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«Primary Eye Care and Training Manual Summary reaching out to people and programs near and far to promote healthy eyes and clear vision for all ...»

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3. If patient makes one or more errors in reading plates or any complaint about color vision, then refer to eye doctor for complete examination.

4. Examiner records either “pass” or “refer” on Patient’s Record.


Color Vision Plates Color vision plates may be ordered from any ophthalmic supply firm. Request pseudo-isochromatic plates for testing color perception. Care should be taken when handling the plates so that they are not smudged with fingerprints. If Color Vision Plates are not available, test whether the patient correctly identifies the red and green lines on the Eye Chart. Red-green color deficiency is the most common type of color blindness.

Causes of Color Blindness Color blindness is usually caused by a genetic defect in the cone cells in the retina.

If color blindness is detected in only one eye, then cause may be pathology instead of genetics. If color blindness develops, the cause may be medication the patient is taking.

Procedure: Screening for Acanthosis Nigricans Purpose: To detect early symptom of Type II Diabetes Mellitus, a major cause of blindness Illumination: Moderate

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1. Look at the nape (back) of the patient’s neck for a darkened band.

2. Distinguish between birthmarks and Acanthosis Nigricans, which has a raised velvety texture.

3. If Acanthosis is present, alert the patient that this mark is often an early sign of Type II Diabetes. Encourage patient to see a doctor to learn how to manage the disease and prevent blindness. Patient should also have their eyes examined regularly by an eye professional.

4. Examiner records either “pass” or “refer” on patient’s record.

Note: This darkened band is often mistaken for a birthmark or dirt.

– Eye Health & Safety Preventive Practices Many of the problems that affect the eyes are preventable by practicing appropriate hygiene, good nutrition and basic preventative steps. Prevention is directly related to people’s behavior and the choices they make in how they live their lives. Good health education can lead to making healthier behavior choices.

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Other materials: Millimeter ruler, pen, and patient record Instructions: Tell patient to fixate at the penlight with both eyes open and to stay still.

To measure Near Pupillary Distance (P.D.)

1. Examiner holds penlight close to his/her left eye 14” in front of the patient. Examiner closes his/her right eye.

2. Examiner tells patient to look at the penlight with both eyes open.

3. Examiner holds a centimeter ruler in front of the patient and aligns the zero on the ruler with the outer edge of the patient’s right iris.

4. Examiner finds the Near P.D. by noting the distance between  the outer edge of the patient’s right iris and  the inner edge of the patient’s left iris. See diagram below.

5. Record the Near P.D.

Examiner and Patient: Be careful not to move ruler or head between measuring Near P.D.

and Distance P.D.

To measure Distance Pupillary Distance (P.D.)

1. Examiner moves penlight to just below his/her right eye. Examiner closes his/her left eye.

2. Examiner tells patient to keep looking at the penlight with both eyes open.

3. Examiner finds the Distance P.D. by noting the distance between  the outer edge of the patient’s right iris where the ‘zero’ on the ruler is placed as shown in the diagram below.

 the inner edge of the patient’s left iris.

This is the ‘Distance P.D.’ Without moving the ruler now the patient is asked to look at the penlight just below the examiner left eye.

4. Examiner records the Distance P.D. (Same two points as in step 3) Notes: P.D. is usually within a range of 55 to 75 centimeters. Near P.D. is always less than

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Basic Primary Eye Care Techniques How to make and apply an eye bandage (patch) It is often necessary to cover a person’s eye before sending him or her to a hospital or to a physician. Other times it is necessary to change the bandage for a person who has had an operation. What should you do?

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How to evert (turn out) the upper eyelid

1. Look for the foreign body on the eyeball without lifting the upper eyelid

2. If you cannot find it, take the upper eye lid between the thumb and forefinger

3. Lift the eye lid so it stays on the match stick and with the entire conjunctiva in view, look for the foreign body

4. When you have found it, carefully remove with a clean

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