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Last week Content > Eye and Vision disorders > Flashcards

Eye and Vision disorders Flashcards

1
Q

What is a cataract?

A

An opacity or cloudiness of the lens.

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2
Q

Cataracts have increased incidence with what?

A

Aging.

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3
Q

By age ____, more than half of all Americans have ________.

A

80 years, cataracts

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4
Q

What is a leading cause of disability on the US?

A

Cataracts

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5
Q

What are the four types of cataracts?

A

Secondary, traumatic, radiation, and congenital

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6
Q

What are the risk factors for cataracts?

A

Age, environment (trauma, excessive sun exposure), heredity, DM, smoking and ETOH, drugs

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7
Q

What are the clinical manifestations of cataracts?

A
  • tends to occur bilaterally at different rates.
  • decreased acuity; painless blurred vision
  • diplopia; sensitivity to glare
  • color distortion
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8
Q

What are the diagnostic tests for eye and vision loss?

A
  • visual acuity test
  • Absent red reflex
  • dilated eye exam
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9
Q

What is the visual acuity test used for the diagnosis of vision loss?

A
  • snellen and Rosenbaum
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10
Q

What is the instrument used in a dilated eye exam?

A

Opthalmoscope

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11
Q

When is eye surgery indicated?

A

When vision and ADL’s are affected

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12
Q

Is eye surgery for cataracts typically outpatient with local anesthesia?

A

Yes

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13
Q

True or false.

Complications are a regular occurrence for cataract eye surgery.

A

False.

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14
Q

What is red reflex?

A

A reddish-orange reflection of light from the eye’s retina that is observed when using an opthalmoscope or retinoscope from one foot away.

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15
Q

For the client who has developed cataracts, the nursing process is geared toward what two things?

A

Treatment and prevention

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16
Q

What is macular degeneration?

A

Eye disease that causes vision loss.

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17
Q

What other name is macular degeneration referred to as?

A

Age-related macular degeneration.

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18
Q

What is the most common cause of vision loss in persons older than 60 yrs old?

A

Macular degeneration

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19
Q

What are the two types of macular degeneration?

A

Dry or nonexudative and wet type

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20
Q

Which is the most common type of macular degeneration?

A

Dry, nonexudative

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21
Q

How is dry or nonexudative macular degeneration described?

A

Slow breakdown of the layers of the retinal with the appearance of drusen

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22
Q

How is the wet type of macular degeneration described?

A

Proliferation of abnormal blood vessels growing under the retina-choroidal revascularization

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23
Q

True or false:

Wet type of macular degeneration may have an abrupt onset

A

True.

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24
Q

What does the macula provide?

A

Sharp central vision.

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25
Q

Explain the characteristics of nonexudative (dry) macular degeneration:

A
  • gradual accumulation of deposits
  • pigment epithelium detaches in small areas
  • vision loss typically not significant
  • vision loss progresses slowly
  • risk that disorder will progress to exudative stage
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26
Q

Explain the characteristics of exudative (wet) macular degeneration?

A
  • formation of new weak blood vessels
  • new vessels prone to leak
  • elevate retina from choroid
  • bleeding can occur
  • acute vision loss
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27
Q

Who is at lower risk for developing macular degeneration?

A

Asians, those with darker pigmentation

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28
Q

What are the risk factors of macular degeneration?

A
  • aging
  • smoking
  • race (white is higher risk)
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29
Q

What are the manifestation of a damaged macula?

A
  • central vision blurred

- peripheral vision intact

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30
Q

What are the manifestations in wet AMD?

A

Straight lines appear crooked or wavy

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31
Q

What are the diagnostic tests for AMD?

A
  • Vision and retinal examination
  • ambler grid
  • fluorescein angiogram
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32
Q

Who is involved int eh collaboration for care of AMD?

A

Ophthalmologist, OT, social worker, adaptive technology

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33
Q

What type of drugs are given for wet AMD?

A

Antiangiogenic drugs

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34
Q

Where must the antiangiogenic drug be injected for AMD?

A

Into the eye

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35
Q

What do antiangiogenic drugs do?

A

Block vascular endothelial growth factor that stimulates angiogenesis

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36
Q

What are three types of antiangiogenic drugs?

A
  • ranibizumab
  • bevacizumab
  • pegaptanib
37
Q

In the early stages, what are the nonpharmacological ways that AMD can be slowed?

A

High-dose antioxidants, zinc

38
Q

What are some nonpharmacologic ways to help with AMD?

A

Large-print books, magnifying glasses, lighting

39
Q

What is glaucoma?

A

A disturbance of the functional or structural integrity of the optic nerve

40
Q

What is the leading cause of blindness of adults in the US?

A

Glaucoma

41
Q

What does incidence of glaucoma increase with?

A

Age

42
Q

What are the different types of glaucoma?

A

Open angle, angle closure (pupillary), congenital and glaucoma that is secondary to other conditions

43
Q

What is open angle glaucoma?

A

Open-angle refers to the angle between the iris and sclera. The aqueous outflow is decreased due to blockages in the eye’s drainage system causing a gradual rise in IOP.

44
Q

In glaucoma what happens to aqueous production and drainage?

A

They are not in balance

45
Q

What happens when aqueous outflow is blocked?

A

Pressure builds up in the eye

46
Q

What does increased IOP cause?

A

Irreversible mechanical or ischemic drainage.

47
Q

Open-angle glaucoma is what percentage of all glaucoma’s?

A

90%

48
Q

What are the characteristics of open-angle glaucoma?

A

It is chronic, gradually progressive and bilateral

49
Q

What are the characteristics of angle-closure glaucoma?

A
  • Corneal flattening, bulging of iris into anterior chamber
  • intraocular pressure rises abruptly
  • angle between iris and the sclera suddenly closes, causing a corresponding increase in IOP
50
Q

What is angle-closure glaucoma often called?

A

“Silent thief”

51
Q

When is glaucoma first noticed?

A

When there is significant vision loss, blurring, halos, difficulty focusing, difficulty focusing in low lighting

May also have aching or discomfort around eyes or headache.

52
Q

What are the characteristics of angle-closure glaucoma?

A
  • usually unilateral

- less common

53
Q

What type of med should you avoid if you have angle-closure glaucoma?

A

Mydriatics.

54
Q

What do mydriatics cause?

A

Dilation of pupil

55
Q

What are the symptoms of angle-closure glaucoma?

A

Headaches, severe eye pain, n/v, rainbows around lights at night, very blurred vision profuse tearing

56
Q

What are the three p’s of blindness?

A
  • prevention (i should have seen this coming)
  • painless (i didn’t feel a thing)
  • permanent (and know I’m blind forever)
57
Q

What are the risk factors of glaucoma?

A
  • familial
  • over age 40
  • DM, HTN
  • history of ocular problems
  • race AA 6-8 x > whites
  • Infection, trauma
58
Q

What types of ophthalmic meds are used for glaucoma?

A

Anti inflammatory drugs, corticosteroid suspensions

59
Q

How do the drugs used for glaucoma work?

A

They increase aqueous outflows or decrease production, may constrict the pupil and affect ability to focus lens of the eye, may produce systemic affects

60
Q

Side effects of long-term topical steroids include glaucoma, cataracts, and increased ris of infection, what type of therapy may be used instead of steroidS?

A

NSAID’s

61
Q

What are the diagnostic tests for glaucoma?

A

Tonometry, funduscopy, gonioscopy, visual field testing

62
Q

What does tonometry measure?

A

IOP. IOP is elevated in glaucoma, especially angle-closure

63
Q

What does Gonioscopy measure?

A

The drainage angle of the anterior chamber of the eye

64
Q

What does perimeter assess?

A

Vision loss

65
Q

What is the goal of treatment of glaucoma?

A

To prevent further optic nerve damage.

66
Q

What are other forms of treatment of glaucoma?

A

Maintain IOP within range unlikely to cause damage, pharmacologic therapy, surgery

67
Q

What is used for pharmacological therapy for glaucoma?

A
  • topical beta-adrenergic blocking agents
  • prostaglandin analogs
  • adrenergic agonists
  • carbonic anhydrase inhibitors
68
Q

What types of surgeries are for angle-closure glaucoma?

A

Gonioplasty, Laser iridotomy

69
Q

What is Timolol?

A

A Beta-adrenergic drug

70
Q

What is the action of timolol?

A

Decrease the production of aqueous humor in the eye.

71
Q

What should you assess for when taking timolol?

A

Hypotension, bradycardia, SOB

72
Q

What type of surgical procedures are for open angle glaucoma?

A
  • laser trabeculoplasty
  • trabeculectomy
  • photocoagulation, cyclocryotherapy
  • drainage implants, or shunts
73
Q

What are the pharmacological therapies for angle-closure glaucoma?

A
  • IV diuretic

- Fast-acting miotic drugs

74
Q

What is the fundus of the eye?

A

The back part of the eyeball.

75
Q

Why is laser therapy used for wet AMD?

A

To seal leaking blood vessels

76
Q

What are ocular injections in wet AMD for ?

A

To inhibit blood vessel growth

77
Q

Is there a cure for macular degeneration?

A

No.

78
Q

What are the common causes of cataracts?

A
  • age-related
  • traumatic
  • toxic
  • associated
  • complicated
79
Q

What are the age-related causes of cataracts?

A

Drying of lens due to water loss, increase in lens density due to lens fiber compaction

80
Q

What are the traumatic causes of cataracts?

A

Blunt or penetrating injury or foreign body in the eye, exposure to radiation or ultra violet light

81
Q

What are the toxic causes of cataracts?

A

Long term use of corticosteroids, phenothiazine derivatives, beta-blockers, or miotic medications

82
Q

What are the associated causes of cataracts?

A

DM, hypoparathyroidism, Down syndrome, chronic sunlight exposure

83
Q

What are the complicated causes of glaucoma?

A

Intraocular disease such as retinitis pigmentosa, glaucoma, or retinol detachment

84
Q

What is diplopia?

A

Double vision

85
Q

What type of drug is timolol?

A

Beta-blocker

86
Q

What type of IV diuretic is commonly used in emergency treatment of or primary angle-closure glaucoma?

A

IV mannitol

87
Q

What type of drug is the first line of drug therapy for glaucoma?

A

Beta blockers

88
Q

What is a potential consequence of untreated glaucoma?

A

Blindness.

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