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MedSurg > eye disorders > Flashcards

eye disorders Flashcards

1
Q

glaucoma

A
  • increased IOP
  • optic nerve atrophy
  • peripheral visual field loss
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2
Q

normal IOP

A

10-21 mmHg

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3
Q

prevention of glaucoma

A

early detection and treatment

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4
Q

pathophysiology of glaucoma

A

rate of aqueous production (inflow) is greater than the rate of aqueous reabsorption (outflow)
-IOP rises above the normal limits

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5
Q

primary open angle glaucoma

A
  • most common type
  • outflow is decreased in the trabecular meshwork
  • drainage channels become clogged
  • damage to the optic nerve can result
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6
Q

s/s of primary open angle glaucoma

A
  • develops slowly without symptoms
  • tunnel vision
  • IOP: 22-32 mmHg
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7
Q

primary closed angle glaucoma

A
  • reduction in outflow

- lens bulging forward d/t aging

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8
Q

causes of acute closed angle glaucoma

A
  • drug induced mydriasis
  • emotional excitement
  • darkness
  • is an ocular emergency
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9
Q

s/s of acute closed angle glaucoma

A
  • sudden excruciating pain in or around the eye
  • n/v
  • HA
  • IOP>50
  • colored halos around lights
  • blurred vision
  • ocular redness
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10
Q

s/s of subacute/chronic closed angle glaucoma

A
  • colored halos around lights
  • blurred vision
  • ocular redness
  • eye or brown pain
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11
Q

collaborative care for chronic open angle glaucoma

A
  • argon laser trabeculoplasty

- trabeculectomy/filtration surgery

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12
Q

argon laser trabeculoplasty

A
  • non surgical tx
  • used when meds are not successful
  • outpt procedure
  • laser stimulates scarring and contraction of trabecular meshwork, which opens outflow channels
  • reduces IOP approx 75%
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13
Q

trabeculectomy

A
  • surgery
  • removes part of the iris and trabecular meshwork
  • closes scleral flaps loosely
  • success rate: 75-85%
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14
Q

collaborative care acute closed angle glaucoma

A
  • miotics
  • mannitol
  • laser peripheral iridotomy
  • surgical iridectomy
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15
Q

glaucoma assessment

A
  • pt’s ability and psychological reaction
  • visual acuity
  • visual fields
  • IOP
  • fundus changes
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16
Q

glaucoma teaching

A
  • avoid activity that increases IOP: bending, straining, coughing, suctioning
  • instillation of eye drops
  • wear ID bracelet
  • avoid self treatment
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17
Q

gerontological considerations

A
  • additive effects of beta adrenergic blocking glaucoma agents
  • contraindications for beta adrenergic blockers: bradycardia, HTN, heart block, bronchospasm
  • aspirin and CAI= increased salicyclic toxicity and acidosis
  • eye drops and systemic absorption
18
Q

cataracts

A
  • opacity within the lens
  • can be in one of both eyes
  • age related
19
Q

s/s of cataracts

A
  • gradual decreased vision
  • abnormal color perception/color blind
  • glare worse @ night, when pupils dilate
20
Q

non surgical treatment for cataracts

A
  • postpones the need for surgery
  • change prescription of glasses
  • strong reading glasses or magnifiers
  • increased lighting
  • lifestyle changes: no driving at night
21
Q

cataract extraction

A
  • when palliative measures no longer provide acceptable visual function
  • anterior capsule opened and the lens nucleus and cortex are removed
  • capsular bag is intact
  • surgery is the only cure
22
Q

assessment for cataracts

A
  • visual acuity
  • impact of visual disability
  • level of knowledge
23
Q

age related macular degeneration (AMD)

A
  • degenerative disease of the central portion of retina
  • results in loss of central vision
  • most common cause of irreversible central vision loss in 60+
24
Q

dry AMD

A
  • nonexudative
  • macular cells start to atrophy
  • leads to a slowly progressive and painless vision loss
  • close vision tasks become difficult
25
Q

wet AMD

A
  • exudative
  • more severe
  • rapid onset
  • development of abnormal blood vessel in or near the macula
  • pt with wet had dry first
26
Q

causes of AMD

A
  • aging
  • genetics
  • long term exposure to UV light
  • hyperopia
  • cigarette smoking
  • light colored eyes
  • nutrition
27
Q

s/s of macular degeneration

A
  • blurred vision
  • darkened vision
  • scotomas (blind spots in vision)
  • metamorphopsia (distortion of vision)
28
Q

diagnosing macular degeneration

A
  • visual acuity
  • opthalmoscopy
  • amsler grid test: finds involved area
  • fundus photography
  • IV angiograph
29
Q

treatment for wet AMD

A
  • photodynamic therapy
  • meds
  • vitamins and minerals
  • smoking cessation
30
Q

photodynamic therapy

A

destroys abnormal blood vessels without permanent damage to retinal pigment epithelium and photoreceptor cells

31
Q

treatment for dry AMD

A

no treatment

32
Q

retinal detachment

A

separation of the sensory retina and underlying pigment epithelium, with fluid accumulation between the 2 layers

33
Q

risk factors for retinal detachment

A
  • increasing age
  • severe myopia
  • eye trauma
  • diabetic retinopathy
  • cataract surgery
  • family or personal hx
34
Q

untreated retinal detachment

A

become blind

35
Q

retinal holes

A

atrophic retinal breaks that occur spontaneously

36
Q

retinal tears

A

vitreous humor shrinks during again and pulls on the retina

37
Q

s/s of retinal detachment

A
  • photopsia (light flashes)
  • floaters
  • cobweb or hairnet vision
  • ring int he field of vision
  • painless loss of peripheral or central vision
  • curtain falling like vision
38
Q

diagnostic studies for retinal detachment

A
  • visual acuity
  • opthalmoscopy
  • slit lamp microscopy
  • ultrasound
39
Q

treatment for retinal detachment

A
  • *goal is to seal any retinal breaks
  • laser photocoagulation
  • cryopexy
  • *and to relieve inward traction on the retina
  • scleral buckling
  • vitrectomy
  • pneumatic retinopexy
40
Q

postop care for retinal detachment

A
  • topical agents: abx, steroids, dilators, analgesics
  • position: prone
  • activity restriction: no flying d/t high altitude

MedSurg (22 decks)

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