Sensory Chapter 63 Enrichment
s/s of AMD
"wet"=exudative, or neovascular, more abrupt onset, 15% of pt's with AMD; "dry"=nonexudative, or nonneovascular, 85% of pt's with AMD (see fig. 63-15, p.1867)
refractive errors
In __________ ______, vision is impaired because a shortened or elongated eyeball prevents light rays from focusing sharply on the retina; can be corrected with eyeglasses or contact lenses
strategies for interacting with ppl who are blind or have low vision
ID yourself upon approach, use clock cues when serving food, place person's hand on seat when offering one, usually appropriate to touch the person's hand or arm to indicate you are about to speak
cataract
a(n) ________ is a lens opacity or cloudiness that can develop at any age
blindness
absence of light perception; ranges from 20/400 to no light perception at all
risk factors for cataracts
aging, obesity, diabetes, poor nutrition, renal disorders, retinal detachment
types of conjunctivitis
allergic; irritating toxic stimuli; microbial (viral or bacterial---if viral, can be acute or chronic with common causes being adenovirus or herpes simplex---> if adenovirus, very contagious, usually preceded by URI)
risk factors for AMD
arthritis, hyperopia, overweight, increased age, hypertension, smoking hx, fam. hx
color vision test
assesses ability to differentiate colors; sometimes indicated conditions of the optic nerve
s/s of glaucoma
blurred vision, difficulty focusing, halos around lights, loss of peripheral vision, aching or discomfort around eyes, difficulty adjusting eyes in low light
diabetic retinopathy
changes in the small blood vessels in the retina; leading cause of new cases of blindness in ages 20-74; subject to many visual complications
emmetropia
condition of the eye in which vision is accurate
common gerontologic changes in the eye
decreased visual acuity, decreased tear production, thickening and flattening of cornea, loss of skin elasticity, decreased muscle tone, wrinkles develop
risk factor for diabetic retinopathy
diabetes
diplopia
double vision
ptosis
drooping of the eye lid
risk factors for glaucoma
family hist., thick cornea, African Am. race, older pop., diabetes, cardiovascular dz, migraine ha, myopia, use of steriods
hyperopia
farsightedness; eyeballs shallow in the socket
myopia
nearsightedness; eyeballs set deeper in socket
Tx for AMD
no tx for dry AMD; wet AMD can be treated
s/s of cataracts
painless, blurry vision; perception that surroundings are dimmer as if glasses need cleaned; astigmatism; diplopia
s/s of diabetic retinopathy
painless, blurry vision; symptoms indicative of hemorrhaging include floaters or cobwebs in visual field
glaucoma
refers to a group of ocular conditions characterized by optic nerve damage (esp. in older pop.); increased IOP damages the optic nerve causing congestion of the aqueous humor in eye; "silent thief of sight"
astigmatism
refractive error due to irregularity in the curvature of the cornea
instilling eye medications
remove contacts---may reinsert after med is absorbed; instill in lower conjunctival sac; do not touch tip of med container to any part of eye; wait 5 min b4 instilling another drop in same eye and 10 min b4 instilling a different med; after drops, keep eye lid closed and apply gentle pressure to inner canthus
ultrasonography
tests for lesions
trichiasis
turning in of the eye lashes
entropian
turning in of the lower eye lid
ectropian
turning out of the lower eye lid
when assessing for conjunctivitis look for
type of discharge (watery, mucoid, or purulent), type of conjunctival reaction
post op care after cataract surgery
wear eye patch first 24 hrs, then wear glasses during day and eye shield at night; expect morning discharge from eye, redness, scratchy feeling for few days; report new "floaters" in line of vision, flashing light, decrease in vision, increased redness, or pain
post-op teaching for common eye surgeries
wear eye shield, avoid straining (coughing, sneezing, Valsalva maneuver), avoid lifting or bending, report sharp pain, hemorrhage, or infection
tx of diabetic retinopathy
maintain normal b/p and BS, cessation of smoking, laser treatment to destroy leaking blood vessels
tonometry
measures intraocular pressure (IOP) needed to flatten the cornea; TEACH: do not squeeze eyes, hold breath, or perform Valsalva maneuver b/c will increase IOP
Tx of conjunctivitis
meds, isolation of infected patients
pin hole vision test
By looking through a pinhole (an occluder with small holes), the refractive errors of the peripheral cornea and crystalline lens of the eye are significantly reduced or eliminated, simulating corrected vision. No pinhole improvement indicates refractive error is less likely the cause of subnormal visual acuity.
s/s of conjunctivitis
itching, photophobia, foreign body sensation, scratching or burning sensation
Pt Teaching for glaucoma
keep record of eye pressure measurements and visual field test results to monitor own progress (see chart 63-7; p.1857)
Amsler grid
for pt's with macular problems (like macular degeneration) test each eye separately
Tx of glaucoma
goal of Tx: prevention of optic nerve damage (cannot be reversed or cured); pharmacological Tx, laser procedures, surgery, or combination of these
age-related macular degeneration (AMD)
gradual blurring of vision esp. in older adults; clusters of debris or waste material in macula or beneath retina called drusen (yellowish spots assoc. with aging)
conjunctivitis
inflammation of the conjunctiva characterized by a pink appearance, hence "pink eye"
nystagmus
involuntary, oscillating movements of the eye; esp after trauma or neurologic concerns