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Eye Assessment Procedure Guide

This document summarizes a student nurse's eye assessment of a patient named Miss Raya. The assessment included testing visual acuity using a Snellen chart, visual fields, pupillary reactions to light, accommodation, extraocular muscle function, and convergence. No abnormalities were found in Miss Raya's eyes based on the assessment results. The student thanked Miss Raya for her cooperation in completing the eye exam.
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100% found this document useful (2 votes)
4K views4 pages

Eye Assessment Procedure Guide

This document summarizes a student nurse's eye assessment of a patient named Miss Raya. The assessment included testing visual acuity using a Snellen chart, visual fields, pupillary reactions to light, accommodation, extraocular muscle function, and convergence. No abnormalities were found in Miss Raya's eyes based on the assessment results. The student thanked Miss Raya for her cooperation in completing the eye exam.
Copyright
© All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
  • Introduction and Preparation
  • Visual Assessment Procedures

EYE ASSESSMENT – SAM ALBERT J.

RENACIA
Good morning to my dear CI’s, my name is Sam, your student nurse from BSN 1E. Today, I am going to
demonstrate the eye assessment. Most of the people considered vision as the most important sense.
So in this case, in doing the eye assessment it will help us determine if the patient has any abnormalities
with his/her vision.

The first thing to do is to review the client’s medical record, if available but my patient dt have previous
medical record because this is first assessment. Determine the scope of assessment. Prepare the
necessary materials such as:

Snellen Chart

Ishihara Chart

Penlight

Opaque Card

Introduce yourself and ask the patient his/her name.

So good morning ma’am, today I am going to do and eye assessment on you but before the procedure,
what I am going to to do is I am going to assess your eyes and to see if you can see in a specific angle in
light or in dark. So before I process, do you have any clarification?

As you can see, I have closed the curtains to provide privacy. The information that I will be getting from
you is secured and safely handed to the doctors.

VISUAL ACUITY

So in assessing visual acuity, so check in any use of visual aids prior to the test such as lenses or glasses
and make sure that the client wears it during the test but if it is a reading glasses, tell the patient to
remove it because it can cause blurring of vision.

Ma’am Raya, do you use any type of lenses?

So now let the client stand 2 feet away from the Snellen’s chart then cover the eye that is not going to
be tested and expose only the eye that is being tested. Ask the client to read the line until she cannot
decipher the letters.

Okay miss Raya, can you cover your eyes for me and read the letters. (should be done left, right
the uncovered.

So it should be done in three different reading. Left, Right, and both eyes. (DOCUMENT)
EYE ASSESSMENT – SAM ALBERT J. RENACIA
So record the reading of each eye and both eyes and perform the vision test such as the light perception,
hand movement and of course the counting fingers.

Vision Test

So now ma’am, I am going to perform a hand gesture and tell me where my hand is directly
pointing

UP DOWN RIGHT LEFT

So now I am going to perform the light perception test to indicate if you need prescription lenses
or what prescription lense you need to see properly. Tell me if you can see the light. (UP DOWN LEFT
RIGHT).

TESTING FOR VISUAL FIELDS

So in testing the visual fields, face the client directly at a distance of 60-90 centimeters. Instruct the
client to look directly to the examiners eye then both hands should be 2 feet apart lateral to patients
ear then slowly move the wiggling fingers along with the imaginary ball and in upper and lower
quadrant or temporal quadrant until the patient identifies it. Ask the client to tell you if she spotted
your moving hand

So miss raya, tell me if you have already spotted my moving hands. (wiggle finger).

If defect is detected, slowly move the wiggling finger into the defect area and then repeat until the body
of the defect is defined. Test the other eye for an accompanying defect but for my case I haven’t seen
any defects.

VISUAL INSPECTION OF THE EYES

For visual inspection of the eyes, Visually inspect for the eyes alignment and symmetry.

Inspect the eyebrow for any hair distribution, alignment, skin quality, and movement and ask the
patient to move her eyebrows (BASAHON NAKO NI MINSTRAS GA INSPECT)

Can you move your eyebrows for me miss raya. OKAY

Inspect for the eyelash for the evenness and the direction of curve. Inspect the eyelid surface and the
characteristic and of course the relation of the cornea, ability to blink.

Can you blink for me raya? Good


EYE ASSESSMENT – SAM ALBERT J. RENACIA

So to see the frequency of blinking, inspect for the lower eyelids and ask the patient to close her eyes

Can you close your eyes maam?

Inspect the area over the lacrimal gland and lacrimal duct to check if there is any swelling. Ask the
patient to look up.

Can you look up miss rraya?

And then press the lower lid to assess the schlera and bulbar conjunctiva. Now invert the eyelid to
assess the peripheral conjunctiva. (use gloves)

ASSESSING DIRECT AND CONSENSUAL PUPILLARY REACTION TO LIGHT

Inspect each iris and pupil carefully and inspect each cornea and lens for opacity, clarity and texture.

Shine a pen light to the eyes of the patient and ask the client to look straight onto you.

So miss raya, can you look straight to me? Your cornea is brown and there is no opacities.

Assess on direct consensual pupillary reaction with the light. Assess each pupil for a consensual
reaction. Darken the room partially and ask the patient to look at distance then shine the light on each
pupil using this penlight then look for any direct consensual reaction.

Maam, I will turn off the lightfor a while then shine this pen light to your eye so just look into my
eyes directly (PASUGAAN IYANG MATA)

ASSESSING THE ACCOMODATION

Assessing the accommodation is to each pupils reaction to accommodation. Hold this penlight for about
10 cm away from the bridge of the nose of the patient the ask the client to look first at the top of the
pen light, away from the penlight or at the back of the penlight the instruct the client to alternate his
or her gaze for near to far object then observe the pupils reaction.

So miss raya, can you look at the top of the penlight, at the back, vice versa

Then bring the penlight to the clients nose (PADUOL PALAYO ANG PENLIGHT)
EYE ASSESSMENT – SAM ALBERT J. RENACIA
PERFORMING HIRCHBERG TEST

In perfoming hirchberg test, the penlight should be atleast 2 feet away and shine the light to the
patients eye then tell the patient to look at it and inspect for the reaction of the cornea and look for
the direct and consensual reaction.

So maam raya, I will shone this light on your eyes 2 feet away from you the lets see if your eyes
react equally.

PERFOMING THE CARDINAL FIELDS OF GAZE TEST

Performing the cardinal fields of gaze test or the extraocular muscles test is to assess the extraocular
movement, looking for a normal conjugate movements of the eyes in each direct or any deviation from
normal, nystagmus and lead lag and convergence. Watch the ring of the sclera between the upper lid
and iris as the eyes move up and down.

You should be 2-3 feet away from the patient to follow a pentlight or any object that you are holding.
While at it, look for a jerky movement of nystagmus on the lateral gaze and on upward gaze.

What you are going to do miss raya is to follow this penlight

Its good

TESTING FOR CONVERGENCE

In convergence testing, ask the patient to look at the examiners finger or examiners penlight and as it
moves towards the nose bridge then check for any convergence

Just look at this penlight miss raya to see if there is any convergence.

For the summarize and findings, summarize the informations during the working phase and discuss the
findings and possible plan to resolve the help, concern, if present then assess the clients understanding
of the plan for the further teaching. The provide the client’s opportunity to ask or raise for concern then
don’t forget to thank the client for cooperation.

THAT IS ALL FOR THE EYE ASSESSMENT, THANK YOU!!!

Common questions

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Securing patient information during an eye assessment is significant because it ensures patient confidentiality and compliance with legal and ethical standards. By maintaining privacy, healthcare professionals protect patient trust and adhere to regulations such as HIPAA, preventing unauthorized access to sensitive health information .

The direct and consensual pupillary reaction to light is significant in diagnosing neurological function because it reflects the integrity of the optic and oculomotor nerves. Shining a light into one eye should cause both pupils to constrict, which is known as the consensual response. Any deviation from this expected response might indicate potential neurological issues such as lesions affecting the cranial nerves or brainstem malfunction .

The purpose of assessing the accommodation reflex in an eye assessment is to determine the eyes' ability to adjust focus between near and distant objects. This reflex is evaluated by having the patient alternate gaze from a penlight to a distant object while observing the pupils for constriction and dilation. Accommodation assessment checks the functionality of the oculomotor nerve and is an important aspect of diagnosing potential neurological or ophthalmological conditions .

Assessing extraocular movements enhances the understanding of ocular health by evaluating the function and coordination of the eye muscles. Through the cardinal fields of gaze test, practitioners observe the smoothness and range of eye movements in multiple directions, detecting any deviations such as nystagmus or lead-lag that might indicate muscle paralysis, nerve dysfunction, or central nervous system disorders .

It is important to test both eyes separately and together in a vision assessment to identify any differences in visual acuity and function between the eyes. Testing individually helps detect unilateral visual impairments, while testing both simultaneously ensures that binocular vision is intact. This comprehensive approach facilitates the diagnosis of asymmetrical conditions like amblyopia or strabismus .

Testing for convergence aids in detecting visual abnormalities by evaluating the eyes' ability to work together as they track a moving object toward the nose. If the eyes do not converge, it could indicate issues with binocular vision or coordination of the extraocular muscles, which may cause double vision or the inability to focus on close objects effectively .

Visual acuity tests, utilizing tools such as the Snellen Chart, are crucial in clinical assessments because they help determine the clarity or sharpness of an individual's vision. These tests are essential for identifying any abnormalities or deficiencies in the patient's capability to see distant objects, which could indicate the need for corrective lenses or further medical evaluation .

Evaluating the visual fields is crucial in a comprehensive eye assessment as it helps identify peripheral vision defects that could suggest conditions such as glaucoma, retinitis pigmentosa, or brain lesions. By instructing patients to detect the movement of wiggling fingers in various quadrants of their visual field, healthcare providers can detect abnormalities in vision that are not apparent through standard tests focused on central vision .

Visual inspection of the eyes is significant in identifying potential health issues by examining external features such as alignment, symmetry, eyelid condition, and corneal clarity. Abnormalities like eyelid drooping, redness, or asymmetric blinking might suggest underlying conditions such as infections, neurological disorders, or structural deformities in the ocular region .

The Hirschberg test contributes to the eye assessment process by evaluating the alignment of the eyes and detecting strabismus. During the test, light is shone into the patient's eyes from a specific distance to observe the reflection on the corneas. The symmetry of the reflection in each pupil is used to assess whether the eyes are properly aligned or if there is any misalignment, which could affect visual acuity and depth perception .

EYE ASSESSMENT – SAM ALBERT J. RENACIA 
Good morning to my dear CI’s, my name is Sam, your student nurse from BSN 1E. Today,
EYE ASSESSMENT – SAM ALBERT J. RENACIA 
So record the reading of each eye and both eyes and perform the vision test such as t
EYE ASSESSMENT – SAM ALBERT J. RENACIA 
 
So to see the frequency of blinking, inspect for the lower eyelids and ask the pati
EYE ASSESSMENT – SAM ALBERT J. RENACIA 
PERFORMING HIRCHBERG TEST 
In perfoming hirchberg test, the penlight should be atleas

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