Use of alcohol (how

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much and how often)?

Objective data: Eyes and ears

Adapted from Weber, Kelly & Sprengel, 2014: Lippincott, with permission.

Questions Findings

Current Symptoms: Eyes

Perform Vision Tests The vision charts for these tests are available at no cost on the internet.

1. Distant visual acuity (with Snellen chart, normal acuity is 20/20 with or without corrective lenses).

2. Near visual acuity (with a handheld vision chart, normal acuity is 14/14 with or without corrective lenses).

3. Visual fields (use procedure discussed in textbook to test peripheral vision).

Perform Extraocular Muscle Function Tests

4. Corneal light reflex (using a penlight to observe parallel alignment of light reflection on corneas).

5. Cover test (using an opaque card to cover an eye to observe for eye movement).

6. Positions test (observing for eye movement).

External Eye Structures

7. Inspect eyelids and lashes (width and position of palpebral fissures, ability to close eyelids, direction of eyelids in comparison with eyeballs, color, swelling,

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lesions, or discharge).

8. Inspect positioning of eyeballs (alignment in sockets, protruding or sunken).

9. Inspect bulbar conjunctiva and sclera (clarity, color, and texture).

10.Inspect the palpebral conjunctive (eversion of upper eyelid is usually performed only with complaints of eye pain or sensation of something in eye).

11.Inspect the lacrimal apparatus over the lacrimal glands (lateral aspect of upper eyelid) and the puncta (medial aspect of lower eyelid). Observe for swelling, redness, or drainage.

12. Palpate the lacrimal apparatus, noting drainage from the puncta when palpating the nasolacrimal duct.

13. Inspect the cornea and lens by shining a light to determine transparency.

14.Inspect the iris and pupil for shape and color of the iris and size and shape of the pupil.

15.Test pupillary reaction to light (in a darkened room, have client focus on a distant object, shine a light obliquely into the pupil, and observe the pupil’s reaction to light—normally, pupils constrict).