ANATOMY-OF-THE-EYE-1.pptx

ASSESSMENT OF THE EYES EXTERNAL STRUCTURE EXTRAOCULAR MUSCLES RODS AND CONES  VISUAL FIELD WHAT A PERSON SEES IN ONE EYE 4 QUADRANTS: - UPPER TEMPORAL - LOWER TEMPORAL -UPPER NASAL -LOWER NASAL BINOCULAR VISION Using tw...

ASSESSMENT OF THE EYES EXTERNAL STRUCTURE EXTRAOCULAR MUSCLES RODS AND CONES  VISUAL FIELD WHAT A PERSON SEES IN ONE EYE 4 QUADRANTS: - UPPER TEMPORAL - LOWER TEMPORAL -UPPER NASAL -LOWER NASAL BINOCULAR VISION Using two eyes with overlapping fields  VISUAL REFLEXES PUPILLARY LIGHT REFLEX The constriction and dilatation of pupils when exposed to light  Direct reflex- pupil immediately constrict when exposed to bright light  Indirect/consensual reflex- exposure of one eye to light results in constriction of the other eye  ACCOMODATION  Functional reflex allowing the eyes to focus on near objects PHYSICAL EXAMINATION Assessment of the eye function through specific vision tests Inspection of the external eye Inspection of the internal eye through ophthalmoscope  Consider the following Factors:  Age use of corrective lens, artificial eye, allergies, pain, visual disturbances  Health related factors such increase Blood Pressure, or Diabetes mellitus  Ask the client about history of previous eye surgery, trauma, use of corrective glasses or contact lenses, blurred vision, Diplopia, strabismus, recent changes in vision, date of previous vision test, allergies, eye redness, and frequent watering discharge.  Structures to inspect:  Position and alignment of eyes  Eyebrows  Eyelids  Lacrimal Apparatus  Conjunctiva and sclera  Cornea and lens  Iris  Pupils Examination Techniques Inspection Palpation ophthalmoscope  EQUIPMENTS Snellen’s chart /E chart Near vision screener/ newspaper Penlight Opaque card Ophthalmoscope Disposable gloves  VISUAL ACUITY RESOLVING POWER OF THE EYES Sharpness of vision PURPOSE: 1. To quantify visual acuity 2. To determine the severity of the impairing disorder 3. To classify visual impairment, low vision, blindness  VISUAL ACUITY Done by placing the client 20 feet from the Snellen’s eye chart and testing each eye alone. TEST FOR THE VISUAL ACUITY  Snellen’s chart / E-chart Normal distant visual acuity -20/20  The client can distinguish what the person with normal vision can distinguish from 20 ft away.  ABNORMALITIES (ERROR OF REFRACTION) MYOPIA/ NEARSIGHTEDNESS – develops in eyes that focus images IN FRONT OF THE RETINA instead of in the retina, which results in blurring of vision.  Eyeballs are too long and prevents incoming light from focusing directly on the retina  Abnormal shape of the cornea or lens  ABNORMALITIES (ERROR OF REFRACTION) HYPEROPIA / FARSIGHTEDNESS – develops in eyes that focus images BEHIND OF THE RETINA instead of in the retina, which results in blurring of vision.  Eyeballs are too short and prevents incoming light from focusing directly on the retina  Abnormal shape of the cornea or lens  ABNORMALITIES (ERROR OF REFRACTION) PRESBYOPIA -Aging of the lens of the eyes.  After age 40, the lens of the eye becomes more rigid and does not flex as easily.  –loses its focusing ability and become difficult to read at close range. (DECREASED ACCOMODATION)  -ASSESS THROUGH NEAR VISUAL ACUITY  ABNORMALITIES (ERROR OF REFRACTION) ASTIGMATISM -Uneven curvature of the cornea that prevents horizontal and vertical rays from focusing on the retina -Distorted, wavy mirror -Blurred vision at all distances ASSESSING VISUAL FIELD  ASSESSING EXTRAOCULAR MUSCLE FUNCTION  CORNEAL LIGHT REFLEX TEST -HIRSCHBERG TEST -To detect strabismus  PSEUDOSTRABISMUS – normal in young children , the pupils will appear in the inner canthus  STRABISMUS ( TROPIA )  Constant malalignment of the eye axis  Types: ESOTROPIA – EYES TURN INWARD  STRABISMUS ( TROPIA ) EXOTROPIA – EYE TURNS OUTWARD  HYPERTROPIA  TH VISUAL AXIS OF THE EYE IS HIGHER THAN THE FELLOW FIXATING EYE  HYPORTROPIA  TH VISUAL AXIS OF THE EYE IS LOWERTHAN THE FELLOW FIXATING EYE Phoria( mild weakness) – covered test Go back to normal once covered Paralysis strabismus  NYSTAGMUS An oscillating (shaking) movement of the eye Assoc. with inner ear dis. , multiple sclerosis, brain lesion or narcotics INSPECTION AND PALPATION EYELIDS AND EYELASHES  Note width and position of palpebral fissures  Ability of the eyelid to close -color, swelling, lesions, discharge Ptosis  Droopingof the eyelid  Oculomotor damage Ectropion  Outwardly turned lower lid  CONJUNCTIVITIS  INFLAMMATION OF THE CONJUNCTIVA EXOPHTHALMOS  PROTRUDING OF EYEBALLS AND RETRACTED EYELIDS SUNKEN EYEBALLS CHALAZION  INFECTED MEIBOMIAN GLAND STYE /HORDEOLUM ENTROPION  INWARDLY TURNED LOWER EYELID BLEPHARITIS  STAPHYLOCOCCAL INFECTION OF THE EYELID DIFFUSE EPISCLERITIS  INFLAMMATION OF THE SCLERA SUBCONJUNCTIVAL HEMORRHAGE SCLERAL JAUNDICE CORNEAL ABNORMALITIES  CORNEA- TRANSPARENT, NO OPACITIES PTERYGIUM  THICKENING OF THE BULBAR CONJUNCTIVA THST EXTENDS ACROS THE NASAL SIDE  PINKISK TRIANGULAR TISSUE GROWTH ON THE CORNEA OF THE EYE  CAUSE IS UNKNOWN LENS ABNORMALITIES  CATARACT –Clouding of the lens of the eyes  Lens-protein and water, as ages protein clamps LENS ABNORMALITIES  GLAUCOMA –Clouding of lends caused by increased intraocular pressure that damage the optic nerve  ABNORMALITIES OF THE IRIS AND PUPIL COLOBOMA- Irregular shape of the iris -mising tissues around the eye is missing PUPILLARY REACTION TO LIGHT PERRLA- PUPILS EQUALLY ROUND AND REACTIVE TO LIGHT AND ACCOMODATION MIOSIS  PINPOINTPUPILS  NARCOTIC DRUG OR BRAIN DAMAGE MYDRASIS  DILATED PUPILS  CNS INJURY, DEEP ANESTHESIA ANISOCORIA  UNEQUAL SIZE  TRAUMA  BRAIN INJURY  IMPARIRED PARASYMPATHETIC NERVE SUPPLY TO IRIS –BRIGHT  PARALYSIS OF CERVICAL P. NERVERS- HORNER SYNDROME-DIM