Head-To-Toe Assessment (D. Eye lids and Lacrimal Apparatus)

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1. Inspect the eyelids for position and symmetry.
2. Palpate the eyelids for the lacrimal glands.
a. To examine the lacrimal gland, the examiner, lightly slide the pad of the index finger against the client’s upper orbital rim.
b. Inquire for any pain or tenderness.
3. Palpate for the nasolacrimal duct to check for obstruction.
a. To assess the nasolacrimal duct, the examiner presses with the index finger against the client’s lower inner orbital rim, at the lacrimal sac, NOT AGAINST THE NOSE.
b. In the presence of blockage, this will cause regurgitation of fluid in the puncta

Normal Findings:

Eyelids

· Upper eyelids cover the small portion of the iris, cornea, and sclera when eyes are open.
· No PTOSIS noted. (drooping of upper eyelids).
· Meets completely when eyes are closed.
· Symmetrical.

Lacrimal Apparatus

· Lacrimal gland is normally non palpable.
· No tenderness on palpation.
· No regurgitation from the nasolacrimal duct.

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