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MS Finals > Ch. 49 Eye And Vision Problems > Flashcards

Ch. 49 Eye And Vision Problems Flashcards

0
Q

The external hordeolum is an infection of the sweat glands in the eyelid whereas an internal hordeolum is an infection of what?

A

The sebaceous glands

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1
Q

A “stye” is also known as what?

A

A Hordeolum

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2
Q

The most common causative agents of hordeolum are?

A

Staphylococcus aureus
Staphylococcus epidermis
Streptococcus

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3
Q

Treatment of Hordeolum includes?

A

Warm compresses 4x a day and an antibacterial ointment

*ointment may cause blurry vision. Instruct patient on driving precautions

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4
Q

An inflammation of a sebaceous gland in the eyelid

A

Chalazion

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5
Q

The difference between Hordeolum and chalazion is?

A

After redness/tenderness, a chalazion is followed by gradual painless swelling and usually no inflammatory signs are present.

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6
Q

Treatment for chalazion include?

A

Warm compresses for 15 minutes 4x a day followed by installation of ophthalmic ointment

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7
Q

Keratoconjunctivitis or dry eye syndrome can occur with the use of some drugs such as?

A

Antihistamines
Beta-adrenergic blocking agents
Anti cholinergic drugs

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8
Q

Patient with dry eye syndrome may feel?

A

A foreign body in the eye
Burning or itching eyes
Photophobia

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9
Q

Treatment of keratoconjunctivitis depend on the severity of manifestations which include:

A

Restasis, cyclosporine ophthalmic emulsion
Artificial tears for daytime
Lubricating ointments at night

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10
Q

Conjunctiva is inflammation of the?

A

Conjunctiva

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11
Q

Conjunctivitis is caused by?

A

Exposure to allergens or irritants

Not contagious

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12
Q

Conjunctivitis is contagious when?

A

Exposed to bacterial or viral infection

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13
Q

Manifestations of conjunctivitis include?

A 
Edema
Sensation of burning
Engorgement of blood vessels (bloodshot)
Excessive tears
Itching
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14
Q

Treatment of conjunctivitis include

A

Instillation of vasoconstrictors

Corticosteroid eyedrops

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15
Q

Bacterial conjunctivitis or pink eye is usually caused by

A

Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa

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16
Q

Manifestations of bacterial conjunctivitis include

A

Blood vessel dilation
Mild conjunctival edema
Tears and discharge (watery then gets thicker with shreds of mucus)

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17
Q

Pink eye treatment is aimed at elim infection with?

A

Topical antibiotics

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18
Q

Trachoma is the chief cause for preventable blindness and is caused by what

A

Chlamydia trachomatis

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19
Q

The manifestations for trachoma are similar to bacterial conjunctivitis with the exception that?

A

As the disease progresses, eyelid scars and turns inward causing lashes to damage the cornea.

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20
Q

Treatment for trachoma include

A

A 4 week course of oral or topical tetracycline
Erythromycin
Azithromycin once per week for 1-3 weeks

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21
Q

Why is corneal abrasion, ulceration and infection an emergency?

A

The cornea has no separate blood supply and cant defend itself from infections that may permanently impair vision

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22
Q

Manifestations of corneal disorder include

A 
Pain
Reduced vision
Photophobia 
Eye secretions
Cloudy or purulent (pus filled) fluid
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23
Q

Fluorescein stain is used and appears as

A

Green in patchy areas

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24
Q

Treatments for corneal disorders include

A

Anti-infective therapy
Broad spectrum antiobiotics
Eyedrops Qh for first 24 hrs
Health teaching and compliance on drug regimen

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25
Q

Treatment for corneal disorders are aimed at restoring

A

Corneal clarity and enhancing ability to use remaining vision

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26
Q

The surgical removal of diseases corneal tissue and replacement with tissue from a donors cornea is what?

A

Keratoplasty

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27
Q

After keratoplasty, lying on the non operative side reduces what?

A

IOP

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28
Q

Manifestations of graft rejection include?

A

Continuous leak of clear fluid, not tears
Excessive bleeding
Decreased vision
Increased redness
Pain
Photophobia
Light flashes “floaters” in field of vision

*report if w/i first 48 hours and persist for more than 6 hours

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29
Q

Activities that increase IOP include

A 
Bending at waist
Lifting more than 10lbs
Sneezing coughing
Nose blowing
BM strain
Vomiting
Intercourse
Head in dependent position
Tight shirt collars
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30
Q

Opacity of the lens that distorts the image projected onto the retina

A

Cataracts

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31
Q

Early manifestations of cataract include?

Progresses to?

A

Slightly blurred vision and decreased color perception

Blurred and diplopia
No pain or eye redness asso. With age related cataracts
Blindness without surgical intervention

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32
Q

Most common nursing dx for cataracts

A

Disturbed sensory perception (visual) related to altered sensory reception

Fear
Risk for injury
Self care deficit

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33
Q

The only “cure” for cataracts is surgery. What is done before surgery?

A

Sedative is given with a series of ophthalmic drugs
Pupils will dilate and cause vasoconstriction
Local anesthetic is injected into muscle cone behind eye for paralysis

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34
Q

What is the difference between extracapsular or phacoemulsification lens extraction?

A

Extracapsular removal is where the front portion of the capsule is opened by a small incision and the lens is removed whole

Phacoemulsification is where a probe is inserted through the casule and high frequency sound waves break the cataractous lens into sm. pieces and suctioned

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35
Q

Postop care for cataracts include

A

Mild itching, bloodshot eyes, and creamy white dry crusty drainage is NORMAL

pain with nausea and vomiting, yellow or green drainage must be reported

And activity restrictions must be taken

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36
Q

What is the difference between the aqueous and vitreous humor in the eye?

A

The vitreous humor is in the posterior segment and the gel doesn’t change in volume.

The aqueous humor in the anterior segment is continuously made up if blood plasma.

37
Q

What is normal IOP?

A

10-21mmHg

38
Q

What is glaucoma?

A

Ocular disease caused by increased IOP
Poorly oxygenated photoreceptors
Nerve tissues become ischemic and die
Commonly painless

39
Q

What are the types of glaucoma and their corresponding causes?

A

Primary- aging, heredity, and central retinal vein occlusion

Secondary- uveitis, iritis, neovascular disorders, trauma, ocular tumors, surgery, degenerative disease

Associated- DM, hypertension, severe myopia, retinal detachment

40
Q

What is the most common form of primary glaucoma and what does it do?

A

Primary open-angle glaucoma (PAOG) affects both eyes and is asymptomatic in the early stages

Outflow Aq. Humor through he chamber angle is reduced and cannot leave the eye at the same rate it is produced. IOP increases

41
Q

What is angle-closure glaucoma (closed angle, narrow angle, acute glaucoma)?

A

Has a sudden onset. Movement of iris against cornea closes chamber angle obstructing outflow of aq. Humor

42
Q

Late manifestations of glaucoma

A

Halos around lights
Peripheral vision loss
Decreased visual acuity

43
Q

Manifestations of acute angle glaucoma include

A 
Sudden severe pain radiating over face
Headache or brow pain
Colored halos around lights
Sudden blurred vision
Decreased light perception 
Reddened sclera
Foggy cornea
44
Q

What is the tonometry reading for PAOG and angle closure glaucoma?

A

22-32 mmHg

30mmHg or higher

45
Q

Most common class of drugs to manage glaucoma?

A 
Prostaglandin agonists
Adrenergic agonists, 
beta-adrenergic blockers, 
cholinergic blockers
Carbonic anhydrase inhibitors
46
Q

What systemic osmotic drugs can be given for angle closure glaucoma?

A

Oral glycerin(osmoglyn) and IV mannitol (osmitrol)

47
Q

The two most common surgical procedures for treating glaucoma are?

A

Laser trabeculoplasty - burns trabecular meshwork causing meshwork fibers to tighten and increases size of spaces between fibers improving outflow of aqueous humor decreasing IOP.

Filtering microsurgery- creates a drainage hole in the iris between pos/ant chambers

*both ambulatory procedures

48
Q

Conjunctiva is inflammation of the?

A

Conjunctiva

49
Q

Conjunctivitis is caused by?

A

Exposure to allergens or irritants

Not contagious

50
Q

Conjunctivitis is contagious when?

A

Exposed to bacterial or viral infection

51
Q

Manifestations of conjunctivitis include?

A 
Edema
Sensation of burning
Engorgement of blood vessels (bloodshot)
Excessive tears
Itching
52
Q

Treatment of conjunctivitis include

A

Instillation of vasoconstrictors

Corticosteroid eyedrops

53
Q

Bacterial conjunctivitis or pink eye is usually caused by

A

Staphylococcus aureus
Haemophilus influenzae
Pseudomonas aeruginosa

54
Q

Manifestations of bacterial conjunctivitis include

A

Blood vessel dilation
Mild conjunctival edema
Tears and discharge (watery then gets thicker with shreds of mucus)

55
Q

Pink eye treatment is aimed at elim infection with?

A

Topical antibiotics

56
Q

Trachoma is the chief cause for preventable blindness and is caused by what

A

Chlamydia trachomatis

57
Q

The manifestations for trachoma are similar to bacterial conjunctivitis with the exception that?

A

As the disease progresses, eyelid scars and turns inward causing lashes to damage the cornea.

58
Q

Treatment for trachoma include

A

A 4 week course of oral or topical tetracycline
Erythromycin
Azithromycin once per week for 1-3 weeks

59
Q

Why is corneal abrasion, ulceration and infection an emergency?

A

The cornea has no separate blood supply and cant defend itself from infections that may permanently impair vision

60
Q

Manifestations of corneal disorder include

A 
Pain
Reduced vision
Photophobia 
Eye secretions
Cloudy or purulent (pus filled) fluid
61
Q

Fluorescein stain is used and appears as

A

Green in patchy areas

62
Q

Treatments for corneal disorders include

A

Anti-infective therapy
Broad spectrum antiobiotics
Eyedrops Qh for first 24 hrs
Health teaching and compliance on drug regimen

63
Q

Treatment for corneal disorders are aimed at restoring

A

Corneal clarity and enhancing ability to use remaining vision

64
Q

The surgical removal of diseases corneal tissue and replacement with tissue from a donors cornea is what?

A

Keratoplasty

65
Q

After keratoplasty, lying on the non operative side reduces what?

A

IOP

66
Q

Manifestations of graft rejection include?

A

Continuous leak of clear fluid, not tears
Excessive bleeding
Decreased vision
Increased redness
Pain
Photophobia
Light flashes “floaters” in field of vision

*report if w/i first 48 hours and persist for more than 6 hours

67
Q

Activities that increase IOP include

A 
Bending at waist
Lifting more than 10lbs
Sneezing coughing
Nose blowing
BM strain
Vomiting
Intercourse
Head in dependent position
Tight shirt collars
68
Q

Opacity of the lens that distorts the image projected onto the retina

A

Cataracts

69
Q

Early manifestations of cataract include?

Progresses to?

A

Slightly blurred vision and decreased color perception

Blurred and diplopia
No pain or eye redness asso. With age related cataracts
Blindness without surgical intervention

70
Q

Most common nursing dx for cataracts

A

Disturbed sensory perception (visual) related to altered sensory reception

Fear
Risk for injury
Self care deficit

71
Q

The only “cure” for cataracts is surgery. What is done before surgery?

A

Sedative is given with a series of ophthalmic drugs
Pupils will dilate and cause vasoconstriction
Local anesthetic is injected into muscle cone behind eye for paralysis

72
Q

What is the difference between extracapsular or phacoemulsification lens extraction?

A

Extracapsular removal is where the front portion of the capsule is opened by a small incision and the lens is removed whole

Phacoemulsification is where a probe is inserted through the casule and high frequency sound waves break the cataractous lens into sm. pieces and suctioned

73
Q

Postop care for cataracts include

A

Mild itching, bloodshot eyes, and creamy white dry crusty drainage is NORMAL

pain with nausea and vomiting, yellow or green drainage must be reported

And activity restrictions must be taken

74
Q

What is the difference between the aqueous and vitreous humor in the eye?

A

The vitreous humor is in the posterior segment and the gel doesn’t change in volume.

The aqueous humor in the anterior segment is continuously made up if blood plasma.

75
Q

What is normal IOP?

A

10-21mmHg

76
Q

What is glaucoma?

A

Ocular disease caused by increased IOP
Poorly oxygenated photoreceptors
Nerve tissues become ischemic and die
Commonly painless

77
Q

What are the types of glaucoma and their corresponding causes?

A

Primary- aging, heredity, and central retinal vein occlusion

Secondary- uveitis, iritis, neovascular disorders, trauma, ocular tumors, surgery, degenerative disease

Associated- DM, hypertension, severe myopia, retinal detachment

78
Q

What is the most common form of primary glaucoma and what does it do?

A

Primary open-angle glaucoma (PAOG) affects both eyes and is asymptomatic in the early stages

Outflow Aq. Humor through he chamber angle is reduced and cannot leave the eye at the same rate it is produced. IOP increases

79
Q

What is angle-closure glaucoma (closed angle, narrow angle, acute glaucoma)?

A

Has a sudden onset. Movement of iris against cornea closes chamber angle obstructing outflow of aq. Humor

80
Q

Late manifestations of glaucoma

A

Halos around lights
Peripheral vision loss
Decreased visual acuity

81
Q

Manifestations of acute angle glaucoma include

A 
Sudden severe pain radiating over face
Headache or brow pain
Colored halos around lights
Sudden blurred vision
Decreased light perception 
Reddened sclera
Foggy cornea
82
Q

What is the tonometry reading for PAOG and angle closure glaucoma?

A

22-32 mmHg

30mmHg or higher

83
Q

Most common class of drugs to manage glaucoma?

A 
Prostaglandin agonists
Adrenergic agonists, 
beta-adrenergic blockers, 
cholinergic blockers
Carbonic anhydrase inhibitors
84
Q

What systemic osmotic drugs can be given for angle closure glaucoma?

A

Oral glycerin(osmoglyn) and IV mannitol (osmitrol)

85
Q

The two most common surgical procedures for treating glaucoma are?

A

Laser trabeculoplasty - burns trabecular meshwork causing meshwork fibers to tighten and increases size of spaces between fibers improving outflow of aqueous humor decreasing IOP.

Filtering microsurgery- creates a drainage hole in the iris between pos/ant chambers

*both ambulatory procedures

86
Q

Prostaglandin agonists do what?

A

Lower IOP by dilating the blood vessels in the trabecular mesh collecting more aqueous humor and allowing more fluid to leave the eye

  • dont use when cornea is intact
  • using with a normal IOP May reduce vision
87
Q

Adrenergic agonists do what?

A

Bind to receptors inneye to reduce amount of aqueous humor produced by ciliary bodies and dilating the pupil

  • increases BP and may cause hypertensive crisis
  • pupils remain dilated causing discomfort with light
88
Q

Beta adrenergic blockers do what?

A

Blocks Ba receptors and less aqueous humor is produced by ciliary bodies

  • if drug absorbs systemically they constrict pulmonary smooth muscle and narrow airways
  • drugs induce hypoglycemia
89
Q

Cholinergic drugs do what?

A

Decrease amount of aqueous humor produced and cause miosis, making room between iris and lens allowing fluid to flow through pupil better

  • can cause headache flushing increased saliva and sweating
  • use good lighting because pupils constrict
90
Q

Carbonic anhydrase inhibitors so what?

A

Inhibit production of aqueous humor and dont affect flow or absorption of fluid

  • sensitivity to sulfonamides
  • shake well before applying
  • wait 15 minutes to use contacts
91
Q

Main manifestation of vitreous hemorrhage?

A

Reduced visual acuity

Mild- red haze or floaters
Moderate- black streaks or tiny black dots
Severe- reduce visual acuity to hand motion

MS Finals (1 decks)

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