Physical Examination of the Eye Vocabulary

Vocabulary terms and definitions regarding eye anatomy, development, common diseases, and physical examination techniques derived from nursing lecture notes.

Macula

The area of keenest vision; it is absent at birth, begins developing by $4\text{ months}$, and is mature by $8\text{ months}$.

Binocularity

The ability to fixate on a single image with both eyes simultaneously, which an infant usually establishes by $3\text{ to } 4\text{ months}$ of age.

Adult Eyeball Size

The structural size reached by the eyeball by the age of $8\text{ years}$.

Arcus senilis

A ring of degenerative lipid material that shows around the limbus in the aging adult; it is a normal finding and not to be confused with opacity.

Presbyopia

A condition in the aging adult where the lens loses elasticity and becomes hard and glasslike, decreasing its ability to change shape to accommodate for near vision.

Cataract

A clouding of the crystalline lens due to continual growth of lens fibers and photo-oxidative stress; it affects half of Americans by age $75\text{ years}$.

Floaters

Debris that accumulates in the vitreous humor because it is not renewed continuously; acute onset of these may indicate retinal detachment.

Diabetic retinopathy (DR)

A leading cause of blindness in working-age adults caused by chronic hyperglycemia, resulting in edema in the macula and growth of nonfunctional blood vessels.

Glaucoma

Optic nerve compression caused by increased intraocular pressure which gradually robs peripheral visual fields; age is the primary risk factor.

Age-related macular degeneration (AMD)

A loss of central vision characterized by yellow deposits (drusen) and neovascularity in the macula; peripheral vision is not affected.

Drusen

Yellow deposits in the macula that characterize age-related macular degeneration.

Visual impairment (VI)

The inability to see letters on the eye chart at line $\text{20/40}$ or below.

Strabismus

A deviation in the parallel axes of the two eyes; commonly known as "cross-eye."

Amblyopia

A condition commonly known as "lazy eye," for which screening between ages $3$ and $5\text{ years}$ is critical.

Scotoma

A blind spot inside an area of normal or decreased vision, occurring with glaucoma and optic nerve disorders.

Photophobia

The inability to tolerate light.

Diplopia

The perception of two images of a single object.

Binocular diplopia

Double vision seen only when both eyes are open, occurring with misalignment of the axes of the eyes.

Lacrimation

The physiological term for tearing.

Epiphora

Excessive tearing caused by irritants or obstruction in the drainage of tears.

Purulent discharge

Eye discharge that is thick and yellow, often forming crusts at night.

Snellen Eye Chart

The most commonly used and accurate measure of visual acuity, featuring lines of letters in decreasing size.

Numerator (Snellen Fraction)

The top number in a visual acuity score that indicates the distance the person is standing from the chart (normally $20\text{ feet}$).

Denominator (Snellen Fraction)

The bottom number in a visual acuity score that indicates the distance at which a normal eye could have read that particular line.

Jaeger card

A handheld vision screener used for testing near vision, held about $35\text{ cm}$ from the eye.

Confrontation Test

A screening test for the loss of peripheral vision that compares the person's peripheral vision with the examiner's.

Corneal Light Reflex (Hirschberg Test)

A test to assess parallel alignment of eye axes by shining a light toward the person's eyes and checking for symmetrical reflections on the corneas.

Diagnostic Positions Test

A test leading the eyes through the six cardinal positions of gaze to elicit muscle weakness or cranial nerve dysfunction.

Nystagmus

A fine, oscillating movement of the eye best seen around the iris; can occur with disease of the semicircular canals or brain lesions.

Lid lag

The appearance of a white rim of sclera between the eyelid and the iris during downward movement, occurring with hyperthyroidism.

Seborrhea

A condition associated with scaling of the eyebrows.

Ptosis

Drooping of the upper eyelid.

Periorbital edema

Swelling around the eyes or eyelids.

Ectropion

The outward turning of the eyelid margin.

Entropion

The inward turning of the eyelid margin.

Exophthalmos

The medical term for protruding eyes.

Enophthalmos

The medical term for sunken eyes.

Scleral icterus

An even yellowing of the sclera extending up to the cornea, indicating jaundice.

Puncta

Openings on the eyelid that normally drain tears into the lacrimal sac.

Anisocoria

A condition affecting about $5\%$ of people where the pupils are of two different sizes.

Direct light reflex

The constriction of the same-sided pupil when a light is advanced from the side.

Consensual light reflex

The simultaneous constriction of the opposite-side pupil when a light is advanced into one eye.

Adult Resting Pupil Size

The range normally measuring between $3\text{ to } 5\text{ mm}$.

Accommodation

The adaptation of the eye for near vision, characterized by pupillary constriction and convergence of the axes of the eyes.

PERRLA

The acronym used to record normal findings: Pupils Equal, Round, React to Light, and Accommodation.

Glycemic Control Target for DR

Maintaining a Hemoglobin A1c at less than $7\%$ to postpone diabetic retinopathy.

Myopia

The medical term for nearsightedness.

Hyperopia

The medical term for farsightedness.

Astigmatism

A refractive error along with nearsightedness and farsightedness commonly found in school-aged children.

Corneal abrasion

An injury leading to irregular ridges in reflected light, creating a shattered look to light rays across the cornea.