Assessment Week 3: Health History and Eye Exam Guidelines

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Questions and Answers

Which condition is characterized by a gradual loss of vision typically associated with aging?

Cataracts

Diabetic retinopathy

Presbyopia (correct)

Glaucoma

Which of the following tests assesses the corneal light reflex?

Cover–uncover test

Snellen eye chart

Hirschberg test (correct)

Penlight examination

What does the presence of redness and swelling in the eye likely indicate?

Corrective lens need

Vision loss

Normal eye function

Potential infection (correct)

Which of these is a common age-related visual impairment involving damage to the central part of the retina?

Macular degeneration Signup and view all the answers

What is the purpose of using the ophthalmoscope during an eye examination?

To view the internal structures of the eye Signup and view all the answers

What condition is indicated by the presence of diplopia?

Double vision Signup and view all the answers

Which objective data collection equipment is used to evaluate visual acuity?

Snellen eye chart Signup and view all the answers

Which visual reflex is demonstrated by changes in pupil size in response to light?

Pupillary light reflex Signup and view all the answers

Which condition is commonly diagnosed through a cover–uncover test?

Strabismus Signup and view all the answers

What does a negative diopter on an ophthalmoscope indicate?

Focus on objects farther away Signup and view all the answers

What is indicated by a lesion at the optic chiasm?

Visual field loss in both eyes Signup and view all the answers

Which of the following conditions is characterized by an increase in ocular pressure?

Acute glaucoma Signup and view all the answers

What type of opacity is identified as a star-shaped opacity?

Cataract Signup and view all the answers

What could be observed in cases of diabetic retinopathy?

Microaneurysms Signup and view all the answers

What is a common result of optic atrophy as seen in the optic disc?

Disc pallor Signup and view all the answers

Which condition presents with circumcorneal redness?

Iritis Signup and view all the answers

What type of hemorrhage is associated with retinal damage?

Intraretinal hemorrhages Signup and view all the answers

What term describes the finding of arteriovenous crossing changes?

Diabetic retinopathy Signup and view all the answers

Which abnormality is a characteristic of a nuclear cataract?

Central grey opacity Signup and view all the answers

Papilledema is primarily associated with what condition?

Increased intracranial pressure Signup and view all the answers

What is assessed when evaluating the optic disc?

All of the above Signup and view all the answers

Which of the following conditions is characterized by protruding eyes?

Exophthalmos Signup and view all the answers

What finding indicates inflammation of the eyelids?

Blepharitis Signup and view all the answers

What is the term for unequal pupil size?

Anisocoria Signup and view all the answers

In an examination of the ocular fundus, the artery–vein ratio is assessed. What aspect does this measurement relate to?

Calibre of vessels Signup and view all the answers

Which abnormal finding is characterized by a drooping upper lid?

Ptosis Signup and view all the answers

What does the presence of dilated and fixed pupils indicate?

Cranial nerve III damage Signup and view all the answers

Which condition is associated with inflammation of the lacrimal sac?

Dacryocystitis Signup and view all the answers

What is the main characteristic of tonic pupil (Adie's pupil)?

Unresponsive to light Signup and view all the answers

Which of the following is NOT typically evaluated in a routine ocular fundus examination?

Visual acuity Signup and view all the answers

Study Notes

Subjective Data: Health History

Common vision difficulties include decreased acuity, blurring, and blind spots.
Pain may be associated with ocular issues like strabismus and diplopia.
Symptoms such as redness, swelling, watering, and discharge can indicate ocular problems.
Important to gather information on past ocular issues, including glaucoma, dry eyes, and the use of glasses or contact lenses.
Assess self-care behaviors, medications, and any history of vision loss.

Developmental Considerations for Older Adults

Age-related changes:
- Presbyopia contributes to difficulty in near vision.
- Macular degeneration affects central vision.
- Cataracts lead to clouding of the lens.
- Glaucoma involves increased intraocular pressure.
- Diabetic retinopathy stems from uncontrolled diabetes.

Objective Data: Physical Exam Preparation

Positioning is crucial for accurate assessment.
Essential equipment includes:
- Snellen eye chart or handheld visual screener.
- Opaque card or occluder for cover-uncover tests.
- Penlight, applicator stick, and ophthalmoscope.

Visual Pathways and Visual Fields

Light rays refract as they pass through the eye, impacting image focusing.
Fibers cross at the optic nerve to facilitate processing visual information.

Visual Reflexes

Pupillary light reflex indicates eye reaction to light.
Fixation and accommodation are vital for focusing on objects at varying distances.

Extraocular Muscle Function

Inspection includes:
- Corneal light reflex (Hirschberg test) to check for alignment.
- Cover-uncover test for binocular vision assessment.
- Diagnostic positions test to evaluate extraocular movement.

Inspection of Ocular Structures

External ocular structures include:
- Eyebrows, eyelids, and lashes.
- Conjunctiva and sclera integrity assessed.
Anterior eyeball structures assessed:
- Cornea and lens should be clear.
- Iris and pupil evaluated for size, shape, and light reflex.

Using the Ophthalmoscope

Ophthalmoscope allows for detailed examination of the internal eye.
Contains lenses measured in diopters:
- Positive (black) for near objects; negative (red) for distant objects.

Ocular Fundus Inspection

Key evaluations include:
- Red reflex and retinal vessels examination.
- Optic disc assessment includes color, shape, margins, and cup-to-disc ratio.
- General fundus background, including macula details.

Abnormal Findings: Extraocular Motor Function

Abnormalities may include strabismus, esotropia, and exotropia.
Eyelid abnormalities consist of ptosis, ectropion, and entropion, among others.
Periorbital edema indicates potential underlying conditions.

Abnormal Findings: Lesions and Pupils

Eyelid lesions like blepharitis, chalazion, and hordeolum noted for inflammation.
Anomalies in pupil size (anisocoria) or fixed constricted/dilated pupils may indicate neurological issues.

Eye Abnormalities: Visual Field Loss

Retinal damage, including localized scotoma and retinal detachment, affect vision.
Increased ocular pressure may suggest glaucoma or other conditions.

Abnormal Findings: Opacities in the Lens

Conditions like pterygium, corneal abrasion, and hyphema present as lens opacity or damage.

Retinal Vessels and Optic Disc

Opacities and changes in optic disc observed in conditions like papilledema and diabetic retinopathy.
Arteriovenous crossing changes are critical indicators of vascular conditions in the eye.

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Description

This quiz covers important aspects of subjective and objective data collection in health history, particularly focused on ocular health. It addresses common vision difficulties, age-related changes in older adults, and the essential equipment for physical exams. Test your understanding of effective assessment techniques and clinical considerations.