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Eye Disorders

Eye Disorders. Metropolitan Community College NURS 1110 Adult Nursing I. Objective 1: Describe the normal structure and functions of the eye, and identify structures which help protect the eye. Review A&P from A&P class, and Linton.

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Eye Disorders

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  1. Eye Disorders Metropolitan Community College NURS 1110 Adult Nursing I

  2. Objective 1: Describe the normal structure and functions of the eye, and identify structures which help protect the eye. • Review A&P from A&P class, and Linton

  3. Objective 2: Identify the principles of providing basic eye care which should be taught to all clients with eye disorders.

  4. Good lighting • Rest eyes on distant object • Meds only by MD; discard old meds; maintain sterility • Avoid bright light exposure • Goggles • Do NOT share eye make up

  5. Don’t rub eyes • Under 40, test every 3-5 yrs; over 40, every 2 years • Report to MD: sudden sharp eye pain, deep eye pain; photophobia; blurred or double vision; loss of part of visual field; halos around lights; floaters; excess tearing; drainage from eye

  6. Clean eye from inner to outer canthus • Vitamins A & B are important • Wear contacts appropriately

  7. Objective 3: Explain the basic principles to be practiced when providing care to a visually impaired client.

  8. Client is blind, not deaf • Treat as adults • Speak when entering or leaving room • Inform before touching

  9. Determine amount of help needed • Let person take your arm when walking • Independence fostered by: • Braille • Special cane • Seeing eye dog

  10. Keep bed low position • Eliminate noise • Room free of clutter • Reduce glare

  11. Objective 4: Name five diagnostic tools commonly used to diagnose eye disease

  12. Ophthalmoscopy • Look into eye-see retina, optic disk, blood vessels • May see changes with eye disorders • May see changes with diabetes mellitus

  13. Refraction • Look into series of refractors-lenses • Client chooses the clearest vision

  14. Tonometry • Measures eye pressure • Pneumotonometer uses puff of air • Normal pressure 12-21 mm Hg

  15. Visual field • Peripheral vision • Important in some eye diseases

  16. Snellen eye chart • Visual acuity • Normal is 20/20 • Example: 20/30—the person sees at 20 feet what a person with normal vision sees at 30 feet • 20/70 is visual impairment • 20/200 is legally blind

  17. Objective 5: Describe the nursing assessments made when examining a client with any eye problem.

  18. Assessments • Eye lid, conjunctiva, sclera • Any discharge, signs of inflammation or infection • Visual acuity • PERLA

  19. Current and past medical Hx RT eyes • Dry, red, edema

  20. Change from medical problems • Diabetes mellitus • Neurological damage • Hypertension • Eye injury • Family history • Corticosteroid use • Occupation

  21. Objective 6: Describe four major external eye disorders and their treatment.

  22. Keratitis • Inflammation of cornea • From infection, irritation, injury, allergy • Symptoms: severe eye pain, red watery eye, photophobia

  23. May cause reduced vision, rash • Treatment: anesthetics, mydriatics, dark glasses, antibiotics

  24. Stye or hordeolum: pustular inflammation of eyelash follicle or sebaceous gland on lid margin • Staphylococcal organism

  25. Symptoms: pain, redness, swelling • Treatment: warm compress; topical antibiotic • May need I&D if severe

  26. Chalazion • Cyst of meibomian glands • Hard, filled with fatty material • Painless • Develops over weeks • Treatment: surgical excision if infected, interferes with sight

  27. Blepharitis • Inflammatory condition of lash follicles meibomian glands of eyelids • Swelling, redness, crusts

  28. Conjunctivitis • Inflammation of conjunctiva from bacteria, virus, ricketsia, allergen, irritant • Symptoms: burning, itching eyes, discharge, edema, pain, redness

  29. Treatment: WMC, antibiotic, antiviral ointments; if allergy, treat allergy • Is contagious-use infection control measures

  30. Objective 7: Define the following refractive errors: myopia, hyperopia, astigmatism, presbyopia.

  31. Myopia: nearsightedness • Light focuses on front of retina • Starts with children • Hyperopia: farsightedness. Light focuses behind the retina

  32. Astigmatism: hard to see small objects. Light rays distorted • Presbyopia: poor accommodation

  33. Objective 8: describe the pre and postoperative care for a client having eye surgery

  34. Preoperatively • Orient to room if bilateral eye patch, very important • Consent form • NPO • Expectations postoperatively • Eye drops • Report any S/S of infections

  35. Postoperatively • Safe environment • HOB up 30-45 degrees • NO cough, lifting, stooping over, straining, laying on affected side • If nausea, get antiemetic order • Avoid constipation • Eye shield, esp. at night

  36. Report any eye pain STAT • Report any bloody drainage • PO meds for mild to moderate pain

  37. Objective 9: Review how to instill eye drops, ointments, and perform eye irrigation. • Review from NURS 1510

  38. Objective 10: discuss drugs used to treat eye disorders • Drugs will include • Anticholinergics, mydriatics, cycloplegics

  39. Mydriatics: dilate the pupil • Cycloplegics: paralyze muscles of accommodation • Both used in diagnostic eye procedures, eye surgery

  40. Anticholinergics: dilate the pupil; paralyze muscle of accommodation • Relax ciliary & dilator muscles by blocking acetylcholine

  41. Examples: Atropine sulfate (cycloplegic); Propine for open angle glaucoma; epinephrine for eye surgery or open angle glaucoma

  42. Objective 11: define the following diseases and explain the treatment and nursing interventions for each: • Cataract • Retinal detachment • Glaucoma • Macular degeneration

  43. Cataract disease • Opacity or clouding of lens • Congenital, chemical, traumatic, mechanical, or degenerative • Assessment: subjective—C/O cloudy vision, seeing spots or ghost images; floaters • Gradual loss of vision • Advanced: can see milky white lens

  44. Cataract treatment • Extract lens, implant new one • Outpatient status, go home 2-3 hrs. post op

  45. Mild sedative, local anesthesia • Preop: mydriatic, cycloplegic • Post op: avoid increasing IOP • Do not drive car until released to do so • Wear dark glasses

  46. Retinal detachment • Separation of retina from choroid layer • Collection of fluid between sensory and pigmented layer

  47. From: trauma, degenerative changes; secondary to other surgeries • Myopic clients at more risk • Assessment: C/O flashes of bright lights or floaters

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