Eyes
Normal eye pressure
10-21 mmHg
Legally blind
20/200 with correction (can't drive)
Which type of glaucoma presents an ocular emergency? A. Acute angle closure glaucoma B. Normal tension glaucoma C. Ocular hypertension D. Chronic open-angle glaucoma
A. Acute angle closure glaucoma Acute angle-closure glaucoma results in rapid progressive visual impairment. Normal tension glaucoma is treated with topical medication. Ocular hypertension is treated with topical medication. Chronic open-angle glaucoma is treated initially with topical medications, with oral medications added at a later time.
Risk factors for Cataracts
Age (#1 cause) Diabetes Family history Previous eye injury Eye surgery Medications Corticosteroid use UV light Smoking
Age of cataracts
Any age But typical patient is 65 years old (leading cause of blindness over 65) More than 1/2 of 80 year olds have or had cataracts
The nurse is demonstrating how to perform punctal occlusion. Which activities does the nurse perform?
Applies gentle pressure bilaterally on the bridge of the nose to the inner canthus of each eye Punctal occlusion is done by applying gentle pressure to the inner canthus of each eye for 1 to 2 minutes immediately after eye drops are instilled. The nurse does not apply pressure to the eyeball when administering medications. The lower eyelid is held down to expose the conjunctival sac. The other action described will not aid in the retention or absorption of medication.
Signs and Symptoms of Cataracts
Blurring vision Abnormal color perception Glare Gradual visual decline No pain No redness
A client has just been diagnosed with early glaucoma. During a teaching session, the nurse should: A. provide instructions on eye patches B. Assess the clients visual acuity C. Demonstrate proper eyedrop instillation D. Teach about intraocular lens cleaning
C. Demonstrate proper eyedrop instillation Eyedrop instillation is a critical component of self-care for a client with glaucoma. After demonstrating eyedrop instillation to the client and family, the nurse should verify their ability to perform this measure properly. An eye patch isn't necessary unless the client has undergone surgery. Visual acuity assessment isn't necessary before discharge. Intraocular lenses aren't implanted in clients with glaucoma.
Which cranial nerve is the optic nerve
CN II
What test is done to assess color blindness
Color vision is assessed with Ishihara polychromatic plates. The client receives a series of cards on which the pattern of a number is embedded in a circle of colored dots. The numbers are in colors that color-blind persons commonly cannot see. Clients with normal vision readily identify the numbers. The Jaeger and the Rosenbaum test near vision while the Snellen tests far vision.
A client is color blind. The nurse understands that this client has a problem with:
Cones Cones provide daylight color vision, and their stimulation is interpreted as color. If one or more types of cones are absent or defective, color blindness occurs. Rods are sensitive to low levels of illumination but can't discriminate color. The lens is responsible for focusing images. Aqueous humor is a clear watery fluid and isn't involved with color perception.
Test for visual acuity
Snellen chart
Manifestations of cataracts
Decreased visual acuity Glaring Painless Opacity of the lens Can lead to blindness
A nurse practitioner examines the fundus of the eye using direct ophthalmoscopy and notes a yellow lipid in the retina. What is this indicative of?
Diabetes A yellow lipid is indicative of hypercholesterolemia or diabetes. Hypertension is associated with intraretinal hemorrhages. Macular degeneration is suspected when drusen is present.
Cataracts pre-surgery interventions
History & Physical, other disease issues
Cataracts
clouding of the lens
There are four major types of ophthalmic procedures to complete a glaucoma examination. If the health care provider wants to inspect the optic nerve, the nurse would prepare the patient for:
Ophthalmoscope Four major types of examinations are used in glaucoma evaluation, diagnosis, and management: tonometry to measure the IOP, ophthalmoscopy to inspect the optic nerve, gonioscopy to examine the filtration angle of the anterior chamber, and perimetry to assess the visual fields.
A client is diagnosed with a corneal abrasion and the nurse has administered proparacaine hydrochloride per orders to assess visual acuity. The client requests a prescription for this medication because it completely took away the pain. What is the best response by the nurse?
Proparacaine hydrochloride can cause corneal softening and other complications if overused. Clients with corneal abrasions or other painful eye disorders have a tendency to overuse the medication, thus leading to the complications. It would not be appropriate to give the bottle with written instructions, and it is not a standard prescription for eye disorders because of the complications from overuse. Telling the client that you will let the doctor know does not provide the education needed about this medication.
Which of the following surgical procedures involves taking a piece of silicone plastic or sponge and sewing it onto the sclera at the site of a retinal tear?
The scleral buckle is a procedure in which a piece of silicone plastic or sponge is sewn onto the sclera at the site of the retinal tear. The buckle holds the retina against the sclera until scarring seals the tear. The other surgeries do not use this type of procedure.
How often do you go to the eye dr when you have glaucoma?
Usually 2x year (every 6 months0
Where is the vitreous humor? the aqueous humor?
Vitreous is in the back 2/3 of the eyeball Aqueous is in the front Remember A comes before V
presbycusis
age related hearing loss
Hyperopnia
farsightedness (can not see near)
presbyopia
impaired vision as a result of aging
myopia
nearsightedness (can not see far)