Visual and Auditory

What are the 4 parts of the eye?

Periocular, external ocular, middle ocular, and internal

What are the 3 main openings in orbit?

Optic canal, superior orbital fissure, and inferior orbital fissure

What are the 3 layers of the eye?

Outer, middle, and inner

What are the 3 external structures of the eye?

Cornea, sclera, and conjunctiva

What are the 4 middle structures of the eye?

Iris, pupil, choroid, and ciliary body

What are the 4 inner structures of the eye?

Lens, retina, aqueous humor, and optic nerve

What are the 2 photoreceptors on the retina?

Rods and cones

What are rods responsible for?

Night vision and peripheral vision

What are cones responsible for?

Central vision and color vision

What is subjective data?

Information the patient tells you

What is objective data?

Information you observe

what information could be included in subjective data about eye health?

Past health history, medications, surgery or other treatments, health perception/management, and nutrition - metabolic patterns (elimination, activity/exercise, sleep/rest, cognitive/perceptual, self perception/self concept, role/relationship, sexuality/reproductive patterns, coping/stress tolerance, and value/belief)

What information is included in objective data of eye health?

Initial observation and assessing functional status (visual acuity - Snellen chart, Jaeger, extraocular muscle function - corneal light reflex, eye movement iii, iv, vi, and pupil function and intraocular pressure - PERRLA), and assessing structures (eyebrows, eyelashes, eyelids, conjunctiva, sclera, cornea, iris, retina and optic nerve using an opthalmascope)

What are 2 special assessment techniques for eye health?

Color vision and stereopsis

What is the definition of refraction?

The eyes ability to bend light rays so that they fall on the retina

what are 4 refractive errors you need to know?

• myopia

• hyperopia

• presbyopia

• astigmatism

what is myopia?

nearsightedness

what is hyperopia?

farsightedness

what is presbyopia?

as you age, your ability to see farsightedness

what is astigmatism?

uneven or irregular curvature of the cornea

what is the treatment for the 5 refractive errors?

• glasses/contacts

• LASEK - use a laser to correct the refractive error

• refractive IOL - removes the natural lens and replaces it with another unnatural one

• Phakic IOL - implants another unnatural lens along with the natural lens

what is the nursing process for eye health?

ADPIE

A: assessment

D: diagnosis

P: planning

I: implementation

E: evaluation

eye trauma is often preventable! irrigate eyes for chemical exposure (Morgan lens) or stabilize injury and DO NOT try to remove foreign objects

what are the 4 extraocular disorders you need to know?

• hordeolum (sty) —→ Chalazion (chronic sty)

• blepharitis (chronic lid infection, itching!)

• conjunctivitis (pink eye due to staph aureus, spreads quickly so good hygiene)

• keratitis (infection of the cornea, herpes simplex virus)

what are the 4 other extraocular disorders?

• dry eyes

• strabismus (straying of the eye)

• corneal scars

• keratoconus (anterior thinning of the cornea which causes it to protrude forward)

*treatment for corneal scars or keratoconus is corneal transplants given through an organ donor. easiest!

what are cataracts?

most often age related opacity/clouding of the lens which could lead to loss of vision

*other causes could be diabetes and hypertension

what is the nonsurgical care for cataracts?

• change glasses

• reading glasses

• magnifying glasses

• lifestyle changes

*no nonsurgical cure for cataracts!

what is the surgical care for cataracts?

• preop

• intraop

• postop care

what is the definition of retinal detachment?

“separation of the sensory retina and the underlying pigment epithelium, with fluid accumulation between the 2 layers”

• tears or holes

• light flashes, floaters, and “cobwebs”

• painless

• 25% can happen to the other eye if untreated

what is the goal for treatment of retina detachment?

• re-attach the retina and seal any retinal breaks

• laser photocoagulation and cryopexy

• scleral buckling

• intraocular procedures like pneumatic retinopexy and vitrectomy

what are some nursing management retinal detachment?

• postoperative care

• medications

• activity restrictions

• emotional support

what is the most common cause of irreversible central vision loss in people over age 60 in US?

age-related macular degeneration (AMD)

what are the two types of age-related macular degeneration?

• dry = most common

• wet = most severe; over accumulation of blood vessels

what to use to identify age-related macular degeneration?

• Amsler grid test

• fundus photography

• IV angiography

• optical coherence tomography (OCT)

• scanning laser ophthalmoscopy n

what are some treatments for age-related macular degeneration?

• medications for wet AMD are directly injected into the vitreous cavity and to stop new vessels from forming

• photodynamic therapy

• dietary supplements

• management of vision loss

what is glaucoma?

• leading cause of blindness of people over 60 years old

• no early symptoms

• disease that damages the optic nerve which is responsible for sending visual messages to the brain

• often happens when the fluid in the eye doesn’t drain like it should causes pressure that damages the optic nerve

• treatment preserves the vision you have not the vision you loss

what is the most common type of glaucoma?

primary open angle glaucoma

what are the 4 intraocular inflammations and infections you need to know?

• uveitis (inflammation of the uvula tract, vitreous body, retina, and/or the optic nerve)

• CMV retinitis (opportunistic infection that can occur with AIDS)

• autoimmune disorders, cancer, IBD; associated with pain and and photophobia

• endophthalmitis (extensive infection of the vitreous body)

• treatment varies depending on the underlying cause

ocular tumors can be benign or cancerous. they can can affect the conjunctiva, retina, and orbit. an example is uveal melanoma (iris)

what is the most common place for melanoma in the eye?

the choroid

what is enucleation?

removal of the eye

• prosthesis

• surgical management (bleeding, pain, infection, swelling)

what are the other systemic disorders with ocular manifestations?

• diabetes

• hypertension

• AIDS