Lecture 6 - EYES

Canadian's top concern

- too much screen time

- too much exposure to sun/UV rays

- environmental factors such as wildfires smoke, and pollution

most common eye problems

- vision changes

- itchy eyes

- dry eyes

- infection

- glaucoma

- cataracts

general survey of eyes

- skin

- anatomy

- movement

- behaviours

skin general survey

- color

- rasges/tags

- oozing

anatomy general survey

- as expected symmetry

- placement and presence

- lashes

- color

movement general survey

should by symmetrical and appropriate

Eye health history

- visual difficulty

- refraction errors

- pain

- photophobia

- strabismus

- diplopia

- redress, swelling discharge

- medications

- chronic illness

- surgical history

- allergies

- use of glasses/contact lenses

- self care

- community connections/resources

refraction errors

- myopia

- hyperopia

- presbyopia

- astigmatism

photophobia

sensitivity to light

strabismus

altered extra ocular movements

diplopia

double vision

self-care

- eye protection

- vision loss effect

- ADLs

community connections/resources accessed

want to ensure that patient have the ability to access the optometrist

conjuctiva (expected)

clear, some small blood vessels

sclera (expected)

white

anisocoria

unequal size of patient's pupils

anisocoria characteristics

can be harmless and 20% of population has genetic variation

when is anisocoria dangerous

can be dangerous, especially if presenting after trauma

miosis

small or constricted pupils

charecteristics of miosis

small pupil in one eye and dilated in other can indicate trauma

mydriasis

dilated pupils

mydriasis characteristics

- can be normal after eye drops

- may indicate brain injury

arcus senalis

discolouration around cornea

arcus senalis charecteristics

- cholesterol deposits around eyes

- mostly in older adults, big concern if in younger populations

pupillary light response

- should respond symmetrically and as expected when light sources is introduced look for both direct and consensual response - look at both eyes that light is shown in and the opposite eyes

what does light response

indicates neural response

visual acuity

- test for macular function

- macula gives risk to the majority of optic nerve fivers

- ability to accommodate to see far and near

Snellen's test for

visual acuity and distance

snellen's test

distance from chart (always 20 feet)/distances that someone with expected visions would stand from the chart to read that line

normal vision

20/20

legal blindness is best corrected vision

20/200

better test

(20/<20) can occur

jaeger test

near vision

jaeger test distance from eyes

14 inches from eyes

- read the smallest letter

other eye testing

colour blindness test

extraocular muscles and movements

test if eyes response to requested movements in an appropriate manner

eye movement

should be symmetrical in manner

tests of extra ocular muscles

- cardinal direction

- corneal reflection

- cover test

cardinal direction

one of the four compass points: north, south, east, west

corneal reflection

Shine penlight in front of patient, reflection of light on corneas should be symmetrical

Hypotropia

eye turns down

Hypertropia

eyes turn up

Exotropia

Eyes turn out

Esotropia

Eyes turn in