a. Inspection. Look at the patient's face. Notice the symmetry of the face. Are
there any involuntary movements? Is there any edema? Are there any masses?
b. Palpation. Using the pads of your fingers with the fingers together, gently
feel in all parts of the face. Do not use short, quick jabs. Move your fingers smoothly
being sensitive to any areas of tenderness.
EYE ASSESSMENT PROCEDURES
a. Check for Accommodation. Accommodation is the adjustment of the eye for
seeing at different distances. Accommodation is another word for focusing. It is a
change in the curvature of the lens of the eye to adjust to see objects both near and far.
The eye lens curves greatly to focus on objects that are close. When a person is
focusing on an object far away, the lens becomes flatter. In both instances, the eye
lens adjusts or accommodates to the object being looked at. The eye muscle which
controls whether the eye lens is very curved or flattened is the ciliary muscle.
b. Check Visual Acuity. Visual acuity is clearness or sharpness of vision. A
visual acuity test should be a routine examination of all patients. There are several
special charts of test letters used, but the most commonly used chart is the Snellen
chart. The patient is seated twenty feet from the chart. He places a clean card in front
of one eye without putting pressure on the eye globe. The chart has several rows of
progressively smaller letters. The patient is asked to read the letters down the chart as
far as possible. A patient who can read the letters on the "20/20" line from a distance of
twenty feet is said to have 20/20 vision in that eye. The same process is repeated for
the other eye. If the patient normally wears glasses for distance, the test should be
repeated with his glasses on. Results should then be recorded as "uncorrected" and
c. Check for Color Vision.
(1) Color vision test. A color vision test determines a person's ability to
distinguish primary colors and shades of those colors, usually a total of ten primary
colors and shades. The most commonly used test is the one developed by Ishihara,
Stilling, and Hardy- Rand-Ritter. The person being tested looks at a series of plates
made up of dots of the primary colors printed on a background of similar dots in a
variety of colors. The dots are set up in patterns which a person with normal color
perception can identify (numbers or symbols). A person who is color deficient will be
unable to identify any patterns.