Eye Flashcards
where does the aqueous humor originate
ciliary body of posterior chamber
what is aqueous humor
clear, watery fluid
where does the aqueous humor drain
into the nervous system through canal of schlemm
*what is important to note about aqueous humor
production has to match outflow
what happens if pressure from aqueous humor builds
destruction of the optic nerve
patho of aqueous humor
originate in ciliary body of posterior chamber - flows thru the pupil into the anterior chamber
what is the role of the aqueous humor
nourishes/bathes whole part of the eye
visual pathway crosses at
optic chiasm
with a left sided stroke which eye would be effected
opposite side is effected - right eye
light passes through the eye through these structures
cornea, lens, aqueous humor, vitreous humor
structures must be clear for light to pass through, t or f
true
what conditions effect clarity of vision
cataracts, cornea abrasion
2 types of conjunctiva
bulbar - palpebral
what is conjunctiva
transparent mucous membrane covering inner surface of eyelid (palpebral) - extends over sclera (bulbar) - forming a pocket under eyelid -
conjunctiva that covers inner surface of eyelid
papebral
conjunctiva that extends over the sclera
bulbar
glands in conjunctiva secrete what
mucous and tears
what is sclera
the white of the eyes - shell which protects
how to communicate w/pt who is visually impaired
normal tone of voice - doesn’t mean they are deaf
use clock when offering food
what is the sighted guide technique for visual impairment
slightly to front - holding elbow - describe environment
what do you NOT want to do to environment w/visual impairment
change things around
dx studies of visual impairment
refractometry
ultrasonography
fluorescein angiography
amsler grid
what happens during refractometry
looking through lens (which looks clearer?)
what happens in fluorescein angiography
inject dye to look at vessels
when would you see fluorescein angiography used
retinopathy
when would you see amsler grid used
macular degeneration
what is myopia
near-sighted
what is hyperopia
far-sighted
what is astigmatism
cornea is uneven - light rays are bent right
what is presbyopia
normal aging of the eye - seen in elderly - lose ability to accommodate (focus)
what are refractive errors
myopia, hyperopia, astigmatism, presbyopia
uncorrectable visual impairments
total/functional blindness (legally blind), partially sighted
what is functional blindness
some light perception w/no usable vision
total/functional blindness are both legally blind, t or f
true
what is total blindness
no light perception, no usable vision
is partially sighted considered legally blind
no
to be classified legally blind you must meet this criteria
visual acuity of 20/200 or worse in better eye
visual field no > than 20 degrees in better eye
what does 20/200 vision mean
what a person can see at 20ft you can see at 200 ft
eye trauma types
non penetrating
contusion
abrasion
how would we treat a corneal abrasion
patch - cold compress - Tylenol
how would we trt penetrating eye injury
shield - refer to ophthalmology specialist - DON’T PULL IT OUT
how would we trt a splash injury to the eye
flush it - irrigate for 15-20 min (lukewarm or norm. saline)
what is hyphema
blunt trauma to the eye - blood covers eye
hyphema usually goes away on its own, t or f
true
retinal detachment is often described as a
curtain covering the eye
another term for external sty
hordeolum
how does a hordeolum present
red, swollen, tender
how do we treat hordeolum (sty)
warm compresses - Tylenol
if a sty gets worse what should we do
refer to ophthalmologist for trt. (antibiotic)
another term for an internal sty
chalazion
how do we treat chalazion (internal sty)
warm compresses - OR for surgical removal
infections of the eye
blepharitis - conjunctivitis - keratitis
what is blepharitis
inflammation of the lid margin
trt for blepharitis
lubricating eye drops
what is conjunctivitis
inflammation of the conjunctiva
trt for conjunctivitis
allergic (allergy med) - antibiotic eye drops
what are the 3 different types of conjunctivitis
allergic, viral, bacterial
important teaching for conjunctivitis
wash your hands - don’t touch your eye - avoid make-up - don’t wear contact lenses - don’t share wash rags
what is keratitis
inflammation/infection of the cornea
common dry eye disorder commonly found in elderly and those with lupus or scleroderma
keratoconjunctivits sicca “sand in eye”
trt for keratoconjunctivitis sicca
artificial tears/ointment
what is strabismus
pt can’t focus both eyes - wandering eye
what part of the eye is affected in strabismus
the muscle is weakened
trt of strabismus in children
corrective lenses - patch for good eye - surgery
in adults strabismus is usually caused by
palsy of cranial nerves 3, 4, or 6
primary complaint in adult strabismus
double vision - diplopia
new trt for strabismus
botox injected into muscle of the eye
pt complains of windshield glare, abnormal color perception and decreased vision what do you suspect
cataracts - lens becomes opaque
another name for age related cataracts
senile cataract
congenital factor that causes cataracts in kids
maternal rubella
long term use of steroids can cause
cataracts
diabetics are very prone to cataracts, t or f
true
trt of cataracts
conservative (non- surgical)
surgical
non-surgical methods to trt cataracts
magnifying glass/chg prescriptions
surgical treatment for cataracts
phacoemulsification - break up cataract - suck it out - replace lens
does pt have pain post phacoemulsification
no - red flags with pain/drainage
what to teach pt post phacoemulsification
don’t rub eye - use shield when sleeping - don’t lift anything heavy
what is retinopathy
micro-vascular damage to the retina
early retinopathy presents like this
tiny pinpoint hemorrhages or small infarcts “cotton wool spots”
non proliferative retinopathy presents like this
capillary micro aneurisms - exudate - hemorrhage
retinopathy becomes proliferative retinopathy when pt is
not controlling blood pressure/diabetes
what happens when pt develops proliferative retinopathy - what do they form
new vessels (fragile/leak)
**biggest risk factor for retinopathy
hyperglycemia - tight glucose control
***most common diagnosis in eye exam
type II diabetes
trt of retinopathy
argon laser
meds that restrict new vessels from forming
pt complains of light flashes, floaters, ring in field of vision, curtain came over field of vision what do you suspect
retinal detachment
what happens in retinal detachment
separation of neuro-sensory retina from pigment epithelium
most common cause of retinal detachment
aging - vitreous shrinks (gel-like substance)
are floaters always an indication of retinal detachment
no
caring for pt w/suspected or confirmed retinal detachment
lay down - don’t lift - limit activity
pt complains of central vision loss, blurred/darkened vision, scotoma, metamorphopsia what do you suspect
macular degeneration
what is a scotoma
blind spot in visual field
what is metamorphopsia
distorted vision
major risk factor for macular degeneration
family history - nutritional factors
2 types of macular degeneration
dry (non-exudate) and wet (exudate)
what causes macular degeneration
unknown
what happens in dry (non-exudate) macular degeneration
atrophy and degeneration of macula (clear vision of eye)
what happens in wet (exudate) macular degeneration
formation of new vessels, leak causing loss of sight
how/when does wet macular degeneration occur
rapid onset, ***always comes after dry
trt for macular degeneration
laser
photo-dynamic therapy
*vitamins
*stop smoking
once vision is affected can it improve w/macular degeneration
not usually
pt complains of peripheral vision loss, IOP (increased ocular pressure), optic nerve atrophy what do you suspect
glaucoma
2nd leading of cause of permanent blindness in the US
glaucoma
***is blindness from glaucoma preventable
yes - get pressure measured and treated
patho of glaucoma
balance of aqueous humor is off causing IOP
primary glaucoma usually occurs without
an identifiable cause - usually 65> - can be congenital
most common type of glaucoma
Primary Open Angle Glaucoma (POAG)
when outflow occurs its called
angle of the eye
secondary glaucoma is usually caused by
eye trauma
the angle of the eye is where the
iris meets the cornea
patho of open angle glaucoma
drainage channels become clogged (at angle of eye) - aqueous humor can’t drain out (reduction in outflow)
patho of closed angle glaucoma
bulging lens pushes forward blocking the canal of schlemm
manifestations of open angle glaucoma
**only symptom peripheral vision loss, develops slowly
acute closed angle closure is an emergency, t or f
true
manifestations of acute closed angle glaucoma
headache with n/v - pain around the eye - halo around lights - reddened/nonreactive pupil - will go blind w/o trt
normal IOP
10-21 mm Hg
unrelieved pressure r/t glaucoma causes blindness, t or f
true
IOP w/closed angle glaucoma
> 49 mm Hg
IOP w/open angle glaucoma
22-32 mm Hg
care/trt for open-angled glaucoma
eye drops
care/trt for acute closed-angled glaucoma
osmotic agents
*OR - iridectomy (keyhole surgery) - usually trt both eyes
if someone goes to surgery with artificial eye (enucleation) what must you do
take the eye out