Activity E PERFORMING PHYSICAL ASSESSMENT OF THE EYES AND VISUAL ACUITY

Use the following Physical Assessment Guide to examine the eyes and visual acuity of a lab
partner, peer, or client. Column 1 will serve as a reminder as to what part of the exam you will
do next. Column 2 will be used to record your findings. Your instructor may ask you to turn this
in to be evaluated.

Physical Assessment Guide to Collect Objective Client Data

Questions Findings
1. Gather equipment (Snellen chart,
handheld Snellen chart or near vision DONE INC DONE NOT DONE
screener, penlight, opaque card, and 5 PTS 3 PTS 0
ophthalmoscope).
2. Explain procedure to client. DONE INC DONE NOT DONE
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Perform Vision Tests DONE INC DONE NOT DONE
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1. Distant visual acuity (with Snellen chart, 
normal acuity is 14/14 (20/20) with or
without corrective lenses).
2. Near visual acuity (with handheld Snellen 
chart, normal acuity is 20/20 14/14 with
or without corrective lenses).
3. Visual fields (use procedure discussed in 
textbook to test peripheral vision).
Perform Extraocular Muscle Function Tests DONE INC DONE NOT DONE
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1. Corneal light reflex (using a penlight to 
observe parallel alignment of light
reflection on corneas).
2. Cover test (using an opaque card to cover 
an eye to observe for eye movement).
3. Positions test (observing for eye 
movement).
External Eye Structures DONE INC DONE NOT DONE
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1. Inspect eyelids and lashes (width and 
positions of palpebral fissures, ability to
close eyelids, direction of eyelids in
comparison with eyeballs, color, swelling,
lesons, or discharge).
2. Inspect positioning of eyeballs (alignment 
in sockets, protruding or sunken).
3. Inspect bulbar conjunctiva and sclera 
 (clarity, color, and texture).
4. Inspect the palpebral conjunctiva Eversion of
(eversion of upper eyelid is usually upper eyelids
performed only with complaints of eye not included
pain or sensation of something in the
eye).
5. 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.
6. Palpate the lacrimal apparatus, noting 
drainage from the puncta when palpating
the nasolacrimal duct.
7. Inspect the cornea and lens by shining a 
light to determine transparency.
8. Inspect the iris and pupil for shape and 
color of the iris and size and shape of the
pupil.
9. 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).
10. Test accommodation of pupils by shifting 
gaze from far to near (normally, pupils
constrict).
Analysis of Data
1. Formulate nursing diagnoses (health
DONE INC DONE NOT DONE
promotion, risk, actual).
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2. Formulate collaborative problems.
3. Make necessary referrals. DONE INC DONE NOT DONE
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