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Eye Disorders

Nursing Cares of Eye Disorders

3 layers of the eye 1. Sclera-hard, outer connective tissue, holds shape; ant. portion is cornea; 2. choroid-blood vessels, nutrition for eye, ant. portion iris; 3. Retina-focusing, rods & cones
Other eye structures *lens-divides eye, in front is clear fluid, behind is vitreous fluid * iris * ciliary body-smooth muscle, changes shape of lens to focus *aqueous humor-front of lens *vitrous humor-behind lens, jelly
Hx related to eye *medications-could be the cause, O2 therapy *diseases: diabetes (leading cause of blindness), glaucoma, hereditary disorders
Vision issues: Myopia *nearsighted *large eyeball-deeper than normal *focus is in front of retina *requires concave lens for correction )(
Vision issues: Hyperopia *farsighted *small eyeball-shallower than normal *focus is behind retina *requires convex lens for correction ()
Vision issues: Astigmatism irregularly shaped cornea; need weighted lens
Vision issues: Presbyopia *occurs c age *loss of lens elasticity *decreased accommodation
Cataract symptoms *cloudy vision in front of lens or throughout *blurred vision *PAINLESS
Cataract info *most common surgery in US *affects 90% of ppl over 70 y-o *CAUSES: meds, diseases, genetics, occupations (radiology)
Cataracts Tx: Surgery **Intracapsular-removes entire depth of lens when cloudy throughout, more invasive; **Extracapsular-takes outer layer of lens off; **Lens implant is often necessary-otherwise need special glasses for vision correction
Post cataract surgery complications *Hyphema-blood in front of eye, more c intracapsular; *vitreous prolapse-intracapsular, pearl shaped pupil could lead to retinal dettachment; *infection-can lead to loss of vision
Nursing cares post surgery c cataracts *eye shield-especially at noc to prevent scratching; *mydriatic eyedrops-dilates pupil to allow healing; *check visual acuity-blurred if no implant; *assess eye appearance; *avoide increasing IOP-no stooping, straining, leaning forward
glaucoma info *blocked outflow of aqueous humor *20% of blindness cases from glaucoma *2 in 100 ppl in US over 40 yrs *4X as prevalent in Blacks *increases if family hx
1 and 2 glaucoma Primary-hereditary; Secondary acquired from injury or infection OR steroid use-may overstimulate aqueous humor production
Open angle glaucoma *degeneration of aqueous flow: -SLOW increase in IOP, -loss of peripheral vision, -PAINLESS, -insidious, -aching brow (could be mistaken for sinus infection), -halo around eyes from corneal edema; more common in Black population
Nursing cares for open angle glaucoma *beta blockers, cause vasodilation so that excess fluid can be reabsorbed (ex: inderal) *BEWARE beta blockers slow heart rate
Closed angle glaucoma can be mistaken for migraine *complete block of aqueous flow *emergency! *INSTANT increase in IOP *sudden blurred vision *eye PAIN *rapid loss of vision *photophobia *dilated pupil *lacrimation
Closed angle glaucoma-risk factors more common in women; age > 60; dark occupations-long term pupil dilation blocks drainage
Nursing cares for closed angle glaucoma *surgical iridectomy-removal of part of iris to allow drainage, notched iris appearance; *pilocarpine eye drops to shrink pupil (thins iris to allow drainage), *no caffeine, *medic alert bracelet, *read OTC meds for contraindications c flaucoma
Retinal disorders: Macular degeneration *results from aging: breakdown and scarring of retina *FIXED spots in centarl fision *no cure: laser to coagulate vessels *Wet-bleeding in area OR Dry-scarring
Retinal disorders: detachment *retina pulls away from choroid layer, shrinking vitreous humor *spontaneous in myopia or diabetic retinopathy *slow OR sudden *flashing lights *floaters *shadows *blurred vision *PAINLESS
Retinal detachment tx *laser repair-90% success *if not reattached-blindness b/c necrotic tissue
Enucleation *eye destruction *blind *loss of eye-remove prosthetic for surgery
General post-op eye care *prevent trauma-patch *don't touch eye *avoid increasing IOP *avoid aerosols and powders *sterile technique *no smoking (vasoconstriction, impaired healing) *safety *assess for pain, if dull-analgesics, if sharp-increasing IOP, call DR STAT
Created by: rlvander
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