Eye

d. LACRIMAL GLANDS
1. External Structures of the eye
a. EYE BALLS
 Coordinated by 6 muscles
 4 Rectus Muscles (lateral,
medial, superior, inferior)
 Responsible for the
movement of the eye
horizontally and vertically
 2 Oblique Muscles (superior,
inferior)
 Responsible for the
movement of the eyes in all
direction
 It is within the upper eyelids,
outer canthus of the eyes
 Production of tears
2. Inner Structures of the eye
a. CONJUNCTIVA
 Not inner or outer
 It is a transparent mucus
membrane that lines the lower
eyelids
Outer Layer (support and protection)

b. OCULAR ADNEXIA a. SCLERA

 The accessory organ of the eyes  More of a fibrous protective
for support and protection coating which changes according
 Muscles to age
 Bony orbit (bony
structure which protect Newborn Light blue (cause of
the eyes) hypopigmentation)
Toddler- Whitish
middle
c. EYELIDS
adult
 Upper and lower eyelids
Adult Slightly yellow or
 A thin layer, elastic folds of skin
dirty white
which protects the eyes

Tear Film  Protective in nature

- Produce moisture in the
eyes
Palpebral Fissure
-the space between the
upper and lower eyelids
when the eyes are close
Canthi (Canthus)
- At the corner of palpibral
fissure
- Inner (nasal) canthus
- Outer (lateral) canthus
b. CORNEA
 Posterior part of the sclera
 It is the refractory medium
which is govern by contraction
or relaxation of ciliary muscle
 Refraction
 Bending of light govern
by contraction and
relaxation of ciliary
muscle

1 Eye Lecture | [Type the company name]

Middle Layer (Blood Supply)
E. VITREOUS BODY
a. UVEAL TRACT  Produce vitreous humor
 Vascular in nature which  A jelly like substance,
contains a lot of blood vessel thick in consistency
 Supply the retina responsible for maintain
the shape of the eye
A. IRIS F. LENS
 It is black and highly pigmented  Biconvex, clear
wherein pupil is in the center  Main function is to focus vision
B. PUPIL on retina

 At the center Innnermost Layer

 Constriction and dilatation is
caused by interaction of 2 iris a. RETINA
muscle Contains different sensory receptors
responsible for transmission of light
Bright Constriction
objects/ Near RODS For night time
objects CONES For day time
Dark objects/ Dilation For better Imaging
Far objects

C. CILIARY BODY Normal pathway of Vision

 E xactly responsible for
Production of Aqueous Humor Outside

 Clear and thin in Cornea

consistency which is
found at anterior Aqueous Humor
chamber of the eye
Lens
D. CHOROID
 Also produce aqueous humor Vitreous Humor
 It is found in the posterior/ end
portion of Uveal tract between Retina
Sclera and Retina
 Posterior portion of uveal tract Occipital Lobe
which is located between sclera
and retina. Vision

Should have continuous flow of vision

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Blindness 3. Image processing (retina to occipital
 Damage on retina, optic nerve, lobe)
occipital nerve.  Start when pick up from retina
Central Blindness to occipital lobe
 Tumor in brain cause blindness  Normally 2 visions are seen but
registered as one
 Diplopia is abnormal
Govern by 3 steps:
1. Transmission of light (outside to
retina) Assessment of the eyes

Power of Accommodation History

-ability of eye to see/focus at 1. Biographical & demographic data
near and far object 2. Current health
Conduction of Ciliary muscle a. CC
- Pupils constricted b. Symptoms Analysis
Relaxed Ciliary Muscle  Abnormal Vision
- Pupils dilate  Causes
2. Visceral receptors of retina -poor refraction
-interference from entry
Fovea of light
-A part of retina which has -claudicating of cornea/
the highest level of visual opacity of lens
acuity - malfunctioning of nerve
- Both cones and rod are  Common Visual Changes
located  Glare of halos
-cones are more than rods  Flashing of light
 Floating spots
Dark Adaptation  Diplopia
-From bright place to dark  Abnormal Appearance
place pupil dilates to get as  Red eye
much light as possible (infection,
-After 20-30 mins. The eyes trauma, bleeding)
are adjusted to dark place.  Growth or lesion
- Rods work (sty)
 Edema
Light Adaptation (inflammatory
- Dark place to bright place process/ allergic
- Cones work conditions)
- Too much exposure to
light will bleach
photopigment

3 Eye Lecture | [Type the company name]

  Abnormal sensation Physical Examination
 Eye pain
 Hearing/lacrimati 1. External Eye
on a. Eye Position
 Increase ocular >symmetrical with one another and
secretion at the same level
>assess in side view for presence of
3. Past Health History exopthalmus (protrusion of the eye)
a. Childhood disorders and
infectious diseases (history b. Eyebrows
of eye trauma) >equal hair distribution
>let the patient smile the eyebrows
should be at the same level
b. Major illness and
hospitalization
c. Eyelids & Eyelashes
 Systemic diseases >ask the patient to close the eyes
(DM, HTN) >N= no space
 Ocular Diseases
(Instances of blurring d. Blinking Reflex
of vision) >N=blinks 20x/ min.
 With glasses or >Ab = frequent blinking
contact lens
 Hospitalization r/t e. Eyeballs
>let the patient close the eyes then
eye and brain
palpate for symmetry and firmness
 History of head
> N= not hard, not soft
trauma (e.g bad fall, > IOP = hard or with eye pain
vehicular accident)
f. Lacrimal Apparatus
c. Medications( Prescribed OTC >check for edema and secretions
drugs since when it is used)
g. Conjunctiva and Sclera
d. Allergies >pinkish red

4. Family Health History h. Corneal Reflex

>cotton wisp
a. Familial eye disorder
b. Systemic diseases
i. Cornea
>with the use of penlight it should
5. Psychosocial Factors be shiny
a. Nature of work
b. Leisure activities j. Anterior Chamber
c. Health management k. Iris & Pupil
behaviors r/t the eye l. Ocular Motility
>functioning of ciliary muscles

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CORNEAL LIGHT REFLEX OR
HIRSCHBERG TEST
>12- 15” away, penlight is
directed to nose bridge
>N = reflection to cornea is
equal
>Ab = unequal
COVER-UNCOVER TEST
>covering one eye with a
board, then instructed the
patient to look straight .
>patient eye should be fixed
on one location
m. Vision
>Visual acuity
>visual field testing
n. Special testing for vision
2. Internal Eye
a. Ophthamoscopy
 Assessment of internal eye with
the use of ophthalmoscope (a
hand piece device) which
magnifies all the things that are
seen inside the eyes 15- 20x
b. Tonometry
 A process of measuring the IOP
with the use of tonometer
 Patient should lie down/ sit with
head reclining and instill an
ophthalmic anesthetic agent and
then the tonometer is placed
above the eye ball
 Normal IOP = 8- 21 mmHg
5 Eye Lecture | [Type the company name]
Diagnostic Procedures
1. Fundus Photography
 Visualization of internal aspect
of eye
2. Exopthalmometry
 Measure the degree of forward
protrusion of the eyes
3. Opthalmic Radiography
 Any procedure that will outline
the eyes with dye/ radioisotopes
and will use magnetic waves
4. Electroretonography
 Like a contact lens attached to
the eyeball and monitor the
electrical activity of the eyes
5. Fluorescein Angiography
Visualization of blood vessels that supplies
the eyes with the use of radio opaque dye/
fluorescein dye and put under green light
ERRORS OF REFRACTION
Refractive Errors
 The image is not focused in the
retina
Refractometry
 Process of measuring refractive
errors
Refraction
Process of determining what lens will
benefit the client.
EMMETROPIA Normal refractory state, can see
the image/ refractory to retina at Bifocal Lens Progressive
20 ft Lens
Errors of Definition Correcte
Refraction d by Far vision Far vision
HYPEROPIA >What you see Convex
(farsighted) clearly is far objects lens Intermediate
>Brought about by Near vision Near vision
short antero
posterior diameter of
the lens
>The image is not
reflected in the
retina but at the back
SURGERY
of retina
1. Photorefractive keratectomy (PRK)
MYOPIA >What you see Concave
 The light will pass through the
(nearsighted) clearly is near objects Lens
cornea and flattened it (myopia)
>Brought about by
or make it steeper (hyperopia)
long antero posterior
diameter of the lens
2. Laser In Situ Keratomileusis (LASIKs)
>The image is not
 Peel the outermost layer of the
reflected in the
cornea, flattened it (myopia) or
retina but at the
make it steeper (hyperopia),
front of retina
then return the layer
>Familial in nature
PRESBYOPIA Associated by aging 1.Bifocal
Lens
2.Progres
Optometrist
sive Lens
 Identify error of refraction and
ASTIGMATISM Because of the Cylindri- prescribe lens
unequal curvature of cal Lens
cornea the light is Optician
not properly focused  Makes the eyeglasses
in retina
Ophthalmologist/ Oculist
 Doctor of medicine who
diagnosed eye disorder and treat

6 Eye Lecture | [Type the company name]

CATARACT 3. Intumescent Cataract
The lens which used to be transparent  The lens absorbs more water
becomes opaque/ decreases or loosens
transparency; light will not focus in retina 4. Hypermature
>complete vision but blured  Protein starts to breakdown in lens

3 types **Important component of lens

1. Congenital
 Brought about by pregnant mother
in the first trimester who is exposed
to radiation (xray) or communicable
diseases (german measles)
 If you have a client in the
reproductive stage identify if
pregnant or not
2. Acquired
 Ask the patient if he had an eye
trauma
 May be cause by increase in blood
glucose, BP, or trauma
>>Water
>>Protein
Management
1. Cataract extraction
a. Intracapsular cataract extraction
 Removal of lens and capsule
b. Extracapsular cataract extraction
 Removal of lens
**Phaecoemulsification
 Probe under the lens which vibrates
and remove the opaque lens

3. Senile 2. Intraocular Lens Implantation

 Associated with aging process  Replace the opaque lens with
synthetic lens
Clinical Manifestations
1. Blurring of vision Post-op Directions
 Gradual, can be corrected by 1. Cannot stoop forward
means of glasses 2. No straining
2. Diplopia 3. No coughing
 Double vision 4. No vomiting
3. Photophobia 5. No lifting of objects more than 15 lbs
 High sensitivity to light 6. Lie down on unaffected side @ low
fowler’s position
7. Wear eye shield for 1 month; wear it
Stages
during night time or nap time
1. Immature type of cataract
8. If have to wear eye patch, cover both
 Not all portion of the lens is opaque eyes instead of one
 Reduction of vision but adegquate
vision remainin
Glaucoma
>>Tunnel Vision
2. Mature cataract >>can only see center
 Practically the whole lens is opaque
 Very poor vision probably light
perception is available
Retina Detachment
>> Curtain light vision

7 Eye Lecture | [Type the company name]