eyes and ear disorders

Visual Acuity Assessment

Always assess visual acuity.

Infection Control for Eye Infection

Wash hands frequently, use eye drops as prescribed, don't strain or bend, wash sheets/pillowcases, use 2 different eye drop containers for each eye, change eye makeup, get a new pack of contacts if affected.

Techniques for Patients with Reduced Vision

Counting steps to the bathroom, lost central vision, decluttering the house, using public transportation, keeping items in the same spot, brightly labeling medications, using talking devices.

Increases Intraocular Pressure (IOP)

Bending over, straining while pooping, glaucoma, keratoplasty, retinal detachment, cataracts.

Cataracts

Cloudiness/blurry vision.

Signs of Cataracts

Blurred vision, decreased color perception, double vision, hard to see at night, diminished or absent red reflex, bluish gray, occurs gradually.

Pre-operative Education for Cataract Surgery

Educate patient that vision might not be 20/20, discontinue blood thinners, may have to take eye drops/steroids 2 days prior to surgery, they will numb the eye, and give dilatation drops.

Post-operative Care for Cataract Surgery

Antibiotics/anti-inflammatory/steroids, wear dark glasses outside, use eye drops as ordered, itchy and scratching feeling is normal after surgery, avoid bending or straining, don't lift more than 10 pounds.

Glaucoma

Increased intraocular pressure (IOP) due to excessive production or inadequate drainage of aqueous humor.

Signs of Primary Open-Angle Glaucoma (POAG)

Foggy vision, mild eye aching/headaches, halos around lights, decreased vision that doesn't improve with glasses, progressive peripheral vision loss.

Signs of Acute Angle-Closure Glaucoma (PACG)

Sudden severe pain radiating around the face, headache/brow pain, nausea/vomiting, colored halos around lights, sudden blurred vision with decreased light perception, sclera may appear red, nonreactive pupil.

Nursing Implications of Drug Therapy for Glaucoma

Don't stop taking eye drops, wait 10-15 min in-between each drop, watch for signs of hemorrhage post-op.

Macular Degeneration

Deterioration of the macula causing central vision loss.

Signs and Symptoms of Macular Degeneration

Loss of central vision, becomes blurry.

Dry Macular Degeneration

Gradual blockage, retinal cells become ischemic and necrotic, central vision declines with mild burning and distortion.

Wet Macular Degeneration

Growth of new blood vessels that leak blood and fluids.

Nursing Interventions for Dry Macular Degeneration

Give vitamins E, C, and zinc, provide large print materials, assist with public transportation.

Retinal Detachment

Separation of the retina from the epithelium.

Signs and Symptoms of Retinal Detachment

Floaters, flashes of light, curtain being pulled over, sudden painless vision loss.

Nursing Interventions for Retinal Detachment

Make sure eye is covered, restrict activity and head movement pre-op.

Corneal Abrasions

Scrape or scratch injury of the cornea.

Signs of Corneal Abrasions

Pain, reduced vision, photophobia, secretion.

Refractive Errors

Problems with the bending of light rays.

Myopia

Nearsightedness; eye over-refracts light, can't see far away.

Hyperopia

Farsightedness; refraction is too weak, can't see close up.

Presbyopia

Age-related loss of lens elasticity, affecting close work.

Astigmatism

Uneven curvature of the cornea.

Corrective Measures for Refractive Errors

Glasses, contacts, LASIK.

Conductive Hearing Loss

Obstruction of sound wave transmission.

Sensorineural Hearing Loss

Damage to the inner ear or auditory nerve.

External Otitis

Allergic response or inflammation of the external ear with or without infection.

Otitis Media

Ear infection caused by strep, flu, or viral agents.

Mastoiditis

An infection of mastoid air cells, often progressive otitis media.

Meniere's Disease

Excess of endolymphatic fluid distorting the inner canal.