Eye disorders Flashcards
How is Cataracts described?
Opacity or cloudiness of the lens
Cataracts are the leading cause of what in the united states?
disability
What are the four types of cataracts in addition to aging?
- Secondary
- Traumatic
- Radiation
- Congenital
By age of 80 more than half of all Americans have this.
Cataracts
What are the risk factors of cataracts?
- Age
- Environmental
- Heredity
- Diabetes
- Smoking and heavy alcohol
- Drugs
What environmental factors increase the risk of cataracts?
Trauma and excessive sun exposure
Cataracts tend to occur how?
Bilaterally but at different rates
What are the clinical manifestations of cataracts?
- Decreased acuity
- Painless
- Blurred vision
- Diplopia (sensitivity to glare)
- Color distortion
What are the diagnostic tests for cataracts?
-History and eye exam
What is the visual acuity tests used?
Snellen and Rosenbaum
Cataracts have an absence of what?
Red reflex
This type of exam needs to be done in order to truly diagnose a cataract?
Dilated eye exam with ophthalmoscope.
What is an Intracapsular cataract extraction (ICCE)?
Removal of entire lens
*rarely dine today
What is an extra capsular cataract extraction (ECCE)?
Maintains the posterior capsule of the lens.
Reducing potential postoperative complications
What is a Phacoemulsification?
An ECCE that uses an ultrasonic device to suction the lens out through a tube.
Incision is small than with standard ECCE
How is a lens replacement done?
After removal of the lens by ICCE or ECCE, the surgeon inserts an intraocular lens implant.
Having a intraocular lens implant eliminates the need for what?
Aphakic lenses
When is surgery for cataracts indicated?
When vision and ADLs affected
A cataract surgery is typically done how?
Outpatient and using local anesthesia
A patient just had cataract surgery. You should instruct the patient to call the physician immediately if what?
Vision changes Continuous flashing lights appear Redness, swelling or pain increases. Type and amount of drainage increases Significant pain is not relieved by acetaminophen.
When does the pain from Cataract surgery usually subside?
Within 1-2 days
Tends to be mild to moderate discomfort and some discharge
What should the patient make suer to do after Cataract surgery?
- Wear eye protection
- Take medications as ordered
- Avoid rubbing eyes
- Report symptoms
When does most healing complete after Cataract surgery?
7-8 weeks
What is specific in nursing management for a patient undergoing cataract surgery?
Dilating eye drops are ordered.
For a patient who has developed cataracts what does the nursing process become geared to?
Treatment and prevention of injury
What part of the physical exam should be done for a patient with potential cataracts?
Presence of red reflex
What do you need to implement in a patient with cataracts?
- Prevent injury
- Facilitate informed decision-making
- Teach principles of self-care
- Promote wellness
Which of the following statements indicates to the nurse that the client has understood home care instructions following cataract surgery?
- “I should not bend over to pick up objects from the floor.”
- “I can sleep on whichever side I want as long as my head is raised.”
- “I may not watch television for 6 weeks.”
- “I should keep the protective eye shield in place for 24 hours a day.”
- I can sleep on whichever side I want as long as my head is raised
When assessing a client, the nurse notes absence of the red reflex in the clients right eye. On questioning the client responds, “Oh, yes, my doctor told me I have cataracts. When should I have them removed?” How should the nurse respond?
- “It appears that the right eye is due for surgery.”
- “Are you having difficulty reading or doing activities you enjoy?”
- “Are you starting to experience frequent headaches or pain in your right eye?”
- ” Cataracts can be removed at any time that is convenient for you.”
- “Are you having difficulty reading or doing activities you enjoy?”
When a client who has undergone cataract extraction is preparing to go home, the nurse reinforces which of the following instructions?
- Remove the dressing at bedtime.
- Expect a headache for the first few days after the procedure.
- Avoid sleeping on the operative side.
- Set up new appointment with surgeon for 1 month from the day after discharge.
- Expect a headache for the first few days after the procedure.
What is the most common cause of vision loss in people older than 60?
Macular degeneration
What are the types of macular degeneration?
Dry or non exudative
Wet
What is the most common type of macular degeneration?
Dry or non exudative- 85 to 90%
What happens to the eye in a dry or nonexudative type of macular degeneration?
Slow breakdown of the layers of the retinal with the appearance of drusen
What happens in the wet type of macular degeneration?
Abrupt onset
Proliferation of abnormal blood vessels growing under the retina
What is choroidal revascularization?
Proliferation of abnormal blood vessels growing under the retina
What does the macula provide?
Sharp central vision
How does nonexudative macular degeneration occur?
- Gradual accumulation of deposits
- Pigment epithelium detaches in small areas.
- Typically vision loss not significant -slowly progresses
- Risk that disorder will progress to exudative stage
How does the exudative macular degeneration occur?
- Formation of new, weak blood vessels
- New vessels prone to leak
- Elevate retina from choroid
- Bleeding can occur
- Acute vision loss
Who has a lower risk for macular degeneration?
Asians and those with darker pigmentation