What are the intraocular disorders?
- cataracts
- retinal detachment
- age related macular degeneration
- glaucoma
What are the types of conjunctivitis?
- bacterial (pink eye)
- viral
- Adult Inclusion conjunctivitis (AIC): Chlamydia. This is a major cause of blindness world wide. HANDWASHING very contagious
What is the tx for conjunctivitis?
- systemic or topical antibiotics
- palliative
- corticosteroids
- antihistamines
What are the clinical manifestations of cataracts?
- painless
- decrease in vision is gradual
- abnormal color perception and glare esp at night
What are the pre-op meds before cataracts surgery?
- NSAIDs
- topical antibiotics
- mydriatic medications: (big word big pupil)
- cycloplegic: paralysis accommodation
- note visual acuity in unoperated eye
What should you teach you pt’s post-op cataracts surgery?
-avoid bending, stooping, coughing, valsalva maneuver, or lifting because this increases IOP
Is it unusual if vision decreases right after cataracts surgery?
NO not unusual
What are the gerontologic considerations for cataracts?
- loss of independence
- lack of control
- changes in self perception
- emotional support
- encouragement
- allow maximum level of independent function
What re the 3 types of retinal detachment?
- Spontaneous:
- breaks: full thickness interruption
- holes: atrophic holes
- Aging:
- tears: vitreous humor shrinks and pulls on retina
What are some clinical manifestations of retinal detachment?
- floaters
- cobwebs/hairnet/ring
- “like a curtain coming down”
What should be the first diagnostic procedure with any loss of vision?
visual acuity
What are the 2 types of macular degeneration?
-dry: non-exudate
more common, slow progression with painless vision loss
-wet: exudative
most severe, rapid onset
development of blood vessels in/near macula
What tool is used to monitor macular degeneration?
Amsler grid
What is the medication used for AMD? And what are the nursing considerations?
-Verteporfin: avoid direct sunlight up to 5 days after treatment-may cause burns to skin
Nutritionally what can help AMD?
Vit. C & E. carotene dark leafy veggies fatty fish zinc
What is the pathophysiology behind glaucoma?
abnormal balance of aqueous production (inflow) and rate of reabsorption (outflow).
Explain POAG?
- outflow is low (clogged meshwork)
- gradual visual field loss
- develops slow without pain or pressure
- tunnel vision
Explain angle-closure glaucoma (ACG)?
- decrease in outflow from angle closure
- lens bulges forward (aging)
- possible narrow angle at birth
What causes acute angle closure glaucoma?
- medication induced
- sudden severe pain in or around the eye
What is the normal IOP?
IOP for POAG?
IOP for AACG?
- normal = 10-21
- open angle = 22-32
- AACG = >50
