Eye Disorders Flashcards
(38 cards)
Cataract
an opacity within the lens in the eye, may be in one or both eyes. If in both eyes, one eye may affect the persons vision more than the other
causes of cataracts
· Age
· Blunt or penetrating trauma
· Congenital factors such as maternal rubella
· Radiation exposure or UV light (sunlight) exposure
· Certain drugs such as systemic corticosteroids or long-term corticosteroids
Ocular inflammation
clinical manifestations of cataracts
· Decrease in vision
· Abnormal color perception
· Glare (may be significantly worse at night when the pupil dilates)
· Visual decline is gradual, but the rate of cataract development varies from patient to patient.
diagnosis of cataracts
based on decreased visual acuity or other visual problems.
Opacity is directly observable by ophthalmoscopic or slit lamp examination
nonsurgical management for cataracts
· Change in glasses prescription
· Strong reading glasses or magnifiers
· Increased lighting
· Lifestyle adjustment
Preop for cataract surgery
o Mydriatic (used for dilatation), cycloplegic agents (anticholinergic agent)
§ Teach patient to wear dark glasses to minimize photophobia
o NSAIDs (to reduce inflammation)
o Topical antibiotics
o Antianxiety medications
surgery for cataracts
o Removal of lens
o Phacoemulsification
o Extracapsular extraction
o Correction of surgical aphakia
o Intraocular lens implantation (most frequent type of correction)
o Contact lenses
Phacoemulsification
incision is make in the surface of the eye or near the cornea and ultrasonic vibrations are used to dissolve clouded lens into fragments, then these are suctioned out
Extracapsular extraction
cataract is removed in one piece without being fragmented inside the eye, sutures are needed to close the larger wound
postop for cataracts
o Topical antibiotic
o Topical corticosteroid or other anti-inflammatory agent
o Mild analgesia if necessary
o Eye patch or shield and activity as prescribed by patient’s surgeon
o Activity restriction: Activities that increase IOP: bending, stooping, coughing, or lifting
· Photophobia is common when receiving pupil dilation so decreasing room lighting is helpful. These medications may produce stinging and burning
health promotion for cataracts
Suggest patient to wear sunglasses and avoid unnecessary radiation, and maintain appropriate intake of antioxidant vitamins (C & E)
Patient teaching after eye surgery
· Proper hygiene and eye care techniques to ensure that medications, dressings, and/or surgical wound is not contaminated during eye care
· How to monitor pain, take main medication and report pain not relieved by medication
· Importance of continued follow-up as recommended to maximize potential visual outcomes
· Signs and symptoms of infection and when and how to report these to allow for early recognition and treatment of possible infection
· Importance of complying with postoperative restrictions on head positioning, bending, coughing, and Valsalva maneuver to optimize visual outcomes and prevent increased intraocular pressure
How to instill eye medications using aseptic techniques and adherence with prescribed eye medication routine to prevent infection
age-related macular degeneration
most common cause of IRREVERSIBLE CENTRAL VISION LOSS in people over the age of 60 in the US
dry (nonexudative) AMD
o Close vision tasks are becoming more difficult
o Macular cells start to atrophy
o Slowly progressive and painless vision loss
Wet (Exudative) AMD
o More severe form
o More rapid onset
o Development of abnormal blood vessels in or near the macula
clinical manifestations of macular degeneration
· Blurred and darkened vision, scotomas (blind spots in the visual field)
· Distortion of vision (metamorphopsia)
diagnostic for macular degeneration
Primary diagnostic procedure is ophthalmoscopy
what test may define the involved area of macular degneration
The Amsler grid test
treatment for macular degneration
· Limited treatment
· Medications that are injected directly into the vitreous cavity.
· Photodynamic therapy (PDT) uses verteporfin IV and “cold” laser to excite the dye.
· People at risk for developing advanced AMD should consider supplements of vitamins and minerals (in consultation with their health care provider).
Use of vitamin supplements for macualr degeneration
· A dietary supplement of vitamin C, vitamin E, beta-carotene, and zinc decreases the progression of advanced AMD but has no effect on people with minimal AMD or those with no evidence of AMD.
· Eating lots of dark green, leafy vegetables containing lutein (e.g., kale and spinach) may help reduce the risk of AMD
Retinal detachment
separation of the sensory retinal with fluid accumulation between the two layers
· Retinal break
· Retinal hole
· Retinal tear
causes of retinal detachment
· Increasing age
· Severe myopia
· Eye trauma
· Cataract surgery
Family or personal history of retinal detachment
clinical manifestations of retinal detachment
· Patients with a detaching retina describe symptoms that include:
· Photopsia (light flashes)
· floaters and a “cobweb,” “hairnet,” or ring in the field of vision.
· Once the retina has detached, the patient describes a painless loss of peripheral or central vision, “like a curtain” coming across the field of vision.
medical treatment for retinal detachment
· Laser Photocoagulation & Cryopexy
· Scleral Buckling
· Pneumatic retinopexy
· Vitrectomy
