Term
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Definition
| Passage of rays of light from an object thru the cornea, aqueous humor, the lens, vitreous humor to the retina. From the retina the image is carried to the occipital area of the cerebrum where the image is identified. |
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Term
| What body structures protect the eye? |
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Definition
Boney structure of the cranium (Orbit)
Eyelid, eyelashes and eyebrow (hair catches anything dirty coming at the eye)
Blink reflex (is a protective mechanism)(starts as early as infancy)
Lacrimal system (at the upper outer eye) (washes the eye out and washes the cornea and conjunctiva. Cleans and lubes the eye)
Conjunctiva: covering the whole eye, mucous membrane, barrier to the external environment, nourishes the eye. |
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Term
| What are observations indicating vision problems? |
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Definition
Squinting
c/o headaches
Burning eyes
c/o of being tired
inability to see close or far
doing poorly in school
reddened eyes at the end of the day
refuses to read or answer information from the board |
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Term
| What history questions should you ask about problems with vision? |
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Definition
what’s the problem and how long
blurred, double or distorted vision
loss of acuity(sharpness)
pain
discomfort, itching, or scratchiness
one or both eyes
Discharge? color, consistency, odor
has this happened before
What self-treatment, if any, had been tried?
anything that makes the symptoms better or worse
is problem affecting ADL’s
any other eye issues, or surgeries
any family history of same condition or symptoms |
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Term
| What information should you gather during a physical exam? |
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Definition
any other health problems
medications |
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Term
| What should a nurse inspect on the external part of the eye? |
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Definition
Eyelids
eyelashes
sclera (should be white)
conjunctiva (see by pulling the eyelid)
pupil (make sure it is rounded) (check reaction of pupil)
Lacrimal duct
Cornea (clear covering)
Extraocular eye movements (have pt look around following your finger or pen point) Ptosis (drooping of the eyelid)
6 directions cardinal eye movements |
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Term
| Who is more apt to have a color vision deficit, males or females? |
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Definition
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Term
| is color vision inherited or not? |
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Definition
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Term
| What med can cause deficit in color vision? |
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Definition
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Term
| What abnormality can cause a deficit in color vision? |
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Definition
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Term
| What careers might be closed to someone who is color-blind or has a color vision deficit? |
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Definition
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Term
| What are the two kinds of photoreceptor cells found in the sensory retina? |
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Definition
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Term
| Most common test used for color vision: |
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Definition
| Ishihara polychromatic plates |
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Term
| How do you assess field of vision? |
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Definition
| o assessed using perimetry testing area of physical space visible to an eye in a given position (primary gaze) Visual acuity is sharpest at the top of the field and progressively declines toward the periphery. Helps identify which part of a pts central and peripheral vision are useful |
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Term
| What eye problems can be detected with the field of vision test? |
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Definition
| o assessed using perimetry testing area of physical space visible to an eye in a given position (primary gaze) Visual acuity is sharpest at the top of the field and progressively declines toward the periphery. Helps identify which part of a pts central and peripheral vision are useful. |
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Term
| What are the 2 methods for assessing a clients field of vision? |
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Definition
Manual perimetry
Automated perimetry |
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Term
| what instruments are used for internal inspection of the eye? |
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Definition
direct ophthalmoscope: hand held piece of equipment with magnification
indirect ophthalmoscope: used by an eye doctor to see larger area of the retina without magnification
Slit lamp: binocular microscope mounted on a table used for evaluating cataracts |
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Term
| What parts of the eye are looked at when inspecting the internal part of the eye? |
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Definition
cornea
lens
retina, blood vessels and optic nerve |
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Term
| What is normal Intraoccular Pressure? |
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Definition
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Term
| What is intraoccular pressure? |
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Definition
| the amount of aqueous humor in the anterior chamber |
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Term
| How is the intraoccular pressure measured? |
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Definition
| is measured by a tonometer |
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Term
| what is caused when intraoccular pressure increases? |
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Definition
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Term
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Definition
| fills the prescription for glasses or contact |
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Term
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Definition
| test vision, writes prescription for glasses or contacts, treats minor eye diseases |
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Term
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Definition
| first ophthalmologist, practiced during the middle ages |
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Term
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Definition
| medical doctor who specializes in treating eye diseases, surgery |
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Term
| What's the difference between an eye pad and an eye shield? |
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Definition
eye pad- soft, padded, absorbent material
eye shield- hard plastic or metal for protection
eye patch vs. eye shield
used to rest the eye
prevent touching the eye
absorb secretions
protect the eye |
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Term
| What coping is involved with vision loss? |
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Definition
| emotional, physical and social adaptation |
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Term
| What emotional adjustment is needed? |
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Definition
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Term
| What does acceptance allow a person to do? |
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Definition
| physical and social success |
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Term
| What grieving steps will the pt and family go thru with vision loss? |
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Definition
| denial anger bargaining depression and acceptance |
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Term
| What is a nursing actions for helping a patient with vision loss? |
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Definition
| Assist with spatial orientation and mobility |
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Term
| How do compresses help with eye injuries? |
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Definition
decrease edema
decrease itching
decrease pain
cold or warm |
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Term
| What would be considered proper daily eye care? |
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Definition
adequate light
rest eyes with fine work and computer work
avoid habitual rubbing
avoid excess exposure to ultraviolet light
use safety glasses
wash hands prior to touching eyes
don’t share eye make-up or medication |
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Term
| What are proper nursing actions when administering eye drops? |
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Definition
pt identification is critical
verify correct eye
education on what to expect such as stinging burning blurred vision
proper hand hygiene before and after
never touch bottle or tube to any part of the eye and recap immediately
1 min interval between different eye drops, 5 min interval between successive doses. |
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Term
| What are ocular irrigations used for? |
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Definition
remove secretions
treat infections
remove chemicals or foreign bodies |
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Term
| What equipment is needed for ocular irrigation? |
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Definition
plastic bottle, bulb syringe, or IV tubing
NS
Plastic wash basin |
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Term
| How do you properly perform ocular irrigations? |
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Definition
Flush inner to outer canthus
Periodically allow to close eye |
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Term
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Definition
| ocular pain on exposure to light |
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Term
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Definition
| contracts the pupil: used with glaucoma |
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Term
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Definition
| dilates the pupil: short duration, used for surgery. |
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Term
| What is the proper procedure for irrigating eye in ER after chemical splash? |
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Definition
use eye wash station
copious amounts of water x 25 min
test with pH strip
continue to rise x 15-20 min more until pH strip is neutral |
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Term
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Definition
| ability to adjust to far and near objects |
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Term
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Definition
| dimness of vision (lazy eye) |
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Term
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Definition
| vision (light ray) does not focus at the same point |
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Term
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Definition
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Term
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Definition
| blindness in ½ field of vision in one or both eyes |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| constant, involuntary movements of the eye |
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Term
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Definition
| loss of accommodation or recession of near vision. Seen with advancing age between 40-45 |
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Term
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Definition
| drooping of the upper eye lid |
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Term
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Definition
| the deflection of light from a straight path through the eye by various ocular tissues, including the cornea, lens, aqueous humor and vitreous body. |
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Term
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Definition
| crossed eyes, inability of both eyes to work in tandem |
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Term
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Definition
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Term
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Definition
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Term
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Definition
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Term
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Definition
| irregularly curved cornea |
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Term
| How are refractive disorders corrected? |
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Definition
| Treated with the use of corrective lens, either glasses or contacts |
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Term
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Definition
| the procedure entails placing radial incisions in the peripheral cornea, which results in relaxation and flattening of the central cornea. |
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Term
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Definition
| a procedure in which the eye surgeon creates a thin surface flap of the cornea using a microkeratome to expose underlying tissues. It is within the deeper layers of the cornea that the surgeon then applies the laser beam to create the refraction ablation |
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Term
| What are s/s of cataracts? |
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Definition
Cloudiness or opacity of the lens of the eye
Objects are blurred or distorted, glare with bright lights
No c/o pain
Develops in or or both eyes at any age |
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Term
| What are some predisposing factors for cataracts? |
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Definition
aging after age 70
exposure to ultraviolet light
diabetes
Smoking
over-use of steroids
congenital
trauma |
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Term
| What are the treatments for cataracts? |
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Definition
removal of the lens and the insertion of an intraocular lens
done under a local, in an outpt clinic or surgical center
usually one eye at a time 2 weeks apart |
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Term
| What nursing care should be done before an eye surgery? |
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Definition
recent study showing not necessary to stop anticoagulants prior to surgery
education on what to expect NPO post op care
administer dilating drops every 10 min X4 doses at least 1 hr prior to surgery
antibiotic corticosteroid and anti inflammatory drops may be given prophylactically to prevent postop infection and inflammation |
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Term
| What nursing care should be performed after an eye sugery? |
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Definition
assist in recovery from anesthesia
provide verbal and written instruction on protecting the eye instilling meds recognizing complications and seeking emergency care
instruct on use of mild analgesic acetaminophen for mild pain which is to be expected
meds to be used will be antibiotic corticosteroid and anti inflammatory eye drops or ointments |
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Term
| What actions would help promote rehabilitation after eye surgery? |
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Definition
instruct pt on use of protective eye patch x 24 hours after surgery, then eyeglasses during the day and a metal eye shield work at night x 1-4 wks
instruct on use of sunglasses when outdoors
slight morning discharge, some redness, scratchy feeling may be expected for a few days
retinal detachment is at increased risk, so instruct pt on notifying surgeon if: new floaters or flashing lights appear, or if pt has decrease in vision, increased pain, or increase in redness
instruct on importance of follow-up care |
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Term
| What activities might cause wound disruption after cataract surgery? |
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Definition
pushing, pulling or lifting anything over 15 lbs
bending or stooping for an extended period
any trauma to the post op eye
any strenuous activity |
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Term
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Definition
| obstruction of outflow within the travecular network and canal of Schlemm of the eye |
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Term
| What causes glaucoma and what does it lead to? |
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Definition
| disturbance in the production and drainage of aqueous humor causes increased pressure within the eye that can lead to optic nerve atrophy and blindness |
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Term
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Definition
one of the leading causes of irreversible blindness in the world
the leading cause of blindness in adults in the US
estimated at least 3 million Americans and 5-10 million more at risk
more prevalent among people > 40, incidence increases with age
more in men than women
more in African-Americans and Asians
Acute Glaucoma (narrow angle) |
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Term
| What are symptoms of glaucoma? |
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Definition
sever pain, in and around the eyes
rainbow colors around lights
vision is cloudy and blurred
pupils dilated
nausea and vomiting |
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Term
| What are the treatments for glaucoma? |
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Definition
emergency medications
miotics (pilocarpine)
carbonic anhydrase inhibitors (decrease aqueous humor productions)
Osmotic diuretics (mannatol) |
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Term
| Chronic Glaucoma (open-angle) facts |
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Definition
most common, 90% of cases
onset age 40-45, clinical symptoms as late as 60-65, risk higher in people of African descent |
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Term
| S/S of chronic glaucoma (open-angle) |
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Definition
mild bilateral eye discomfort, tired eyes, foggy vision
slow, gradual development of impaired peripheral vision
halos around lights as ocular pressure increases
most people have no symptoms until vision is lost. By then the damage is done and irreversible. |
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Term
| What are treatments for Chronic Glaucoma (open-angle)? |
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Definition
eye drops, see table 58-4 page 1771
also, sometimes, oral meds to decrease IOP
remission with eye drops but not cured
every 3-6 months follow-up with doctor
surgical intervention if meds are not successful, laser trabeculoplasty |
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Term
| Acute Glaucoma (closed-angle) facts |
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Definition
happens when there is a sudden blockage of the aqueous humor fluid exit
causes quick, severe, painful rise in IOP
In contrast to open-angle glaucoma, closed-angle glaucoma is an emergency
If pt has had acute attack in one eye, they are at risk for acute attack in second eye, and will likely be given preventative tx |
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Term
| Acute Glaucoma (closed-angle) |
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Definition
| Other S/S: decreased or cloudy vision, N/V, pupils non-reactive to light, redness and swelling of the eye, eye and facial pain |
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Term
| Acute Glaucoma (closed-angle) treatment |
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Definition
blindness will occur in a few days if it is not treated
eye drops, po meds, as well as IV meds to get IOP decreased
emergency iridotomy, a surgical laser procedure which opens a new channel in the iris to relieve pressure and prevent another attack |
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Term
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Definition
| detachment of the sensory retina from the epithelium of the retina |
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Term
| What are the for types of detached retinas? |
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Definition
Rhegmatogenous Detachment
Traction Retinal Detachment
Combinations of first and second types
Exudative Retinal Detachment |
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Term
| What is Rhegmatogenous Detachment and who is at risk to get it? |
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Definition
most common form, hole or tear develops in the sensory retina, allowing leakage of liquid vitreous, which causes detachment from the retinal pigment epithelium
at risk: those with high myopia or aphakia(absence of the natural lens) after cataract surgery; also trauma or diabetes |
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Term
| What causes Traction Retinal Detachment? |
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Definition
| caused by tension, or a pulling force, from fibrous scar tissue, formed due to diabetic retinopathy, vitreous hemorrhage, or retinopathy of prematurity |
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Term
| Exudative Retinal Detachment is a result from what? |
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Definition
| the result of production of serious fluid under the retina from the choroid. Uveitis and macular degeneration are two conditions that may cause this production. |
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Term
| Who is at risk for Exudative Retinal Detachment and what are the S/S? |
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Definition
Most common after age 40, slow or rapid in development
S/S: flashes of light; sooty vision; sensation of particles, or floaters, in the line of vision, or cobwebs; or a veil-like coating/shadow, shade, or curtain |
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Term
| What are the treatments for Exudative Retinal Detachment? |
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Definition
Laser surgery
electro diathermy
cryosurgery
all the surgeries cause exudate to form and will cause the retina to re-adhere |
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Term
| During Pose Precedural Care of a Detached Retina, the nurse needs to educate on... |
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Definition
Straight line vision, avoid rapid movements
Avoid intraocular pressure, not straining, bending or lifting
no driving for 3-6 weeks
if CO2 gas bubble utilized to flatten the retina, will need to maintain head position
diversional activities
report reoccurrence immediately
Inflammatory disorders |
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Term
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Definition
| infection of the eye lids |
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Term
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Definition
| sty or infected eyelash follicle |
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Term
| What are treatments for superficial eye lid infections? |
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Definition
warm moist compresses 5 min tid/qid
Opthalmic antibiotic drops
wash hands before and after touching/instilling drops
avoid touching eyes
Conjunctivitis or “Pink Eye”
Result of allergy, bacteria, virus, chemical, or physical trauma |
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Term
| What are S/S for superficial eye lid infections? |
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Definition
| redness, foreign body sensation, scratching or burning, itching, photophobia, tearing, lids adhered with crusts in the morning from discharge |
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