(e) If the patient cannot read the largest line at a distance of one meter,
the examiner tests the patient's ability to see hand motion in front of his face. If the
patient cannot see the examiner's hand at a distance of one or two meters, he is tested
for light perception. A light is flashed from different directions and the patient is asked
from which direction the light appears and when it goes on and, it goes off. If the patient
can do this, the examination is recorded as "light perception present". If no light
perception is present, a person is technically blind.
(5) These functional examinations are routinely performed by the physician
or eye specialist. However, it is recommended that nursing personnel be
knowledgeable of these examinations. To do so will facilitate identification of visual
abnormalities. A gross examination using "field expedient techniques" can be
performed when the proper equipment and personnel
are not available. For example:
(a) Color sense can be observed by having the patient identify the
color of objects around him.
(b) Gross acuity can be tested by having the patient read signs posted
on the walls. Use signs of different sizes and position the patient at varying distances.
In addition to the examinations mentioned previously, the patient should be
assessed for the following:
a. Discomfort or pain in or around the eye.
b. Photophobia. (Abnormal sensitivity to light.)
c. Nystagmus. (Involuntary, rapid movement of the eyeball. May be horizontal,
vertical, rotational, or mixed.)
d. Strabismus. (Deviation of the eye from the normal physiological axis:
e. Diplopia. (Seeing an object in double: "double vision.")
f. Blurred vision.
g. "Spots" or "lights" in the visual field.