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MedSurg 1 > Visual Problems > Flashcards

Visual Problems Flashcards

1
Q

Conjuctivitis

A

pink eye d/t bacterial, fungal, or viral infection

  • transmitted through direct contact
  • chemical irritation
  • ranges from mild to severe
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2
Q

Conjuctivitis: S/Sx

A 
erythema
tearing
discharge (water, purulent, mucoid)
pruritis
burning
photophobia
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3
Q

Conjuctivitis: Tx

A

Rx topical antibiotic (gtts or ointments)

*antihistamine for allergic response to antibiotic

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4
Q

Blepharitis

A

chronic irritation of eyelid margins d/t staph or seborrhea (dandruff)

Sx: red-rimmed eye w or w/o drainage, crusting of lid margins.

Tx: baby shampoo to keep area clean, warm compress, potentially dandruff shampoo

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5
Q

Stye (hordeolum)

A

inflammation or infection of superficial lid margin (staph)

Sx: red, swollen, tender area

Tx: warm compresses (continuous or at least 20 min QID), may need antibiotic ointment

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6
Q

Chalazion

A

chronic inflammation of the meibomian gland

Sx: swollen, non-painful red area of lid (upper lid is more common)

Tx: warm compresses, may need to surgically remove

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7
Q

Keratitis

A

inflammation or infection of cornea from organisms or excessive dryness.

Need to prevent corneal ulcer or scarring.

viral: from herpes simplex

noninfectious from extended wear of contact lenses

trauma: corneal scratch, etc

exposure to intense light

epithelial damage caused by contact lenses, nutritional def, immunosuppressed

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8
Q

Cataract: Definition and Cause

A

opacification or clouding of the lens of the eye which interferes with light transmission to the retina and the ability to perceive images clearly

Cause:

  • Senile cataracts d/t agin process (begins around 50yo)
  • Congenital: first trimester infections, pregnant pt’s who were exposed to mumps, measles, hepatitis, mono, chicken pox, then kids are going to have high risk factors for visual problems when born
  • Trauma
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9
Q

Cataract: Risk Factors

A
  • UV rays
  • systemic or topical corticosteroid use
  • DM
  • ETOH
  • smoking
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10
Q

Cataract: S/Sx

A

Unilateral or bilateral

Early Sx: blurred vision, decreased color perception, glare or halos around light. Difficulty with hs driving.

Late Sx: diplopia, absence of red reflex, white pupil, decreased vision progressing to blindness

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11
Q

Cataract: Interventions

A

Corrective lens, then surgery

Surgery = same day with local anesthetic

  • preoperatively: nurse instills anti-inflammatory, dilating, and paralyzing drops
  • intraoperatively: lens is replaced with another lens
  • postoperatively: patch worn overnight, removed next day by MD at f/u appt in office

no stitches needed as IOP seals eye

education:
- avoid activities that increase IOP for 1 week
- continue eye gtts
- cornea may be cloudy
- vision should be almost normal but may need glasses for near vision
- call or go to ER for sudden severe eye pain or brow pain (signs of increased IOP or hemorrhage)
- primary prevention = wear sunglasses with UV filter, wear hat.

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12
Q

Activities that Increase IOP

A 
lifting more than 5lbs
straining (like when you have BM)
coughing
sneezing
bending
stooping
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13
Q

Retina

A

contains photoreceptors which allow for perception of light and initial processing of images and stimuli for transmission to the optic center of brain.

Disruption of retina interferes with light perception and image transmission and may result in blindness.

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14
Q

Retinal Detachment: Definition and Cause

A

separation of retina (sensory portion) from the choroid (vascular layer), can start as a tear then progress to full detachment

Cause: trauma, cancer, inflammation
-usually spontaneous d/t shrinking of VH which pulls retina away

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15
Q

Retinal Detachment: Risk factors

A

aging
myopia (near-sightedness)
aphakia (lens removal)

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16
Q

Retinal Detachment: S/Sx

A 
floaters
flashing lights
shadows
veils/curtains in vision
progressively blurring vision

c/o = painless loss of peripheral or central vision

medical emergency

17
Q

Retinal Detachment: Interventions

A
  • position supine to promote closer contact of retina with choroid
  • surgery
  • post op education: positioning, avoiding increase in IOP, reporting worsening pain and sudden loss of vision, avoid eye movements (reading/writing), gradual return to normal activity (5-6 weeks).
18
Q

Age-Related Macular Degeneration (AMD): Definition and Types

A

aging retina allows formation of abnormal accumulation of waste material in retinal pigment - failure of outer layer to remove waste

Types:

  • Dry = 90% of cases, atrophy of macular cells
  • Wet = abnormal blood vessels develop near macula, more severe form and causes 90% of AMD blindness
  • dry may develop into wet
19
Q

AMD: Risk Factors

A 
UV light
smoking
light eye color
HTN
FHx
20
Q

AMD: S/Sx

A
  • close vision tasks become difficult
  • gradual loss of central vision progressing to legal blindness
  • c/o holes in vision (scotomas), distortion of straight lines, blurred vision
  • hallmark sign = drusen (yellow exudate) in fundus of eye which causes atrophy and degeneration of macular cells
21
Q

AMD: Interventions

A

focus is on preventative as interventions are only a little effective

  • Dry: nutrition to help prevent progression (dietary supplements - zinc, beta carotene, vit A, C, E - green leafy veggies, fish/omega-3 fatty acids).
  • wet: medications injected directly into VH every 4-6 weeks (slow vision loss), photodynamic therapy (combo of injected medication activated by laser - destroys abnormal blood vessels formed in retina)
22
Q

Glaucoma: Definition and Types

A

condition characterized by increased IOP, ocular nerve atrophy, loss of peripheral vision

Types:
Primary Open-Angle Glaucoma (POAG)
Acute Angle Closure Glaucoma (AACG)

23
Q

IOP Balance

A

balance between AH production (inflow) and AH reabsorption (outflow)

when the balance is correct = normal IOP = 10-21 mm Hg

without balance, glaucoma develop

24
Q

POAG

A

90% of cases of glaucoma
AH outflow is decreased

S/Sx: gradual loss of peripheral vision leading to blindness (tunnel vision = end stage)

Pt doesn’t recognize = silent thief (slow and painless)

Intervention: decrease IOP with medications (no cure, use gtts for rest of life), laser surgery if meds don’t work

25
Q

AACG

A

10% of cases of glaucoma
ocular emergency
AH flows in but cannot flow out d/t lens bulging forward

S/Sx: sudden onset

  • halo/blurry vision
  • severe generalized ocular pain
  • n/v d/t severe pain
  • erythema
  • pupil nonreactive

*IOP greater than 50 mmHg

Interventions: decrease IOP immediately with medications (gtts or IV*), surgery
*use hyperosmotic fluid

Post-op: analgesics, eye gtts
avoid increased IOP and no driving for 1 week
no water in eye
no reading

MedSurg 1 (18 decks)

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