Question

A nurse shines a light toward the bridge of the patient's nose and notices that the light reflection in the right cornea is at the 2 o'clock position and in the left cornea at the 10 o'clock position. Based on these data, the nurse should take what action?

a. Document these findings as normal.
b. Perform the cover-uncover test.
c. Perform the confrontation test.
d. Document these findings as abnormal.

Answer 1

Asymmetrical corneal light reflections observed by a nurse indicates a possible misalignment of the eyes, considered abnormal. The appropriate action is to perform the cover-uncover test to detect strabismus or phorias.

Step-by-step explanation:

When a nurse shines a light toward the bridge of the patient's nose and observes asymmetrical corneal light reflections, this could indicate a misalignment of the eyes, commonly known as strabismus. Normally, the light reflection should be centered or at the same position in each cornea. Since the light reflection is at the 2 o'clock position in the right cornea and 10 o'clock in the left, these findings are considered abnormal. The appropriate action to take would be b. Perform the cover-uncover test.

The cover-uncover test is used to detect the presence of strabismus or phorias by covering one eye at a time and observing for any movement in the uncovered eye. It assesses if there is a latent deviation that becomes evident only when the sensory fusion is interrupted. If the uncovered eye moves to fixate on the object upon covering the other eye, it suggests that the eye was previously misaligned.