Correct Answers.
Health history questions (12) - Answer 1. Vision difficulty
2. Pain
3. Strabismus, diplopia
4. Redness, swelling
5. Watering, discharge
6. History of ocular problems
7. Glaucoma
8. Use of glasses of contact lenses
9. Self-care behaviors
10. Environmental conditions
11. Medications
12. Coping with vision changes or loss
Objective Assessment (7) - Answer 1. Test visual acuity
2. Test visual fields
3. Inspect extraocular muscle function
4. Inspect external eye structures
5. Inspect anterior eyeball structures
6. Inspect ocular fundus
7. Engage in teaching and health promotion
Test visual acuity - Answer - Snellen eye chart
- Near vision (in px older than 40 or those having difficulty reading)
What does the Snellen eye chart test? - Answer CN II Optic nerve (Normal acuity is 20/20)
Test visual fields - Answer Confrontation test
- Gross measure of peripheral vision
- Eye level; 60cm
- Normal results, 50° upward, 90° temporal, 70° downward, and 60° nasal
Inspect extraocular muscle function - Answer - Corneal light reflex (Hirschberg test)
, - Cover-uncover test
- Diagnostic positions test
Hirschberg test - Answer - Assess parallel alignment of eye axes by shining a light towards px
eyes.
- Direct px to stare straight ahead as you hold light ~30 cm away.
- Note reflection of light on the corneas; it should be in exactly the same spot on each eye.
- See bright white dots for symmetry of the corneal light reflex.
Cover-uncover test - Answer - Detects small degrees of deviated alignment by interrupting
fusion reflex that normally keeps two eyes parallel
- Stare straight ahead at nose
- Normal, steady fixed gaze
- Muscle weakness, covered eye will drift into relaxed position
Phoria and tropia - Answer Phoria: mild weakness noted only when fusion is blocked
Tropia: more severe, constant misalignment of eyes
Diagnostic Positions test - Answer - Leading eyes through 6 cardinal positions reveals muscle
weakness during movement
- Holy head steady and follow movement only with eyes
- 30 cm; clockwise
- Normal, parallel tracking of object with both eyes
- Nystagmus
- Lid lag
Nystagmus - Answer - Fine oscillating movement best seen around iris
- Mild at extreme lateral gaze is normal
- Disease of semicircular canals in ears, paretic eye muscle, MS, or brain lesions
Lid lag - Answer - White rim of sclera between eyelid and iris
-Hyperthyroidism
What does extraocular muscle function test? - Answer - CN III Oculomotor
- CN IV Trochlear