Chapter 11- The eyes

Refractive error

Shape of the eye doesn't bend light correctly, resulting in a blurred image (myopia-nearsightedness), (hyperopia- farsightedness), (presbyopia- loss of vision with age)

Are refractive errors the most common visual change in children?

Yes

Scotoma

area of lost or depressed vision within the visual field and is surrounded by an area of normal vision

Flashing lights with new vitreous floaters suggest

detachment of vitreous from retina

ptosis

drooping of the upperlid

Photophobia or light sensitivity is usually from

excess light entering the eye, which may overexcite the photoreceptors in the retina

What is a characteristic symptom of Graves hyperthyroidism?

exophthalmos (eyeball protrudes forward; when bilateral, suggests infiltrative opthalmopathy of graves hyperthyroidism)

Conjunctivis

has a watery, mucoid discharge

What is vital in maintaining vision and a healthy outlook for for clients?

health education

Difficulty with close work suggests

hyperopia (farsightedness) or presbyopia (aging vision)

lateral sparseness occurs in

hyperthyroidism

entropian

inward turning of the lower lid

Where would the nurse look to visualize the optic disc with an opthalmoscope?

medially toward the nose (follow the blood vessels as they get wider)

Glands that are located on the tarsal plates and open on the lid margins

meibomian

Floaters

moving specks or strands (fixed deficits suggest lesions in the retina or visual pathways)

Difficulty with distances suggests

myopia (nearsightedness

Diplopia

patient doesn't see double when focusing on one finger

scaliness occurs in

seborrheic dermatitis

Macular degeneration

slowly losing central vision

Papilledema describes

swelling of the optic disc and anterior bulging of the physiologic cup

What is the primary purpose of the health history in relation to the eyes?

to identify changes

Hermianopsia

unable to see in half the visual field

Red eye with gritty sensation

viral conjunctivis

What color are you expected to see in the disc if the optic nerve is dead?

white

Red painless eye is seen in

-allergies -subconjunctival hemorrhage

If sudden visual loss is unilateral and painful consider

-causes in the cornea and anterior chamber (corneal ulcer, uveitis, traumatic hyphema, & acute-angle glaucoma) -optic neuritis

enlarged blind spot occurs in conditions affecting the optic nerve such as

-glaucoma -optic neuritis -papilledema

red painful eye is seen in

-hyphema -episcleritis -acute-angle glaucoma -herpes keratitis -foreign body -fungal keratitis -sarcoid uveitis

The nurse is using the opthalmoscope to examine the patient's eyes. The nurse holds the scope:

-in the right hand for the right eye -in the left hand for the left eye

If sudden visual loss is bilateral and painless consider

-medications that change refraction such as cholinergic, anticholinergics and steroids may contribute -chemical or radiation exposures

What systemic diseases cause nodular episcleritis?

-rheumatoid arthritis -systemic lupus erythematosus

If sudden visual loss is unilateral and painless consider

-vitreous hemorrhage from diabetes -trauma -macular degeneration -retinal detachment -retinal vein occlusion -central retinal artery occlusion

How many cardinal directions does the nurse test for extraocular movement of the eye?

6

What are you testing for when you ask a patient to follow the pencil as you move it in toward the bridge of the nose?

Convergence