level in a
well-lighted area. The client stands 20 ft from the chart and
covers one eye with an opaque card (which prevents the
client from peeking through the fingers). Then the client
reads each line of letters until he or she cannot longer
distinguish them.
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 E Chart
If the client cannot read or has a handicap that prevents
verbal communication, the E chart is used. The E chart is
contoured dust like the Snellen chart but the characters
on it are only Es, which face in ail directions. The client is
asked to indicate by pointing which way the open side of
the E faces. If the client wears glasses, they should be left
on, unless they are reading glasses (reading glasses blur
distance vision).

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 Jaeger Test

Near vision is assessed in clients over 40 years of age by

holding the pocket screener (Jaeger test) or newspaper
print 14 in from the eye. Clients who have decreased
accommodation to view closer print will have to move
the card or newspaper further away to see it.

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 2.
ophthalmoscope
 ophthalmoscope

A hand-held instrument that

allows the examiner to view the
fundus of the eye by the
projection of light through a
prism that bends the light 90
degrees.

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 Basics of operation

1. Turn the ophthalmoscope “on” and select the aperture with the large round beam of white
light.
2. Ask client to remove any eyeglasses but to keep contact lenses in place. You can rotate the
lenses to accommodate for any refractive errors.
3. Ask the client to fix his or her gaze on an object that is straight ahead and slightly upward.
01 02
4. Darken the room to allow pupils to dilate.
5. Hold the ophthalmoscope in your right hand with your index finger on the lens wheel and
place it to your right eye if you are examining the client’s right eye

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 Abnormalities of the external eye
Ptosis (drooping Ectropion Conjunctivitis
eye) (outwardly turned (inflammation of the
lower lid) conjunctiva)

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 Abnormalities of the external eye
Exophthalmos Chalazion Hordeolum
(protruding (infected (stye)
eyeballs and Meibomian gland)
retracted eyelids)

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 Abnormalities of the external eye
Entropion Blepharitis Diffuse episcleritis
(inwardly turned (staphylococcal (inflammation of the
lower eyelid) infection of the sclera)
eyelid)

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 Abnormalities of the external eye
Subconjunctival Scleral jaundice
hemorrhage (bright red
areas of the sclera)

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 Abnormalities of the cornea and lens
Corneal abnormalities Lens abnormalities
Corneal scar which appears Nuclear cataracts appear gray when
grayish white, is due to an old seen with a flashlight; they appear as a
injury or inflammation. black spot against the red reflex when
seen through ophthalmoscope.

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 Abnormalities of the iris and pupils

Irregularly shaped iris

Causes a shallow anterior chamber, which may increase the
risk for narrow-angle glaucoma.

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 Abnormalities of the iris and pupils
Miosis
Anisocoria
Constricted and Pupils of unequal Mydriasis
fixed pupils possibly size. Dilated and fixed
result of narcotic pupils, result from
drugs or brain central nervous
damage. system injury,
circulatory collapse,
or deep anesthesia.

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 Abnormalities of the optic disc
Papilledema Glaucoma Optic Atrophy

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Abnormalities of the retinal vessels and
background
Constricted Copper wire Silver wire
arteriole arteriole arteriole

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Abnormalities of the retinal vessels and
background
Arteriovenous Arteriovenous Arteriovenous
nicking tapering banking

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Abnormalities of the retinal vessels and
background
Cotton wool Hard exudate Superficial retinal
patches hemorrhage

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Abnormalities of the retinal vessels and
background
Deep retinal Microaneurysms
hemorrhage

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