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Ophthalmology Exam Notes

Open-Angle Glaucoma

  • Most common type of glaucoma.
  • Often presents with no early symptoms.

Macular Degeneration

  • Vision change most associated: Loss of central vision.
  • Patients see distorted straight lines.
  • Affects central vision loss.
  • Test used for screening: Amsler Grid.
  • Diagnostic tool to evaluate central visual field loss: Amsler Grid
  • Vitamin A and zinc may slow AMD progression.

Wet AMD

  • Typical treatment is Anti-VEGF injections
  • Involves neovascularization

Eye Drop Administration

  • Multiple eye drops should be administered 5-10 minutes apart.

Scleritis

  • Condition presents with severe ocular pain.
  • Often autoimmune-related.

Post-Cataract Surgery

  • Patients should avoid bending, lifting, and straining.
  • Requires no pressure or rubbing of the eye afterward.
  • Report pain, floaters, or vision changes immediately after cataract surgery.

Exenteration

  • Removal of the entire orbital contents.

Fluorescein Angiography

  • Exam uses a dye to assess blood flow in the retina.
  • Evaluates retinal vessels in diabetic retinopathy.

Keratitis

  • Condition associated with HSV and corneal inflammation.

Scotoma

  • A blind spot in the visual field.

Atropine

  • Used to dilate the pupil (mydriatic).

Keratoconjunctivitis Sicca

  • Dry Eye Syndrome.

Miotics (e.g., Pilocarpine)

  • Potential side effect: Night vision difficulty.

Artificial Tears

  • Essential teaching: Use regularly even if symptoms improve.
  • Used for lubrication for dry eye.

Glaucoma

  • Leading cause of irreversible blindness.
  • Who is at higher risk: African Americans
  • Condition characterized by increased intraocular pressure.

Pilocarpine

  • Used to constrict the pupil (miotic).

Refraction Testing

  • Determines corrective lens prescription.
  • Helps determine the need for corrective lenses.

Dorzolamide

  • Eye drop should not be used in sulfa-allergic patients.

Tonometry

  • Device helps assess IOP noninvasively.
  • Diagnostic test measures intraocular pressure.
  • Test confirms glaucoma

Gerontologic Considerations in Eye Care

  • Increased glare sensitivity.
  • Elderly should avoid rugs and clutter due to fall risk from poor depth perception

Astigmatism

  • Caused by irregular curvature of the cornea.

Cataracts

  • Treatment: Surgical lens removal/replacement.
  • Most common cause of blindness globally.

Myopia

  • Medical term for nearsightedness.

OCT

  • Stands for Optical Coherence Tomography.

Angle-Closure Glaucoma

  • Symptoms: Severe pain, halos, N/V.
  • Mydriatics should be avoided in angle-closure glaucoma because they increase IOP.
  • What causes halos around lights and mid-dilated pupil: Acute angle-closure glaucoma.
  • What type of glaucoma is a medical emergency?: Angle-closure glaucoma.

Diabetic Retinopathy

  • Treatment: Laser photocoagulation.
  • Eye disorder is due to damaged retinal blood vessels from diabetes.
  • Disease involves both arteries and capillary damage from hyperglycemia.

Entropion

  • Inward turning of the eyelid.

Photophobia

  • Light sensitivity.

Eye drop instillation

  • Technique that must always be used: sterile technique

Latanoprost

  • Eye drop can cause iris darkening and longer eyelashes.
  • Class: Prostaglandin analog

Presbyopia

  • Patient population often experiences: Older adults over 40.
  • Age-related condition results in difficulty seeing up close

Retina

  • Function: Converts light into neural signals.

Ultrasound (B-scan)

  • Imaging is used when cataracts block direct visualization.

Hyperopia

  • Medical term for farsightedness.

Brimonidine

  • Side effects: Dry mouth and fatigue.
  • Medication causes dry mouth and fatigue but lowers IOP
  • Class: Alpha agonist

Photopsia

  • Flashes of light.

Steroid Eye Drops

  • Risk: Increased infection risk.
  • Key sign of ocular infection from steroid use: Persistent redness or discharge

Vision Loss

  • Report immediately after cataract surgery: Pain, floaters, or vision changes.
  • Nursing diagnosis is most appropriate: Risk for injury
  • Vision loss is permanent and irreversible, so patients should not skip glaucoma drops.

IOP Monitoring

  • How often should IOP be monitored in glaucoma patients: As prescribed, usually every 3-6 months

Strabismus

  • Term for misaligned eyes.

Ptosis

  • Drooping eyelid.

Enucleation

  • Removal of the eyeball.

Trabeculectomy

  • Surgical procedure to lower IOP.

Ectropion

  • Outward turning of the eyelid.

Mydriatics

  • Class of drugs are contraindicated in closed-angle glaucoma.

Eye Ointment Application

  • Technique: Apply from inner to outer canthus.

Clockface Placement

  • Used for helping blind patients eat independently.

Slit-Lamp Exam

  • Test uses a special microscope to view the cornea and lens.

Bradycardia

  • Why is bradycardia a concern with eye meds: Systemic absorption of beta-blockers

Trichiasis

  • Inward turning of eyelashes.

Timolol Eye Drops

  • What to check before giving: Blood pressure and heart rate.
  • Medication class: Beta-blocker

Chemical Burn to the Eye

  • First response: Irrigate for 15+ minutes.

Retinal Detachment

  • What causes a 'curtain over vision' symptom?: Retinal Detachment
  • Sign post-surgery: Sudden floaters or curtain vision.
  • Presents with floaters and a curtain over vision

Dry Eye Syndrome

  • Common symptom: Gritty or burning sensation.

Fluorescein Dye Test

  • Highlights corneal abrasions.

Chemical Eye Exposure

  • Priority treatment: Flush immediately.

Foreign Body in the Eye

  • First nursing action: Irrigation.

Refraction test

  • Helps determine the need for corrective lenses.

Lighting for Visually Impaired

  • Best lighting: Bright, non-glare lighting.

Cycloplegics

  • Used for: Paralyze the ciliary muscle and dilate pupil
  • Role of cycloplegics in uveitis: Reduce pain and prevent synechiae

Visual Field Testing

  • Tool helps assess field cuts in glaucoma.

Ketorolac

  • Used for post-op inflammation in eye care.

Environmental Changes for Low-Vision Patients

  • Clear, clutter-free pathways.

Punctal Plugs

  • Purpose: Block tear drainage to treat dry eye.

Eye Drops with Preservatives

  • Medication should be spaced apart from contact lens use.

Chemosis

  • Conjunctival edema.