8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 1/10

ASSESSMENT FINDINGS:

1. InspectionExternal structures

a. Eyebrows

NORMAL: even hair distribution,even alignment, equalmovement as facial

expression changes

ABNORMAL: absence of the lateralthird of the eyebrows(e.g., myxedema)uneven alignmentunequal or absentmovement as facial

expression changesscaliness

b. Eyelashes

NORMAL: eyelashes present andevenly distributed along

the eyelid margins

 ABNORMAL:eyelashes absent or unevenly distributed

along the eyelid margins

c. Eyelids

NORMAL: skin intact, similar in color to the face, smooth and

uniformno sclera visible abovethe corneas and irideswhen the eyelids areopenability to completely closethe eyelidsupper eyelid margins at

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 2/10

or near the limbus (theborder between thecornea and sclera) whenthe eyelids are openblinking symmetrical,

present, at 15 - 20 blinksper minute

 ABNORMAL: lid lag - a rim of scleravisible above the corneasand irides

ptosis - drooping of the

upper eyelid

epicanthus - vertical foldof skin that lies over theinner canthus

ectropion - margin of thelower eyelid is turnedoutward

entropion - margin of thelower eyelid is turnedinward

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 3/10

 

periorbital edema -swelling and puffinessaround the eyelid

blepharitis -inflammation of theeyelids

sty (acute hordeolum) -

redness, tenderness, andswelling around a hair follicle on the eyelid

margin

chalazion - beady,

nontender nodule on theskin around the eyelid(chronic inflammation of 

the meibomian gland)

xanthelasma - slightly

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 4/10

raised, yellowish, wellcircumscribedplaques onthe skin around the eyelidherniated fat - bulging of the lower eyelids, bulging

of the inner third of the

upper eyelids, or both

retracted eyelid -

retraction of the upper eyelid which results in arim of sclera between the

upper eyelid and corneasand irides and a wideeyedstareblinking asymmetrical,absent, less than 15 or greater than 20 blinks per minute

d. Lacrimal gland

and nasolacrimalgland

NORMAL: absence of a bulge in theouter third of the upper eyelids

 ABNORMAL: dacryoadenitis -

inflammation of thelacrimal glandcharacterized by pain,redness, and swelling inthe outer third of the

upper eyelid

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 5/10

e. Lacrimal sac andnasolacrimal sac

NORMAL: puncta mucosa pink,nonedematousabsence of dischargeabsence of tearingabsence of swellingbetween the nose andlower eyelids

 ABNORMAL: dacryocystitis -inflammation of the

lacrimal sac andnasolacrimal ductcharacterized by pain,redness, and swellingbetween the nose and

lower eyelid

f. Conjunctiva andsclera

NORMAL: bulbar conjunctiva istransparent with tinyvessels visiblesclera is blue-white,shiny, smooth, moistpalpebral conjunctiva is

pink, shiny, smooth,moist

 ABNORMAL: Jaundice - sclera yelloworange

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 6/10

 conjunctivitis - diffuse,dilated, reddened bulbar conjunctival vessels thattend to be maximal in theperiphery

subconjunctivalhemorrhage - sharpy

demarcated, bright redarea that fades over daysto yellow then

disappears.

pterygium - triangular 

thickening of the bulbar conjunctiva, usually onthe nasal side, that grows

across the cornea

pinguecula - yellowishwhite,triangular noduleon the bulbar conjunctiva

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 7/10

on either side of the iris

g. Cornea, lens andpupil

NORMAL: cornea transparentlens, visible through thepupil, transparen

anterior chamber, visiblethrough the cornea,transparent

 ABNORMAL: arcus senilis - thin,grayish-white arc or circlein the cornea, not quite at

the edge of the cornea

corneal scar - superficialgrayish-white opacity in

the cornea

nuclear cataract -central grayish-white

opacity in the lens

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 8/10

peripheral corticalcataract - peripheralgrayish-white opacity inthe lens that producesspokelike shadows that

point inward

hyphema - accumulationof blood in the aqueousfluid of the anterior 

chamber 

hypopyon -accumulation of purulentmaterial in the aqueousfluid of the anterior 

chamber 

monocular blindness -shining a penlight into ablind eye produces nopupillary response in the

blind or good eye,whereas shining apenlight into the normaleye produces normalpupillary responses inboth the blind and goodeye

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 9/10

mydriasis - dilated, fixedpupils (greater than 7

millimeters)

miosis - constricted,fixed pupils (less than 3millimeters)

anisocoria - slightly

unequal pupil size

oculomotor nerve

damage - unilateral,dilated pupil that reactsneither to light or accommodationaccompanied bydeviation of the affectedeye downward and ptosisof the eyelid of theaffected eye

Argyll-Robertson pupil- small, irregular pupilsthat do not react to light,but react to

accommodation

8/8/2019 Assessment Findings

http://slidepdf.com/reader/full/assessment-findings 10/10

 Tonic (Adie's) pupil -unilateral, large pupil thathas a sluggish or absentreaction to light, and a

sluggish reaction toaccommodation

Horner's syndrome -unilateral, small, regular pupil that reacts to lightand accommodationaccompanied by ptosis of the eyelid of the affected

eye and lack of tearing

iritis -ciliary injection of the iris accompanied bymoderate, aching, deeppain; decreased vision;absent ocular discharge,and a clear or cloudy

corneairides inconsistent color