1.

Shape, position and alignment of the eyes

2. Pupillary reflex test
3. Ocular movement and convergence test
4. Reading test
5. Structure, shape and symmetry of ears
6. Hearing test
SN: Introduce self, explain procedure, ask client for permission, ask for client’s name
and birthday, ask if comfortable.
*Before starting the assessment, ask client if he/she had any eye problems or disease
1. – 3. AM:
 Inspect for the eyes, conjunctiva, eyebrows, eyelids, sclera
 Check for the sclera and conjunctiva by letting the patient look up and gently
retract/pull the lower lids of the eye.
 Let the client cover one eye, opposite to yours and make him look at you directly.
Intsruct the client to say “now” as he/she sees your finger approaches the left
&right side, up and down. Repeat with the other eye.
 Spread your hands in a 180 degrees angle and wiggle one finger on one side
only. Ask the clinet which side is moving. Do it again by changing the position of
your hands.
 Position pen in front of the client aligning towards his nose. Instruct client to look
at the pen directly. Move pen in six directions(six cardinal fields of gaze)
 Make the client stare at the penlight and move the penlight inward to the nose.
 Draw a letter H and let the client follow the direction.
 Dim the surroundings and directly point the light using a penlight/flashlight on
each eye to check if the pupil constricts.

NCF: Eyes, eyebrows, eyelashes, and eyelids are even, equally distributed, and
symmetrical. The sclera is smooth, white/transparent/yellowish in dark skinned clients.
The conjucntiva is clear, shiny, and pink in color. The pupils are equal, round, and
reactive to light and accommodation. The iris is uniform in color and symmetrical. The
pupils both constrict as light is shined upon from 3 diameters to 1 diameter. Dilates
when it is dark and is focused on an object.

4. AM: Have a newspaper/magazine with font size of 12 and let the client hold the
material 14 inches away. If the client has glasses, let him/her use it.
NCF: Client has 14/14 vision without straining.
5. EARS
AM:
 Inspect position of the ears.
 Look at the pinna and inspect the auditory canal of the ear.
 Use a penlight to inspect the inside of the ear.
 Gently pull the auricle upward and backward. Press on the tragus and apply
pressure on the mastoid process.
NCF:
The ears are upright , auricles are uniform in shape and same color with the skin, equal
in size it is smooth, mobile and firm. There is a small amount of moist in the auditory
canal. Auditory canal is oink and smooth. No foreign bodies, lesions, and nodules
present. No pain felt upon palpation of the mastoid process and no lesions felt.
6. Hearing
Am: Whisper at a distance on both sides of the ear.
NCF: Client was able to hear words whispered.