Assessment Of Eye and the Ear

Zia Ullah
Lecturer, KMU
Objectives

By the end of this session participants will be

able to:
• Identify pertinent eye and ear history questions
• Obtain an eye and an ear history
• Perform an eye and an ear physical assessment .
• Document eye and ear assessment findings
• Differentiate between normal and abnormal
findings.
 Performing Eye Assessment
Health History
1. Biographic data
 Age , Gender, occupation
2. Current health status
 Chief Complaint
 Vision loss
 Eye pain
 Double vision
 Eye tearing
 Dry eyes
 Eye drainage
 Eye Appearance Changes
 Blurred vision
 Cont..

3. Past Health History

Childhood illnesses
Surgery
Serious injuries
Serious chronic illnesses
Immunization
Medication
Recent Travel/Military Service
 Cont…

3. Family History
 Genetically Linked Eye Disorders
 Hypertension
 Diabetes
 Cont..
4. Review of Systems
 General health survey
 Integumentary
 HEENT
 Respiratory
 Cardiovascular
 GI
 GU
 Musculoskeletal
 Neurological
 ENdocrine
 Cont…
5.Psychosocial profile
 Health practices
 Typical day
 Nutritional patterns
 Activity/exercise patterns
 Sleep/rest pattern
 Personal habits
 Occupational health patterns
 Physical Assessment
Equipment for physical exam

– Snellen Eye chart

– Rosenbaum card
– Penlight
– Ophthalmoscope
Techniques
– Inspection
– Palpation
 Cont..
1. Performing a General Survey
General survey includes:
o General Appearance
o Vital signs
o corrective lenses
o Redness
 Cont..
2. Performing Head-to-Toe Physical
Assessment
 General
 Integumentary
 HEENT
 Repiratory
 GI
 Musculoskeletal
 Neurological
 Cont..
3. Performing Physical Assessment of the eye
 Visual Acuity Testing
– Distant
• Snellen eye chart
– Near
• News paper
– Peripheral
• positions of gaze
– Color vision.
• Ishihara’s embedded colors test
 Cont..
3. ASSESSING THE EXTRAOCULAR MUSCLES
• Corneal Light Reflex Test
• Cover/Uncover Test
• Cardinal Fields of Gaze Test
4. INSPECTING THE EXTERNAL STRUCTURES
– General Appearance
– Eyelashes
– Eyelids
– Eyeball
– Lacrimal Gland
– Sclera
– Cornea and Lens
– Pupils
 Cont..
5. PALPATING THE EXTERNAL STRUCTURES
– Eyeball
– Lacrimal Glands and Nasolacrimal Ducts
 Performing Ear Assessment
Health History
1. Biographic data
 Age , Gender, occupation
2. Current health status
 Chief Complaint
 Hearing Loss
 Vertigo
Tinnitus
Ear Drainage (Otorrhea)
 Cont..
3. Past Health History
4. Family History
5. Review of Systems
6. Psychosocial Profile
 Physical Assessment
1. Performing a General Survey
2. Performing a Head-to-Toe Physical
Assessment
3. Performing Physical Assessment of the Ear
 Inspection
 Palpation
 PERFORMING AN OTOSCOPIC EXAMINATION
 Cont.…
Hearing Tests
 Watch tick test:
 Whisper Test
 Weber Test
 Rinne Test
 Romberg’s Test