Is expected.
May indicate a problem with extraocular muscles.
May result in problems with tearing.
Indicates increased intraocular pressure.
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Decreased in the older adult.
Impaired in a patient with cataracts.
Stimulated by cranial nerves (CNs) I and II.
Stimulated by CNs III, IV, and VI.
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The outer layer of the eye is very sensitive to touch.
The outer layer of the eye is darkly pigmented to prevent light from reflecting internally.
The trigeminal nerve (CN V) and the trochlear nerve (CN IV) are stimulated when the outer surface of the eye is stimulated.
The visual receptive layer of the eye in which light waves are changed into nerve impulses is located in the outer layer of the eye.
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Causes pupillary constriction.
Adjusts the eye for near vision.
Elevates the eyelid and dilates the pupil.
Causes contraction of the ciliary body.
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Thickness or bulging of the lens
Posterior chamber as it accommodates increased fluid
Contraction of the ciliary body in response to the aqueous within the eye
Amount of aqueous produced and resistance to its outflow at the angle of the anterior chamber
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The right side of the brain interprets the vision for the right eye.
The image formed on the retina is upside down and reversed from its actual appearance in the outside world.
Light rays are refracted through the transparent media of the eye before striking the pupil.
Light impulses are conducted through the optic nerve to the temporal lobes of the brain.
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Pupillary constriction when looking at a near object
Pupillary dilation when looking at a far object
Changes in peripheral vision in response to light
Involuntary blinking in the presence of bright light
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The eyes converge to focus on the light.
Light is reflected at the same spot in both eyes.
The eye focuses the image in the center of the pupil.
Constriction of both pupils occurs in response to bright light.
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“Vision is not totally developed until 2 years of age.”
“Infants develop the ability to focus on an object at approximately 8 months of age.”
“By approximately 3 months of age, infants develop more coordinated eye movements and can fixate on an object.”
“Most infants have uncoordinated eye movements for the first year of life.”
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Degeneration of the cornea
Loss of lens elasticity
Decreased adaptation to darkness
Decreased distance vision abilities
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Increased night vision
Dark retinal background
Increased photosensitivity
Narrowed palpebral fissures
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Examine the retina to determine the number of floaters.
Presume the patient has glaucoma and refer him for further testing.
Consider these to be abnormal findings, and refer him to an ophthalmologist.
Know that floaters are usually insignificant and are caused by condensed vitreous fibers.
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Perform the confrontation test.
Ask the patient to read the print on a handheld Jaeger card.
Use the Snellen chart positioned 20 feet away from the patient.
Determine the patient’s ability to read newsprint at a distance of 12 to 14 inches.
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At 30 feet the patient can read the entire chart.
The patient can read at 20 feet what a person with normal vision can read at 30 feet.
The patient can read the chart from 20 feet in the left eye and 30 feet in the right eye.
The patient can read from 30 feet what a person with normal vision can read from 20 feet.
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Refer the patient to an ophthalmologist or optometrist for further evaluation.
Assess whether the patient can count the nurse’s fingers when they are placed in front of his or her eyes.
Ask the patient to put on his or her reading glasses and attempt to read the Snellen chart again.
Shorten the distance between the patient and the chart until the letters are seen, and record that distance.
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Has poor vision.
Has acute vision.
Has normal vision.
Is presbyopic.
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Consider this a normal finding.
Refer the individual for further evaluation.
Document this finding as an asymmetric light reflex.
Perform the confrontation test to validate the findings.
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Convergence of the eyes
Parallel movement of both eyes
Nystagmus in extreme superior gaze
Slight amount of lid lag when moving the eyes from a superior to an inferior position
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Yellow fatty deposits over the cornea
Pallor near the outer canthus of the lower lid
Yellow color of the sclera that extends up to the iris
Presence of small brown macules on the sclera
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Perform the confrontation test.
Assess the individual’s near vision.
Observe the distance between the palpebral fissures.
Perform the corneal light test, and look for symmetry of the light reflex.
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Presence of tears along the inner canthus
Blocked nasolacrimal duct in a newborn infant
Slight swelling over the upper lid and along the bony orbit if the individual has a cold
Absence of drainage from the puncta when pressing against the inner orbital rim
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Shine a penlight from directly in front of the patient, and inspect for pupillary constriction.
Ask the patient to follow the penlight in eight directions, and observe for bilateral pupil constriction.
Shine a light across the pupil from the side, and observe for direct and consensual pupillary constriction.
Ask the patient to focus on a distant object. Then ask the patient to follow the penlight to approximately 7 cm from the nose.
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Dilation of the pupils
Consensual light reflex
Conjugate movement of the eyes
Convergence of the axes of the eyes
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Suspect that an opacity is present in the lens or cornea.
Check the light source of the ophthalmoscope to verify that it is functioning.
Consider the red glow a normal reflection of the ophthalmoscope light off the inner retina.
Continue with the ophthalmoscopic examination, and refer the patient for further evaluation.
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Optic disc that is a yellow-orange color
Optic disc margins that are blurred around the edges
Presence of pigmented crescents in the macular area
Presence of the macula located on the nasal side of the retina
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Consider this a normal finding.
Assess the pupillary light reflex for possible blindness.
Continue with the examination, and assess visual fields.
Expect that a 2-week-old infant should be able to fixate and follow an object.
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Check color vision annually until the age of 18 years.
Ask the child to identify the color of his or her clothing.
Test for color vision once between the ages of 4 and 8 years.
Begin color vision screening at the child’s 2-year checkup.
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Examine the external structures of the eye.
Assess visual acuity with the Snellen eye chart.
Assess the child’s visual fields with the confrontation test.
Test for strabismus by performing the corneal light reflex test.
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Decrease in tear production
Unequal pupillary constriction in response to light
Presence of arcus senilis observed around the cornea
Loss of the outer hair on the eyebrows attributable to a decrease in hair follicles
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Check for the presence of exophthalmos.
Suspect that the patient has hyperthyroidism.
Ask the patient if he or she has a history of heart failure.
Assess for blepharitis, which is often associated with periorbital edema.
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Drainage from dacryocystitis.
Presence of conjunctivitis over the iris.
Presence of shadows, which may indicate glaucoma.
Scattered light reflex, which may be indicative of cataracts.
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Dilated pupils.
Excessive tearing.
Pupils of unequal size.
Uneven curvature of the lens.
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Loss of central vision.
Shadow or diminished vision in one quadrant or one half of the visual field.
Loss of peripheral vision.
Sudden loss of pupillary constriction and accommodation.
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Chalazion.
Hordeolum (stye).
Dacryocystitis.
Blepharitis.
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Macular degeneration.
Vision that is normal for someone her age.
The beginning stages of cataract formation.
Increased intraocular pressure or glaucoma.
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Smooth and clear corneas
Opacity of the lens behind the cornea
Bleeding from the areas across the cornea
Shattered look to the light rays reflecting off the cornea
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Retinal detachment.
Diabetic retinopathy.
Acute-angle glaucoma.
Increased intracranial pressure.
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Hypopyon.
Hyphema.
Corneal abrasion.
Pterygium.
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Assessing the eye for a possible foreign body
Documenting the finding as ptosis
Assessing for other signs of ectropion
Contacting the prescriber; these are signs of basal cell carcinoma
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Patient may experience sensitivity to light, nausea, and halos around lights.
Patient experiences tunnel vision in the late stages.
Immediate treatment is needed.
Vision loss begins with peripheral vision.
Open-angle glaucoma causes sudden attacks of increased pressure that cause blurred vision.
Virtually no symptoms are exhibited.
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