Chapter 5: test prep
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| Amblyopia: | lazy eye,” the loss of one eye’s ability to see detail, it is the most common cause of vision problems in children (may be connected with strabismus).
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| Diplopia: | double vision,” it is a visual impairment in which an object is seen as two objects (disappears when one eye is covered).
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| Macula (lutea): | An oval yellowish area surrounding the fovea (a depression in the retina where field of vision is focused and cones are concentrated) near the center of the retina in the eye. It is the region of greatest visual acuity (sharpness of vision).
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| Retinopathy | Refers to noninflammatory eye disorders, in which a disease of the retina caused by blood vessels in the eye or changes in the retinal cells results in the impairment or loss of vision.
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| Tonometry: | A procedure that measures the intraocular pressure of the eye by determining the amount of force needed to make a slight indentation in the cornea (with use of a tonometer). It is used to test for glaucoma.
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| The optic nerve | only nerve to the eye so if it is damaged in any way then vision will be affected.
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| functional process of vision | occurs when light enters the eye, an image is formed on the retina, the rods and cones are stimulated, and nerve impulses are conducted to the brain (vision takes up a much larger part than the other senses) through the optic nerve.
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| The eye is composed of | a wall with 3 concentric layers: scelera (the outermost), choroid, and retina.
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| The eye moves | the aid of six extrinsic muscles, which are attached to the sclera.
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| One important area of the eye is the angle: | where the cornea, iris, and the trabecular meshwork intersect and the aqueous humor produced by the cilary body is drained.
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| 3 chambers to the eye: | the anterior chamber (from the cornea to the iris), the posterior chamber (the small area from behind the iris and in front of the lens), and the vitreous chamber (the area from the lens to the retina
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| blurring vision | o The most common cause for diminished visual acuity it results in the eye being unable to focus light effectively on the retina
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| Hyperopia (farsightedness): | Occurs when light entering the eye is focused behind the retina due to the eyeball being abnormally short (measured front to back), impairing near vision.
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| Strabismus crossed eyes pointing inward, outward | visual defect of misalignment (failure of the eyes to look in the same direction at the same time) that usually occurs due to weakness in the nerves stimulating the muscles that control the position of the eyes.
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| Strabismus signs | May include esotropia (convergent strabismus, eyes directed inward “cross-eye) or exotropia (divergent strabismus, eyes directed outward “wall-eye). The main symptom is diplopia (“double vision”).
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| Strabismus--Causes | include some other underlying disorder or condition or it may develop in infancy or early childhood. In adults it is seen after a head injury or stroke.
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| Strabismus-Treatment includes | corrective glasses, surgery to restore the eye muscle balance (shorten muscles for sight to be symmetrical), or using an eye patch to force vision out of the deviating eye. Amblyopia is associated with this condition because the brain will notice that th
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| Strabismus ot intervention | In OT we may notice the eyes of a client turned a certain direction or not focusing right. It is important to refer the person to a Optometrist and educate parents in the importance of early treatment for their children
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| Cataract | A crystallization or opaqueness of the natural lens of the eye develops slowly with gradual reduction in visual acuity causing a yellowing or fading of colors, loss of brightness, and the need for bright light to read
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| Cataract Causes | is usually from the natural aging process (It is the most common visual disorder in adults),but smoking, nutritional deficiencies, drug toxicity (prolonged high-dose corticosteroid administration), and long term ultraviolet exposure can increase your risk
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| Cataract Treatment | includes surgery (which is usually successful) which is done the same day. The only time surgery is not done is either the patient (1st) is not a good surgical candidate or the cataract has not grown large enough to warrant surgery (not mature).
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| Cataract In ot | will refer the client and even if the patient is already visually impaired, he or she may still need the surgery to address it so that they can regain what little they could see before.
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| Glaucoma | A condition in which damage is done to the optic nerve due to the presence of elevated intraocular pressure from the aqueous humor in the eye. There are 2 types:open and closed angle
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| Glaucoma Chronic open-angle: | The most common form, develops when there is a blockage within the trabecular meshwork, which impairs aqueous humor reabsorption and a build up of fluid in the eye. Open-angle is a functional problem not a structural problem.
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| Glaucoma Chronic open-angle: Treatment | is done with medication to enhance reabsorption or decrease production of the aqueous humor. It may need to be treated with a laser to remove the blockage or create another drainage point (pin-point holes). There is no cure but can be controlled.
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| Glaucoma --Acute Angle-closure (closed-angle): | Able to occur suddenly, it occurs when the mouth or opening of the drainage system is narrowed or closed off (such as with the movement of the iris) causing a rapid increase of intraocular pressure (IOP)the pressure is greater in this type
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| Glaucoma --Acute Angle-closure (closed-angle): treatment | must be immediate in order to prevent loss of vision (medical emergency). It includes surgery by laser iridotomy, which removes a portion of the iris to open the angle back up. It can be cured but the patient may need to have eye drops as well.
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| Glaucoma --Acute Angle-closure (closed-angle): It is more common in patients 60 and older | obut it can occur in any age especially when a patient has nearsightedness, has blood relatives with glaucoma, and is of African-American descent (the leading cause of blindness in this ethnic group). The patient may experience headaches,nausea eye pain,
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| Glaucoma --Acute Angle-closure (closed-angle):Intraocular pressure (IOP) | can be tested with use of a puff-of-air" test,technically known as non-contact tonometry,It is also done with tonometer,as a pressure gauge. Eye drops used and the device is pressed into your eye until it registers resistance(15-18 is normal,20 treatment
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| Glaucoma --Acute Angle-closure (closed-angle)Causes-and | trauma, congenital defects,
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| Glaucoma --Acute Angle-closure (closed-angle)Treatment | Immediate is a must to prevent blindness.
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| Glaucoma --Acute Angle-closure (closed-angle) In OT we will need to | educate the patient such as with the side-effects of their mediation (eye drops with beta-blockers affect the heart rate,blood pressure,If the patient’s glacoma went untreated,modify and use adaptive techniques in order to help the patient move
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| Macular Degeneration | The progressive deterioration or breakdown of the macula of the retina (affects images that are viewed straight on from the eye, center vision).
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| Macular Degeneration There are two types: | The condition is usually painless, develops slowly, and does not affect the peripheral vision (both eyes are usually affected). 2 types
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| Macular Degeneration WET | only 10% of cases) The presence of abnormal blood vessels that overgrown and may hemorrahage if the vessels break apart.
Treatment includes vitamin supplements (vitamin C, E, beta-carotene, zinc) that have been shown to slow down the disease.
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| Macular Degeneration Wet Treatment | includes vitamin supplements (vitamin C, E, beta-carotene, zinc) that have been shown to slow down the disease.
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| Macular Degeneration DRY | The most common it is caused by the atrophic (wearing away of the cells) changes in the macula.
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| Macular Degeneration DRY Treatment is done with traditional laser photocoagulation | (which coagulates, destroys, or fuses small areas of tissue), photodynamic therapy (a light-sensitive medicine called verteporfin is injected into the bloodstream, collects in abnormal blood vessels and laser activates the medicine causing clots
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| Macular Degeneration DRY Causes include | age, genetic factors, and prolonged exposure to bright light (worst for those with lighter eyes since they have less filtering), but is usually causes by degenerative changes in the pigment epithelium of the retina. There is also a connection to smoking.
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| Macular Degeneration DRY in OT adaptave appclations | we will have to provide some adaptations and modification for the patient such as modifying their home environment with magnifiers, closed circuit TVs, and if the patient can no longer drive then we will have address public transportation
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| Diabetic Retinopathy | An alteration of the retinal blood vessels and the proliferation of retinal vessels due to the lack of glucose control from diabetes Mellitus (type 2 diabetes), ultimately affecting sharpness and clarity, and may also cause blindness.
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| Diabetic Retinopathy Usually occurring in both eyes | is characterized by microaneurysm (swelling in the wall of tiny blood vessels, seen as a small, round, red spot), hemorrhages, dilation of retinal veins, and the formation of abnormal new vessels (neovascularization).
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| Diabetic Retinopathy Cause | is from improper blood glucose regulation (although all diabetics are susceptible). Because of poor circulation and low blood sugar, the brain’s response to the decrease of oxygen and the nutrient supply to the eye is to form more blood vessels
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| Diabetic Retinopathy Because of poor circulation and low blood sugar, | the brain’s response to the decrease of oxygen and the nutrient supply to the eye is to form more blood vessels.these vessels can leak into the vitreous humor affecting the retinal cells. progressive condition that starts with lack of vision in “spots,
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| Diabetic Retinopathy The condition is highly preventable by regulating blood sugar but | Treatment includes laser photocoagulation and regulating blood sugar to prevent reoccurrence. If blood enters the vitreous humor (vitreous hemorrhage) than a vitrectomy may be necessary.
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| Diabetic Retinopathy-In OT we will reinforce good diabetic care- | help with adaptive equipment and techniques for those who have loss some vision. If the patient is complaining of loss of sensation in the hands and feet (numbness) then we may need to refer them to get their eyes checked.
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| Hypertensive Retinopathy | o Similar to the affects of Diabetic Retinopathy, this condition is caused by high blood pressure, which increases pressure in the blood vessels of the eye causing them to bleed. It is prevented by treating and controlling the high blood pressure.
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