Visual Problems: Extraocular Inflammation & Infection, Conjunctivitis, Cataracts, Retinopathy, Retinal Detachment, Age-Related Macular Degeneration, Glaucoma, and Enucleation

What is hordeolum?

it is an infection of the meibomian gland caused by S. Aureus

• sty

What is chalazion?

it is a chronic inflammatory granuloma of the meibomian glands

What is blepharitis?

it is a chronic bilateral inflammation of the lid margins

What are some signs and symptoms of hordeolum?

• red, swollen eyelid

• tender eyelid

• developed rapidly

What are some signs and symptoms of chalazion?

• swollen, reddened area on upper eyelid 

• may or may not have pain

What are some signs and symptoms of blepharitis?

• red, crusty eyelid around lashes

• burning sensation on eyelid

• irritation

• sensitivity to light

What are some nursing actions and interventions for hordeolum?

• put a warm compress on eye

• give pt. daily lid scrubs

• administer antibiotics when ordered

What are some nursing actions and interventions for chalazion?

• PHP drain lesson

• PHP inject steroids into affected eye

What are some teachings for patients with extraocular inflammation & infections hordeolum, chalazion, blepharitis?

• tell pt. to do warm compresses on affected eye

• tell pt. to do daily lid scrubs

• tell pt. to take all antibiotics

What is bacterial conjunctivitis caused by?

it is caused by S. Aureus

What is viral conjunctivitis caused by?

it is caused by adenovirus

What are some signs and symptoms of conjunctivitis?

• redness in eye

• drainage from eye

• irritation in eye

What are some nursing actions and interventions for conjunctivitis?

• assess for ocular changes

• do warm or cool compresses on eye(s) affected

• put pt. in dark room

• apply analgesics or eyedrops

• ensure pt. safety

What are some teachings for patients with conjunctivitis?

• tell pt. to wash hands before applying eye drops

• tell pt. to not let eye drop applicator tip touch eye

• tell pt. to throw away used contact lenses

• tell pt. to throw away makeup/makeup brushes that have been used around the eyes

What are cataracts?

it is opacity within the eye lens related to age

What can cause cataracts?

• trauma

• smoking

• alcohol use

• radiation

• UV light

• certain drugs

• ocular inflammation

• diabetes

What are some signs and symptoms of cataracts?

• gradual decreased vision

• abnormal color perception

• glare (worse at night)

What are some surgical interventions for cataracts?

• extracapsular cataract extraction

• phacoemulsification

• laser-assisted cataract surgery

What are some nursing actions and interventions for cataracts?

• apply eye drops

• post-op, elevate head of bed

• post-op, restrict pt.’s activity

• post-op, put eye shield on affected eye

What are some teachings for patients with cataracts?

• tell pt. to restrict TV time

• tell pt. to avoid driving a night if possible

• tell pt. to lower lights while inside

• tell pt. to wear eye shield at night time

• tell pt. to wear dark glasses when going outside

What is retinopathy?

it is microvascular damage to the retina

What can cause retinopathy?

• diabetes

- nonproliferative Retinopathy

- proliferative Retinopathy 

• hypertension

What are some signs and symptoms of retinopathy?

• blurred vision

• progressive vision loss

What is a teaching for a patient with retinopathy?

tell pt. with diabetes that lowering and stabilizing their blood sugar can restore vision

What is retinal detachment?

it is the separation of the sensory retina and the underlying epithelium.

What visual problem can lead to permanent vision loss?

retinal detachment can lead to permanent vision loss

What are some signs and symptoms of retinal detachment?

• flashes of light in vision

• floaters in vision

• loss of peripheral or central vision

• “black curtain falling over one side of vision”

What are some surgical interventions for retinal detachment?

• laser photocoagulation - burning 

• cryopexy- freezing

• scleral buckling

What is age-related macular degeneration?

it is damage or aging of the macula

What are some signs and symptoms of age-related macular degeneration?

• black spot in central vision

• blurred vision

• scotomas (blind spots)

• metamorphopsia (vision distortion)

What are some patient teachings for patients with age-related macular degeneration?

• tell pt. they can get meds injected into vitreous cavity every 4-6 weeks

• tell pt. they need to avoid sunlight for 5 days after doing photodynamic therapy 

• tell pt. to take vitamin E, vitamin C, and zinc to help slow down progression

• tell pt. to quit smoking

What is glaucoma?

it is a group of disorders characterized by increased intraocular pressure and its consequences, optic nerve atrophy and peripheral visual field loss

What are some signs and symptoms of primary open-angle glaucoma?

• loss of vision develops slowly

• gradual visual field loss

• eventual loss of peripheral vision

What are some signs and symptoms of acute angle-closure glaucoma?

• sudden vision loss

• severe eye pain

• nausea & vomiting

• colored halos around lights

• blurred vision

• eye redness

What are some teachings for patients with glaucoma?

• tell pt. to have regular eye exams

• tell pt. that they will have to continue treatment for the rest of their life

• let pt. know there is no cure for glaucoma

What is enucleation?

it is the removal of one of both eyes

What can cause enucleation?

• glaucoma

• infection of the eye 

• trauma to eye 

• cancer of the eye

What are some nursing actions and interventions for enucleation?

• assess for bleeding of where eye was removed

• assess for swelling around area where eye was removed

• assess for pain at area where eye was removed

• assess for fever after eye removal

What is the teaching for patients with enucleation?

tell pt. they can get fitted for a prosthesis about 6 weeks after surgical removal of eye

What is the normal intraocular pressure?

10-21mmHg

What is myopia?

it is nearsightedness

What is hyperopia?

it is farsightedness

What is presbyopia?

it is loss of eyesight due to aging

What is an astigmatism?

it is irregular or abnormal curvature of retina

What is aphakia?

it is a complete absence of eye lens

What is visual impairment?

it is vision that cannot be fully corrected by corrective lenses, medical treatment or surgery

What is legally blindness?

• best corrected vision in better eye of 20/200 or less

• 20 degrees or less of remaining visual field

What is a Morgan Lens?

it has a continuous irrigation of the eye due to chemicals getting in the eye

What picture depicts cataracts?

What picture depicts what someone sees when they have retinal detachment?

What picture depicts what people with age-related macular degeneration see?