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
