Head-To-Toe Assessment (E. Conjuctivae)

The bulbar and palpebral conjunctivae are examined by separating the eyelids widely and having the client look up, down and to each side. When separating the lids, the examiner should exert no NO PRESSURE against the eyeball; rather, the examiner should hold the lids against the ridges of the bony orbit surrounding the eye.

In examining the palpebral conjunctiva, everting the upper eyelid in necessary and is done as follow:

1.          Ask the client to look down but keep his eyes slightly open. This relaxes the levator muscles, whereas closing the eyes contracts the orbicularis muscle, preventing lid eversion.
2.    Gently grasp the upper eyelashes and pull gently downward. Do not pull the lashes outward or upward; this, too, causes muscles contraction.
3.    Place a cotton tip application about I can above the lid margin and push gently downward with the applicator while still holding the lashes. This everts the lid.
4.    Hold the lashes of the everted lid against the upper ridge of the bony orbit, just beneath the eyebrow, never pushing against the eyebrow.
5.    Examine the lid for swelling, infection, and presence of foreign objects.
6.    To return the lid to its normal position, move the lid slightly forward and ask the client to look up and to blink. The lid returns easily to its normal position.

Normal Findings:

·    Both conjunctivae are pinkish or red in color.
·    With presence of many minutes capillaries.
·    Moist
·    No ulcers
·    No foreign objects

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