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Physical Exam and Health Assesment
Chapter 14: eyes
50
Nursing
Undergraduate 3
09/14/2011

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Cards

Term
Palpebral Fissure
Definition
elliptical open space between the eyelids
Term
limbus
Definition
lower lid margin
Term
canthus
Definition
corner of the eye where the lids meet
Term
caruncle
Definition
small, fleshy mass containing sebaceous glands
Term
puncta
Definition
area that the tears drain into, visible at the upper and lower lids at the inner canthus
Term
Rectus muscles
Definition
4 straight muscles: superior, inferior, lateral and medial
Term
Oblique muscles
Definition
slanting muscles, superior and inferior
Term
Cranial nerves responsible for eye function
Definition

Cranial Nerve VI - abducens - innervates lateral rectus

Cranial Nerve IV - trochlear - innervates superior oblique

cranial nerve III - oculomotor-all the rest

Term
Three coats of the eye
Definition

Sclera - fibrous

Choroid - vascular

Retina - Nervous

Term
Iris
Definition
functions as a diaphragm, varying the opening at the center, which controls the light admitted to the retina
Term
lens
Definition
biconvex disk located just posterior to the pupil. keeps viewed object in focus on the retina
Term
anterior chamber
Definition
posterior to the cornea and in front of the iris and lens
Term
posterior chamber
Definition
lies behind the iris, to the sides of the lens
Term
retina
Definition
visual receptive layer of the eye in which light waves are changed into nerve impulses
Term
optic disc
Definition
where retinal fibers converge to form the optic nerve
Term
retinal vessels
Definition
paired artery and vein extending into each quadrant, growing progressively smaller as they move into the periphery
Term
macula
Definition
located on the temporal side of the fundus
Term
fovea centralis
Definition
area of the sharpest, keenest vision
Term
pupillary light reflex
Definition
normal constriction of the pupils when bright line shines on the retina
Term

direct light reflex

consensual light reflex

Definition

constriction of the pupil when light is shined into it

simultaneous contraction of the opposite pupil when light is shined into the other one

Term
presbyopia
Definition
the lens loses elasticity becoming hard and glasslike. Decreases the lens's ability to change shape to accomodate near vision
Term
Cataract formation
Definition
lens opacity resulting from protein clumping in the lens
Term
Glaucoma
Definition
increased intraocular pressure
Term
Macular degeneration
Definition
Most common cause of blindness, breakdown of cells in the macula of the retina
Term
Diplopia
Definition
seeing double
Term
Snellen eye chart
Definition
most commonly used and accurate measure of visual acuity
Term
Confrontation test
Definition

Tests peripheral vision

Normal results: 50 degrees upward, 90 degrees temporally, 70 degrees down, 60 degrees nasally

Term
Hirschberg Test
Definition
Corneal light reflex - light reflection should be in the same place in each eye.
Term
Cover Test
Definition
detects small degrees of deviated alignment by interrupting the fusion reflex that normally keeps the two eyes parallel. Ask patient to stare, straight ahead, cover one eye with an opaque card and remove card noting what happens to the gaze - it should remain steady. If muscle weakness exists, the eye will have to adjust itself when uncovered
Term
Diagnostic Positions Test
Definition
Leading the eyes through the six cardinal positions of gaze to determine muscle weakness. Ask patient to follow movement of pen with only their eyes. Normal = parallel tracking of object
Term
Nystagmus
Definition
fine, oscillating movement best seen around the iris. Mild nystagmus at an extreme lateral gaze is normal. Any other position is not
Term
Exopthalmos
Definition
Protruding eyes
Term
enopthalmos
Definition
sunken eyes
Term
scleral icterus
Definition
even yellowing of the sclera, extending up to the cornea. Indicates jaundice
Term
diopter
Definition

unit of strength on the opthalmoscope. Black numbers indicate positive diopter (for nearer objects)

Red numbers indicate negative diopter (for objects further away)

Term
red reflex
Definition
caused by the reflection of your opthalmoscope light off of the inner retina
Term
Myopia
Definition
Nearsighted
Term
Hyperopia
Definition
Farsighted
Term
Development of eyes in infants
Definition

1) Birth to 2wks: refusal to reopen eyes after exposure to bright light, infant may fixate on object

2) 2-4wks: infant can fixate on object

3)1 mo:Infant can fixate and follow a light or bright toy

4) 3-4 mo: Infant can fixate, follow and reach for a toy

5) 6-10 mo: Infant can fixate and follow a toy in all directions

Term

Color Blindness

 

Definition
inherited, recessive x-linked trait more common in males. Only boys are tested using Isahara's test.
Term
Isahara's test
Definition
A series of polychromatic cards. Each card has a pattern of dots printed against a background of many colored dots. Ask patient to identify the pattern. A color-blind child will not be able to distinguish a pattern
Term
strabismus
Definition
crossed eyes
Term
Opthalmia neonatorum
Definition
conjunctivitis of the newborn
Term
Brushfield's spots
Definition
white specks around the edge of the iris, may indicate Down's syndrome
Term
Pingueculae
Definition
yellowish, elevated nodules on the sclera of older individuals due to thickening of the bulbar conjunctiva
Term
Pterygium
Definition
an opacity of the bulbar conjunctiva, but one that grows over the cornea
Term
arcus senilis
Definition
commonly seen around the cornea, gray-white arc or circle around the limbus due to the deposition of lipid material
Term
xanthelasma
Definition
soft, raised, yellow plaques that occur on the lids at the inner canthus, no pathologic significance
Term
Drusen
Definition
benign, degenerative hyaline deposits. Small, round, yellow dots scattered on the retina, no effect on vision
Term
Hordeolum
Definition
Stye
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