209: Eyes

Question 1

Concept of Sensory Perception

Answer 1

Ability to receive sensory input and translate the stimulus into meaningful information.

Question 2

Why is vision important

Answer 2

Essential to a persons health and well-being. Impacts all ADL.

Question 3

Structures of the eye

Question 4

Structures of internal eye

Question 5

Developmental Considerations in older adults

Answer 5

Presbyopia, Macular degeneration, cataracts, glaucoma, diabetic retinopathy

Question 6

Culutral and social considerations

Answer 6

• vision care is often unaffordable.
• Most provincial health plans only cover eye tests up to age 18.
• None pay for eye exams 20-64.
• none cover eyeglasses
• for low-income vision care assistance have to be on social assistance
• many doctors don’t have necessary screening equipment

OVERALL: nurses must be aware of patients SDOH and advocate and help patients who need help paying for eye care/equipment

Question 7

intersection of eye care and systemic racism and stigma

Answer 7

• racialized groups often underrepresented in research for vision services and care
• african descent experience high rates of visual impairment–NOT genetic but from lack of affordable access to care
• indigenous people have high incidence of diabetes but have limited access to facilities with eye exams

Question 8

presbyopia

Answer 8

decreased ability of accommodation for near vision (after age 40)

Question 9

macular degeneration

Answer 9

breakdown of MACULA, lose central vision (leading cause of blindness over 65)

Question 10

Cataracts

Answer 10

clumping of proteins in the lens causes cloudiness

Question 11

glaucoma and signs

Answer 11

increased pressure in eye. aqueous humor is being produced faster than it can be reabsorbed

signs: sees halos around lights, vision decreased

Question 12

diabetic retinopathy

Answer 12

blood sugars too high so leads to damage to vessels in retina

Question 13

diplopia

Answer 13

see two images

Question 14

strabismus

Answer 14

muscle weakness

Question 15

test for strabismus

Answer 15

cover-unconver test: if eye jumps back when you uncover one then strabismus

corneal light reflex: symmetrical light reflection off of same spot in both eyes

Question 16

test for vision distance

Answer 16

snellen eye chart

Question 17

test for near vision

Answer 17

jaeger eye chart

Question 18

testing pupils

Answer 18

PERRLA
pupil response:
direct and consensual light reflex
AND
accommodation and convergence (looking at a point in distance then focusing on point in front of you)

Question 19

what are we looking for with the opthalmoscope?

Answer 19

inspecting ocular fundus and structures
red reflex (from light)
cornea, anterior chamber and lens
vitreous body: no lumps or floaters
optic disc: colour, shape, margins, cup-disc ratio
retinal vessels: veins are bigger, arteries are smaller
macula: darker circle with dot (fovea) inside

Question 20

test for peripheral vision and occulomotor muscles

Answer 20

confrontation test. examiner and patient cover one eye. test 50 deg superior, 60 deg nasal, 70 deg inferior, 90 deg temporal

Question 21

how to use opthalmoscope

Answer 21

positive dioptres: focus on near objects
negative dioptres: focus on objects farther away