It's all in the Eyes

Cataracts - (3 findings? 3 physical assessment? diagnosis? 5 nursing care?)

opacity of lens —> decreased vision

Findings:

1. Decreased visual acuity: prescription changes, reduced night vision, decreased color perception)

2. Blurred vision

3. Diplopia

Physical Assessment:

1. Absent red reflex

2. Visible opacity

3. Progressive, painless vision loss

Diagnostic - Opthalmoscope

Nursing Care

1. Visual Acuity - Snellen Chart

2. Opthalmoscope

3. Determine functional capacity due to vision

4. Increase light in room

5. Adaptive devices: magnifying lends, talking devices

Surgery (3 conditions)

1. Awake

2. Eyedrops

3. Goes home when sedative wears off

Cataracts: Post Sx Home Instructions

1. Antibiotic drops

2. Instructions for day & night

3. Ensure no IOP increase

Eyedrops for Cataract Surgery (3)

1. Mydriatic - dilation

2. Cycloplegic - paralyzes accommodation

3. NSAID - inflammation & edema

Chemical Eye Trauma?

IRRIGATE IMMEDIATELY

Eye Trauma

• DO NOT remove foreign objects

Macular Degeneration (4 risk factors? 2 treatments? r/t?)

Macular Degeneration (MD) = Irreversible central vision loss

• Age related

Risk

1. White

2. Obesity

3. Smoking

4. HTN

Treatment

1. Eye Injections: 4 to 6 weeks

2. Photodynamic Therapy (IV verteporfin) - seal leaky blood vessels

Dry AMD (what % of cases? progression rate?)

1. 90% of cases

2. Slow progression

Wet AMD (severity? leads to?)

1. severe

2. most cases of blindness

Normal IOP Value

10-21 mmHg

2nd Leading Cause of Blindness in U.S.

Glaucoma

Primary Open Angle Glaucoma

• Aqueous humor clogged

• Most common

• Slow development

• Peripheral vision loss —> tunnel vision

• IOP: 22-32 mmHg

Primary Open Angle Glaucoma Treatment

• Alpha agonists, beta blockers

• Carbonic anhydrase inhibitors

• Miotics, prostaglandin agonists

Acute Angle Closure Glaucoma (3 general symptoms? 3 visual symptoms?)

• Acute

General

1. Nausea/Vomiting

2. Severe Pain

Visual

1. IV PO Isosorbide

2. Mannitol

3. Glycerol

Peripheral Iroidotomy

Hole in iris for aqueous humor to flow

Subacute Angle Closure Glaucoma

1. Develops over time

2. May have same symptoms BUT not severe

Retinal Detachment Symptoms (4)

1. Halos

2. Spiderwebs

3. Loss of central & peripheral vision → curtain vision

4. Painless

Retinal Detachment: Treatment

Depending on severity:

1. watch & wait

2. surgery

Cryopexy/Photocoagulation - stabilize & seal retina

Scleral Buckling - band around globe + silicone implant

Pneumonic Retinopexy - gas bubble

Vitrectomy