Nursing Care of Eye and Ear Disorders

Anatomy of the Eye

• The globe measures about 1 inch in diameter and is housed within the orbit.
• The eye is held in place by connective tissue and muscles that control eye movement.
• The oculomotor nerve (third cranial nerve) causes motion of the eyeballs and upper eyelids.
• The optic nerve (second cranial nerve) provides the sense of vision.

Eye Structures

• Sclera: the "white of the eye".
• Cornea: a transparent layer that allows light to enter the eye.
• Conjunctiva: a thin membrane covering the sclera and inside of the eyelids.
• Iris: a colored part of the eye that controls the amount of light entering the eye.
• Pupil: the opening in the center of the iris that allows light to enter the eye.
• Lens: a clear, flexible structure behind the iris that focuses light.
• Retina: converts light impulses to nerve signals.

Types of Vision

• Central vision: enables visualization of objects directly in front of you.
• Peripheral vision: enables visualization of lateral objects while looking straight ahead.

Lacrimal Apparatus

• Secrete and drain tears from the eye to moisten the conjunctivae.

Symptoms of Serious Ocular Conditions

• Visual loss that does not improve with blinking.
• Double vision.
• Severe eye pain.
• Foreign body sensation.

Patient Assessment

• Assess for pain/tenderness, swelling, abnormal or loss of movement, sensation changes, circulatory changes, and visual changes.
• Examine structures for any abnormalities, such as ecchymosis, swelling, lacerations, foreign bodies, pigmentation, and tenderness.
• Pupils: assess size, shape, equality, and reaction to light.
• Visual acuity: assess ability to see large and small letters.

Aging-Related Eye Changes

• Conjunctivitis: an inflammation of the conjunctiva caused by a virus, bacteria, allergies, or foreign bodies.
• Blepharitis: a chronic inflammatory process causing inflammation of the eyelid margins.
• Keratitis: an inflammation of the cornea that may be associated with bacterial conjunctivitis, viral infections, corneal ulcers, or diseases such as tuberculosis and syphilis.