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–Peripheral vision of patient is compared to peripheral vision of examiner.
This test Tests Visual Fields
•pupils of two different sizes
Pupillary Light Reflex
- •darken the room and person gazes into distance. Advance a light in from the side and
- note response.
Normal response is constriction of same-sided pupils (direct-light reflex) and simultaneous constriction of the other pupil (consensual light reflex)
- •test for ability of pupils to adjust to various distances. Ask person to focus on a distant object. Then have person shift gaze to a near object, such as examiner’s finger held about 3
- inches from the nose.
•Normal response includes dilation of pupils for distance vision and pupil constriction with convergence (axes of the eyes inward) for near vision.
Corneal Light Reflex (Hirschberg)
•Assesses parallel alignment of the eye axes.
•Shine light toward the person’s eyes. Person to stare straight ahead as light is held about 12 inches away.
- •Note the reflection of the light on corneas should be in exactly the same spot on each
•Detects small degrees of deviated alignment by interrupting fusion reflex that normally keeps the two eyes parallel.
- •Person stares straight ahead at examiners nose while covering one eye with an opaque
- card. As eye is covered, note the uncovered eye.
•Normal response is a steady fixed gaze.
- •Uncover the other eye and observe for movement. It should stare straight ahead. If it
- jumps to reestablish fixation, eye muscle weakness exists.
•Repeat with opposite eye.
Six Cardinal Positions of Gaze - EOM
•Person holds head steady and follows the movement of examiner’s finger, pen, or penlight only with the eyes.
•Normal response is parallel tracking of object with both eyes. Mild nystagmus at extreme lateral gaze is normal.
(Extraocular Muscles - CN III, IV, VI)
•enlarges view of the eye so the media (anterior chamber, lens, vitreous) and ocular fundus (internal surface of retinal) can be inspected.
•It directs a beam of light through pupil to illuminate inner structures.
red glow filing the person’s pupil caused by reflection of ophthalmoscope light off inner retina. Follow red reflex as you move steadily closer to eye.
•prominent landmark, located on nasal side of retina.
–Color: creamy yellow-orange to pink
–Shape: round or oval
–Margins: distinct and sharply demarcated, although nasal edge may be slightly fuzzy.
Aging causes (eye)
•Problems with the lacrimal duct
•Decreased tear production
•Dryness and burning of eyes
Normal Changes of Aging (eye)
Pupils are smaller in size
Lens has decreased ability to change size to accommodate for near vision (Presbyopia)
- Arcus Senilis (gray-white arc or circle around
- limbus due to deposition of lipids)
Macular degeneration is the most common cause of
Patients with chronic diseases such as
should have an annual eye examination
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