Care of the Patient with an Eye Disorder

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the correct sequence of structures that light must travel through to reach the retina?

Aqueous humor ➡️ pupil ➡️ cornea ➡️ vitreous humor ➡️ crystalline lens

Vitreous humor ➡️ cornea ➡️ pupil ➡️ crystalline lens ➡️ aqueous humor

Cornea ➡️ aqueous humor ➡️ pupil ➡️ crystalline lens ➡️ vitreous humor (correct)

Cornea ➡️ vitreous humor ➡️ pupil ➡️ crystalline lens ➡️ aqueous humor

Which symptom is NOT typically associated with eye conditions?

Photophobia

Floaters

Chest pain (correct)

Excessive tearing

What does Snellen's test primarily evaluate?

Refraction

Visual acuity (correct)

Eye health

Visual fields

Which condition can be assessed using the Amsler grid?

Disturbances in central vision Signup and view all the answers

The refraction test is primarily used to determine which of the following?

Degree of visual disorders Signup and view all the answers

What is the primary focus of nursing interventions for visually impaired patients?

Assistance with activities of daily living (ADLs) Signup and view all the answers

Which of the following is characteristic of functional blindness?

Light perception but no usable vision Signup and view all the answers

Which diagnostic test is specifically used to evaluate retinal blood flow?

Fluorescein angiography Signup and view all the answers

What type of surgery involves reshaping the cornea to correct myopia?

Radial keratotomy (RK) Signup and view all the answers

Which of the following is not a common clinical manifestation associated with visual impairment?

Improved color perception Signup and view all the answers

In which of the following conditions would dilating drops commonly be used during an examination?

Retinal examination Signup and view all the answers

What is the primary treatment method for retinal detachment?

Pneumatic retinopexy Signup and view all the answers

Which of the following is NOT a common clinical manifestation of open-angle glaucoma?

Severe eye pain Signup and view all the answers

What is the most common cause of retinal detachment?

Age-related changes Signup and view all the answers

Which procedure is indicated for acute angle closure glaucoma?

Iridectomy Signup and view all the answers

What should patients consider when managing glaucoma?

African Americans should have more frequent eye examinations Signup and view all the answers

What is the primary purpose of Intacs in patients with keratoconus?

To improve vision by reshaping the cornea. Signup and view all the answers

Which nursing intervention is appropriate for a patient who has just undergone surgery involving Intacs?

Instruct the patient to wear an eye patch overnight. Signup and view all the answers

What is the common etiology of a hordeolum?

Staphylococcus organism. Signup and view all the answers

Which of the following is a clinical manifestation of blepharitis?

Light sensitivity and tearing. Signup and view all the answers

How can conjunctivitis be described in terms of its contagiousness?

It is self-limiting but highly contagious under certain conditions. Signup and view all the answers

What is the recommended nursing intervention for a patient with a hordeolum?

Application of warm compresses. Signup and view all the answers

Which diagnostic test is commonly performed to assess hordeolum and chalazion?

Culture and sensitivity testing. Signup and view all the answers

Which visual impairment results from strabismus?

Difficulty in maintaining symmetric eye focus. Signup and view all the answers

What is the most common clinical manifestation of the disease mentioned?

Severe eye pain Signup and view all the answers

What viral agent is most commonly associated with corneal issues?

Herpes simplex virus Signup and view all the answers

What is a common clinical manifestation of cataracts?

Blurred vision Signup and view all the answers

Which of the following is NOT a common risk factor for dry eyes?

Excessive screen time Signup and view all the answers

What is the purpose of the Schirmer's test?

To assess tear production Signup and view all the answers

Which of the following is NOT a recommended nursing intervention postoperatively for cataract surgery?

Encourage heavy lifting Signup and view all the answers

Which diagnostic test is commonly used to assess diabetic retinopathy?

Ophthalmoscopy Signup and view all the answers

What is a possible surgical intervention for severe dry eye conditions?

Punctal occlusion Signup and view all the answers

What is the primary treatment method for wet age-related macular degeneration?

Photocoagulation Signup and view all the answers

Which symptom could indicate uncontrolled ocular inflammation and possibly lead to vision loss?

Blepharospasms Signup and view all the answers

What is a characteristic sign of age-related macular degeneration?

Presence of drusen Signup and view all the answers

What is the primary cause of keratoconjunctivitis sicca?

Autoimmune disorder Signup and view all the answers

Which factor has been linked to the development of cataracts aside from aging?

Smoking Signup and view all the answers

Which treatment is likely to provide relief from dry eye symptoms?

Artificial tears Signup and view all the answers

What condition is characterized by the inward turning of the eyelid?

Entropion Signup and view all the answers

What does the term 'floaters' commonly refer to in relation to diabetic retinopathy?

Visible debris in the vitreous humor Signup and view all the answers

How does dry age-related macular degeneration primarily affect vision?

By causing blurred vision due to atrophy of the macular region Signup and view all the answers

In which age group does cataract formation significantly increase?

65 years and older Signup and view all the answers

What is the primary goal of photocoagulation treatment in diabetic retinopathy?

To seal leaking blood vessels Signup and view all the answers

Which intervention is crucial for patients post-cataract surgery when it comes to protecting their sight?

Maintaining prescribed eye shield until removed by HCP Signup and view all the answers

Study Notes

Physiology of Vision

Light travels through cornea, aqueous humor, pupil, crystalline lens, and vitreous humor to reach rods and cones in retina.
Images are transmitted via the optic nerve to the cerebral cortex's visual center.

Patient Assessment for Eye Health

Review body systems verbally.
Assess for symptoms: eye pain, pruritus, photophobia, excessive tearing, dryness, floaters, light flashes, scotomas, halos, diplopia, discharge, visual changes, and blind spots.
Evaluate headaches and nystagmus (involuntary eye movements).
Gather history of allergies, and current medications (OTC and prescriptions).
Note use of visual assistive devices (glasses, contacts, magnifying glasses).
Discuss personal habits regarding eyewear care.
Document any previous eye injuries or surgeries.

Laboratory and Diagnostic Examinations

Conduct tests for visual acuity, visual fields, and refraction.
Snellen’s test measures visual acuity from 20 feet using a chart.
Refraction involves bending light rays to assess visual disorders like hyperopia and myopia.
Visual field tests identify loss in any of six visual fields.
Amsler grid checks for central vision disturbances, like macular degeneration.
Slit-lamp examination assesses various eye structures, potentially using dilating drops for better visibility.
Fluorescein angiography studies retinal blood flow; essential for diagnosing retinal conditions.
Tonometry measures intraocular pressure to detect glaucoma.

Disorders of the Eye

Blindness: Total blindness lacks light perception; functional blindness detects light but no usable vision; legal blindness indicates visual acuity of 20/200.
Common causes include congenital defects, diabetic retinopathy, glaucoma, and trauma.
Clinical signs encompass diplopia, pain, floaters, light flashes, and emotional distress.
Treatments involve corrective eyewear, medications, assistive devices, and potential surgeries.

Refractory Errors

Myopia: Nearsightedness makes long-distance viewing difficult.
Hyperopia: Farsightedness affects close-range vision.
Surgical options for correction include LASIK and various keratoplasty procedures.

Eyelid Disorders

Hordeolum: Stye caused by Staphylococcus, presenting with tenderness and redness.
Chalazion: Inflammatory cyst on meibomian gland, yielding discomfort and visual disturbances.
Blepharitis: Eyelid inflammation due to infection or allergies; characterized by pruritus and erythema.

Inflammation of Conjunctiva

Conjunctivitis arises from viral/bacterial infections or allergies, marked by redness and discharge.
Quick diagnosis via scraping for microscopy, with treatment focusing on infection prevention.

Keratitis

Corneal inflammation resultant from various causes, including irritants and infections like HSV.
Characterized by severe pain, photophobia, and potential visual disturbances; management may include antibiotics and possibly surgery.

Dry Eye Disorders

Result from decreased tear production or increased evaporation, often linked to autoimmune disorders.
Symptoms: redness, sandy sensation, photosensitivity; management includes artificial tears and punctal plugs.

Eyelid Structural Disorders

Ectropion: Outward eyelid turning; may result from muscle dysfunction or trauma.
Entropion: Inward turning of eyelids due to tissue atrophy; leads to dry cornea.
Surgical interventions are preferred for correction.

Cataracts

Characterized by clouding of crystalline lens, affecting vision, especially in older adults.
Approximately 50% of seniors aged 65-74 experience cataract formation.### Cataracts
Incidence increases to approximately 70% after the age of 75.
Can be congenital due to maternal rubella exposure.
Acquired cataracts linked to systemic diseases like diabetes mellitus and hypertension.
Contributing factors include trauma, toxins (radiation, UV light, corticosteroids), intraocular inflammation, and smoking.
Clinical manifestations include blurred vision, diplopia, photosensitivity, glare, difficulty driving at night, and no pain involved.
Assessment includes subjective reports of blurred vision and light sensitivity; objective examination focuses on reading difficulty and diagnostic tests like ophthalmoscope or slit-lamp examination.
Medical management often involves adjusting eyewear for night vision and surgical options, with cataract removal being day surgery.
Nursing interventions include installing eye drops preoperatively and instilling mydriatic or corticosteroid drops postoperatively, including patient education on activity limitations and wearing UV-blocking sunglasses.

Diabetic Retinopathy

Characterized by retinal blood vessel changes like microaneurysms, hemorrhages, and new blood vessels due to diabetes.
Approximately 15 years after diagnosis of Type 1 diabetes, nearly all patients will have some retinopathy.
Early stages may show no visual impact; symptoms often assessed through ophthalmoscope or by reports of floaters.
Medical management includes photocoagulation and vitrectomy, focused on sealing leaking blood vessels and removing excess fluid.
Postoperative care involves monitoring for vision changes and the administration of topical medications.

Condition primarily affects central and near vision, categorized as wet or dry.
Wet ARMD involves new blood vessel growth leading to scarring, potentially resulting in blindness in 10% of cases; may be treated by photocoagulation.
Dry ARMD accounts for 90% of cases, characterized by outer retinal layers' breakdown leading to blurred vision, with no known treatment.
Hallmark signs include drusen in fundus and gradual loss of bilateral central vision.
Medical management may include medications to inhibit new vessel growth and low vision aids for improved function.

Retinal Detachment

Occurs when the retina separates from the choroid, often due to trauma or retinal holes; can lead to flashes of light and visual field loss.
Subjective symptoms include the sensation of a curtain over the eye; objective care focuses on visual capability assessments.
Medical management options include laser photocoagulation and scleral buckling to reattach the retina.
Post-procedure care includes the use of eye drops, patching, and patient education regarding activity limitations.

Glaucoma

Characterized by elevated intraocular pressure and progressive peripheral vision loss, with an incidence of blindness at 12-15%.
Open-angle glaucoma is bilateral and progressive, while closed-angle glaucoma is acute with immediate symptoms.
Clinical manifestations vary; open-angle shows no early symptoms, while closed-angle involves severe pain and nausea.
Management includes pharmacological treatment (beta-blockers, miotics) and surgical interventions like trabeculectomy and iridectomy.
Patient education emphasizes the importance of regular eye exams, particularly for those over age 40 and higher frequency for African Americans.

Corneal Injuries

Corneal injuries can include foreign bodies, burns, abrasions, and penetrating wounds, each with unique manifestations and management needs.
Foreign bodies cause tearing and pain; burns yield acute pain; abrasions result in variable pain; penetrating injuries may not cause pain if the underlying structure is affected.
Diagnostic tests include visual exams, slit-lamp examination, and fluorescein staining.
Management involves irrigation, topical treatments, and emergency care for severe cases like penetrating wounds.

Enucleation and Keratoplasty

Enucleation involves the surgical removal of the eyeball, often post-trauma, allowing for prosthetic fitting afterward.
Preparation includes emotional support and ensuring a safe environment; postoperative care focuses on pain management and monitoring complications.
Keratoplasty entails replacing a damaged cornea and is performed on approximately 40,000 patients annually in the U.S.
Nursing responsibilities include educating families on the risk of infection and the need for careful postoperative care and monitoring.

Photocoagulation and Vitrectomy

Photocoagulation is an outpatient procedure utilizing a laser to manage conditions like ARMD and diabetic retinopathy.
Vitrectomy removes excess vitreous fluid and can treat retinal detachment and other eye conditions.
Postoperative care for vitrectomy involves strict positioning and monitoring for complications, while photocoagulation mainly requires vision assessment and patient support.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers the key components of the physiology of vision, detailing the pathway light takes through the eye. It also assesses symptoms related to eye health, including pain and changes in vision. Test your understanding of both anatomical functions and clinical assessments.