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.