AC 2 Exam 3 Flashcards
What are some risk factors for cataracts?
Exposure to the sun and UVB rays
Long-term corticosteroid meds
Increased age
Smoking and alcohol
Obesity
DM, HLD, HTN
Trauma to the eye or hx of eye surgery
Caucasian race
What are some vision changes with cataracts?
Often bilateral, painless and slow onset of blurry vision
Sensitive to glare
Halos around objects
Loss of acuity
Reading and night driving difficulty
Decreased color perception
What’s the most common cause of adult CURABLE blindness?
Cataract
Cataract is characterized with
Clouding or opacity of lens due to structural changes in proteins, which leads to gradual loss of vision
Pre-op care for cataract surgery includes
NPO, void, measures to decrease IOP, eyedrops to dilate pupil, consents.
May clip eyelashes
Post-op care for cataract surgery includes
Measures to decrease IOP
Eyedrops to constrict pupil
Antibiotics
Anti-inflammatory
Minimum light
What’s the most important cataract post-op care?
Pressure management (IOP)
What are some complications following cataract surgery that require immediate physician notice?
Infection (drainage)
Wound dehiscence (poor IOP control)
Hemorrhage
Severe, acute, unrelieved pain
Uncontrolled, elevated IOP
Excessive tearing
Decline in visual acuity
Sparks, flashes, floaters
Excessive coughing
Why is IOP management so important following cataract surgery?
Because the incision site can burst. We don’t want that.
What are some measures to decrease IOP?
HOB at least 30, lying on back or unoperated side, monitor for N/V
How long do post-cataract surgery patients have to wear eye shield at night?
2-3 weeks
What is one medication that we need to give to eye surgery patients?
Stool softeners (no straining)
What is the leading cause of IRREVERSIBLE blindness?
Glaucoma
How are glaucoma and IOP related?
Increased IOP causes optic nerve damage, leading to glaucoma
What is the recommended schedule for glaucoma screening?
Screening should start at 40
What is glaucoma called a “thief in the night?”
Because there are no noticeable early symptoms
How is glaucoma diagnosed?
Measure IOP and visual acuity
What’s the relation between the aqueous outflow system and glaucoma?
The aqueous outflow system is obstructed, causing increased IOP, leading to optic nerve damage from all those pressure.
What are some ophthalmic medications used to treat glaucoma?
Beta blockers and cholinergics. They both control IOP.
What is the purpose of using ophthalmic agents for glaucoma?
To control IOP; we can’t treat/cure glaucoma, but can control IOP
How does beta blocker help decrease IOP in glaucoma?
It decreases production of aqueous humor, decreasing the IOP.
Patients with what condition should not use beta blockers?
Asthma and CHF. Beta blockers can also cause bradycardia
How does cholinergics help with glaucoma?
Ex. Pilocarpine; it constricts pupils, which opens canal and increases flow of aqueous fluid, decreasing IOP.
Why does glaucoma need to be diagnosed early?
Because it is irreversible. permanent blindness.