64 Questions
When examining the eye, if the patients eyelid margins approximate completely, what does this assessment finding indicate?
It is expected.
During ocular examinations, how is the movement of the extraocular muscles stimulated?
Stimulated by CNs III, IV, and VI.
When performing an external eye examination, which statement regarding the outer layer of the eye is true?
The outer layer of the eye is very sensitive to touch.
What is the function of the palpebral fissure in the eye?
It allows for vision by letting light enter the eye.
What is responsible for decreased near vision abilities?
Presbyopia
Which layer of the eye has pigmentation to prevent internal light reflection?
Choroid
What causes pupil dilation and eyelid elevation?
Stimulation of the sympathetic nervous system
Which nerve is stimulated when the outer eye surface is stimulated?
Trigeminal nerve (CN V)
What determines intraocular pressure?
Amount of aqueous produced and resistance to its outflow
What refers to pupillary constriction when looking at a near object?
Visual accommodation
What is the normal constriction of pupils when bright light shines on the retina?
Pupillary light reflex
What does the retina change light waves into?
Nerve impulses
What layer of the eye is touch-sensitive?
Cornea
What is responsible for the image formed on the retina being upside down and reversed from its actual appearance?
Nature of light refraction
At what age should infants establish binocularity and fixate simultaneously on a single image with both eyes?
3-4 months
What is the outer layer of the eye made up of?
Cornea and sclera
When assessing the lacrimal apparatus, what are the normal findings?
Absence of drainage from the puncta when pressed against the inner orbital rim
How should the nurse assess the pupillary light reflex?
Shine a light across the pupil from the side and observe for direct and consensual pupillary constriction
What is a normal reflection when using an ophthalmoscope to examine a patient's pupils?
A red glow in the patient's pupils
At what age can an infant fixate on an object?
2 to 4 weeks
When should an infant be able to fixate and follow a bright light or toy?
1 month
When is color vision tested in boys using the Ishihara test?
Once between the ages of 4 and 8 years
How is testing for strabismus done?
By performing the corneal light reflex test and the cover test
What should the nurse consider when examining an 80-year-old patient?
Normal age-related changes such as presbyopia and reduced visual fields
How is normal findings for the accommodation response described?
Convergence of the axes of the eyes
How is ptosis observed?
By assessing the distance between the upper and lower eyelids
What color should the optic disc be when examining a patient's retina with an ophthalmoscope?
Yellow-orange
At what age can an infant fixate on an object?
2 to 4 weeks
What may periorbital edema indicate?
Systemic conditions such as heart failure, renal failure, allergy, and hypothyroidism
What does assessing for shadows when light is directed across the iris indicate?
Acute angle-closure glaucoma
What is anisocoria characterized by?
Pupils of unequal size and may indicate central nervous system disease
What may indicate signs of retinal detachment?
Shadows or diminished vision in one quadrant or one half of the visual field
What does a painful, red, and swollen pustule at the lid margin indicate?
Hordeolum (stye)
What does loss of central vision but normal peripheral vision suggest?
Macular degeneration
What does corneal abrasion cause in reflected light?
Irregular ridges, producing a shattered appearance to light rays
What should pupillary constriction be in older adults?
Symmetric
Is periorbital edema associated with blepharitis?
No
What may unequal pupil size indicate?
Central nervous system disease
What may the presence of shadows in the anterior chamber be a sign of?
Acute angle-closure glaucoma
What is the term for pupils of unequal size?
Anisocoria
What is the correct interpretation of 20/30 vision on the Snellen chart?
The patient can read at 20 feet what a person with normal vision can read at 30 feet
What does a visual acuity of 20/80 in each eye indicate?
Poor vision
What does the reflection of light on the corneas indicate?
It should be symmetric, asymmetry requires further assessment
When is the Snellen alphabet chart used to assess visual acuity?
It is the most commonly used and accurate measure of visual acuity
What does the top number in a visual acuity measurement indicate?
The distance the person is standing from the chart
What does a diagnostic positions test assess?
Parallel movement of both eyes
What is the expected finding during an assessment of dark-skinned people's sclera?
Small brown macules
How should the nurse check for ptosis of one eye?
By observing the distance between the palpebral fissures
When may the acute onset of floaters occur?
With retinal detachment
What is the denominator in a visual acuity measurement?
The distance at which a normal eye can see
What should the nurse do if a patient is unable to read the largest letters on the Snellen chart?
Shorten the distance until the letters are seen and record that distance
What should the nurse use to assess the visual acuity of a 16-year-old patient?
The Snellen chart, positioned 20 feet away
What is the correct definition of 20/30 vision on the Snellen chart?
The patient can read at 20 feet what a person with normal vision can read at 30 feet.
What does the top number in a visual acuity measurement indicate?
The distance the person is standing from the chart
What does a visual acuity of 20/80 in each eye indicate?
Poor vision
What is the purpose of shortening the distance on the Snellen chart if a patient is unable to read the largest letters?
To record the distance at which the letters are seen
What is the significance of asymmetric reflection of light on the corneas?
It requires further assessment
What is a normal finding for the diagnostic positions test?
Parallel movement of both eyes
What may be observed in the sclera of dark-skinned people as an expected finding during an assessment?
Small brown macules
How should the nurse check for ptosis of one eye?
By observing the distance between the palpebral fissures
What might the acute onset of floaters indicate?
Retinal detachment
What is the Snellen chart used for?
Assessing visual acuity
What does the denominator in a visual acuity measurement indicate?
The distance at which a normal eye can see
When should the nurse use the Snellen chart to assess the visual acuity of a patient?
When the patient is 16 years old
Study Notes
Eye Assessment and Vision Testing
- A 52-year-old patient reports occasional floaters or spots in his eyes, which are usually insignificant and caused by condensed vitreous fibers.
- The nurse should use the Snellen chart, positioned 20 feet away, to assess the visual acuity of a 16-year-old patient.
- A patient with 20/30 vision on the Snellen chart can read at 20 feet what a person with normal vision can read at 30 feet.
- If a patient is unable to read even the largest letters on the Snellen chart, the nurse should shorten the distance until the letters are seen and record that distance.
- A visual acuity of 20/80 in each eye indicates poor vision.
- The reflection of light on the corneas should be symmetric, with asymmetry requiring further assessment.
- Normal findings for the diagnostic positions test include parallel movement of both eyes.
- In dark-skinned people, small brown macules may be observed in the sclera as an expected finding during an assessment.
- The nurse should check for ptosis of one eye by observing the distance between the palpebral fissures.
- Floaters or spots moving in front of the eyes can be normal, but the acute onset of floaters may occur with retinal detachment.
- The Snellen alphabet chart is the most commonly used and most accurate measure of visual acuity.
- The top number in a visual acuity measurement indicates the distance the person is standing from the chart, and the denominator gives the distance at which a normal eye can see.
Test your knowledge of eye assessment and vision testing with this quiz covering topics such as visual acuity, Snellen chart, diagnostic positions test, and normal findings during eye assessments.
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