Eyes and Vision

Health Data

What is Glaucoma

group of eye diseases that damage the optic nerve, often

caused by abnormally high pressure within the eye (IOP)

Risk Factors for Open-Angle Glaucoma

• High eye pressure

• Family history of glaucoma

• Age 40 and older for American Americans

• Age 60 and older for general population (especially Mexican Americans)

• Thin cornea

• Suspicious optic nerve appearance with increased cupping (space at the center of the optic nerve)

Glaucoma Prevention

• Get regular eye exams and treat elevated IOP promptly

• Wear protective eye gear if involved in activities that risk eye injury

• Maintain appropriate body weight and blood pressure to avoid diabetes

• Control diabetes, if present

• Eat a varied, well-rounded, and healthy diet

• Include fruits and vegetables with higher vitamins A and C in diet

What are cataracts

leading cause of blindness in the world. It is the clouding of the usually clear lens of the eye, causing a person to see as though looking through a frosty or foggy window, with vision even more affected at night.

• develops slowly

• common in those 65 and older

• lens becomes less flexible, thicker, less transparent

List the Risk Factors for Cataracts

• Increasing age

• Diabetes

• Excessive exposure to sunlight

• Smoking

• Obesity

• High blood pressure

• Previous eye injury or inflammation

• Previous eye surgery

• Prolonged use of corticosteroid medications

• Drinking excessive amounts of alcohol

Teachings to prevent cataracts

• Have regular eye examinations (yearly or 2 at 65 years of age)

• Wear sunglasses that block ultraviolet B rays when outside

• Protect eyes if exposed to ionizing radiation sources (x-rays/radiation therapy)

• Avoid smoking or stop smoking

• Maintain healthy weight, exercise most days, develop a plan to lose weight if overweight

• Eat well-rounded diet with a variety of colorful fruits and vegetables for vitamins, antioxidants, and other nutrients

• Ask health care provider about antioxidants supplements that have been shown to prevent cataracts

• Use protective equipment if necessary to prevent eye injuries

• Seek medical care for prolonged or unusual eye inflammation or for any eye injury

Older Adult Considerations to be aware of during the physical exam/objective data collection for vision

Presbyopia (gradual loss of eye’s ability to focus on near objects) is a

common condition in clients over 45 years of age.

Older Adult Considerations to be aware of during the physical exam/objective data collection for External Eye Structure

• Entropion (eyelid turns inward) and ectropion (eyelid turns outward) are common.

• Yellowish nodules on the bulbar conjunctiva are called pinguecula. Common in older clients and appear first on the medial side of the iris and then on the lateral side.

• Arcus senilis (white/gray ring of the outer edge of the cornea) appearsas a white arc around the limbus. The condition has no effect on vision.

Cultural Considerations to be aware of during the physical exam/objective

data collection for External Eye Structures

• The eyes of African Americans protrude slightly more than those of Whites

• Those of Hispanics protrude less

• Eyes of African Americans of both sexes may protrude beyond 21mm.

• A difference of > 2 mm between the two eyes is abnormal.

• Darker-skinned clients may have sclera with yellow or pigmented freckles.

Cultural Considerations to be aware of during the physical exam/objective

data collection for Internal Eye Structures

Optic discs are larger in African Americans, which is thought to be

associated with the higher rate of glaucoma in this group.

Ptosis

Drooping eye

Ectropion

outwardly turned lower lid

Conjunctivitis

Generalized inflammation of the conjunctiva

Exophthalmos

Protruding eyeballs and retracted eyelids

Chalazion

Infected meibomian gland (oil-producing gland located in the eyelids)

Hordeolum

Stye

Entropion

Inwardly turned lower eyelid

Blepharitis

Staphylococcal (staph) infection of the eyelid

Diffuse Episcleritis

Inflammation of the sclera

Subconjunctival Hemorrhage

Bright red areas of the sclera

Scleral Jaundice

Yellowing of the sclera due to buildup of bilirubin (yellow/orange

pigment in blood)

Pseudostrabismus

Pupils will appear at the inner canthus (medial corner of the eyes,

where the upper and lower eyelids meet, near the nose) due to the

epicanthic fold.

Strabismus (tropia)

A constant malalignment of the eye axis, strabismus is defined

according to the direction toward which they eye drifts and may cause

amblyopia

Strabismus Esotropia

when the eye turns inwards

Strabismus Exotropia

When the eye turns outward

Esophoria

Inward drift eye

Exophoria

outward drift of the eye

amblyopia

one eye has weaker vision than the other, despite having no structural abnormalities

Miosis

Also known as pinpoint pupils, miosis is characterized by constricted

and fixed pupils

Cause of miosis

Possibly a result of narcotic drugs or brain damage.

Anisocoria

Pupils of unequal size. Could be normal or abnormal.

If anisocoria is greater in bright light compared with dim light it is caused by

trauma, tonic pupil (caused by impaired parasympathetic nerve supply to iris), and oculomotor nerve paralysis

If anisocoria is greater in dim light compared with bright light it is caused by

Horner syndrome (caused by paralysis of the cervical sympathetic nerves and characterized by ptosis, sunken eyeball, flushing of the affected side of the face, and narrowing of the palpebral fissure)

Mydriasis

Dilated and fixed pupils

Cause of Mydriasis

typically resulting from CNS injury, circulatory

collapse, or deep anesthesia.