Eye Ear Disorders Flashcards
Cataracts etiology/RF
Opacity of the lens
Etiology/RF:
Aging
Trauma
Culumative exposure to ultraviolet
High altitudes or bright sunlight
Down syndrome
Infections (rubella first trimester)
Cataracts patho
Reduced O2 in the lens
⬆️ in water, then dehydration of lens
Electrolyte and protein levels change
Lens yellows becomes opaque
Cataracts CM
⬇️. Or blurry vision
Abnormal color perception & glare - worse at night
⬇️ visual acuity
Opaque white pupil
Cataracts management
Non sx: temporary and palliative
Most common sx in us:
Outpatient
Topical anesthesia
IV sedation
Small corneal incision
Can correct astigmatism during procedure
Intraocular lens implanted for astigmatism (no stitches)
Cataracts post op care
Eye patch/ sunglasses until return visit next am
Photophobia from dilating eye drops
Assistance w/ self care, home 1-2 weeks until vision improves (NO DRIVING)
Avoid activities that ⬆️ IOP
Report unrelieved pain (should have little to no pain)
Retinopathy
Etiology
Prevention
Etiology:
-Microvascular damage w/ capillary leakage or hemorrhage
-blurred vision
Prevention:
Control DM & HTN
Annual eye exams
Retinopathy
Tx
Watch and wait
Manage DM & HTN
Laser treatment to slow leakage
Vitrectomy to remove blood
Retinal detachment
What happens
RF
Separation of retina from choroid with fluid between layers
RF:
Age
Cataract removal
Trauma
Previous detachment
FH
Retinal detachment CM
Visual field loss in opposite quadrant from detachment
Floaters, (curtain closing)
Flashing light
Acute onset
No pain
If untreated=blindness will occur
Retinal detachment
Sx management
Surgically place retina back : Laser
Nitrous oxide to freeze tissue: freezes the break, then scarring seals the break
Scleral buckling: sponge band
Pneumatic retinopexy: gas bubble injected to close retinal break
Retinal detachment
Nursing management
Monitor eye patch for drainage
Restrict activities if air/gas bubble used:
-Head down/side-lying
IV diamox: reduce IOP
Abx, steroid eye drops
Age-related macular degeneration
Most common cause of what
What is macular degeneration
What happends over time (also dry vs wet)
CM
Most common cause of vision loss
Macula: central region of retina
Degenerative changes over time:
Dry: atrophy of macular cells
Wet: (most severe) damage BV leak leading to hemorrhage
CM:
Blurred or darkened central vision
Age related macular degeneration
Dry vs wet tx
Other supportive care
Risk reduction
Dry: no tx
Wet:
-meds to stop growth of new BV (anti-angiogenic)
-laser photocoagulation to stop bleeding
Other supportive care:
-magnifiers
Brighter lights in home
No driving
Risk reduction:
Stop smoking
⬆️ vitamine C & E
Zinc and copper
Routine eye exams
Glaucoma
What happens
Increased IOP (normal 10-21)
Optic nerve atrophy
Peripheral visual field loss
Glaucoma
Etiology
RF
Prevention: primary vs secondary
Know early warning signs
HTN, CVD, DM
Age over 60
FH
Primary prevention:
-reducting RF: HTN, CVD, DM
Secondary prevention:
-screenings
Glaucoma patho
Not related w/ BP
Buildup of aqueous fluid leads to ⬆️ pressure
⬇️ Blood supply to optic nerve and retina=damage
2 types of glaucoma
Primary open-angle glaucoma
Primary angle closure glaucoma
Primary open-angle glaucoma
Most common what
Progresses how
Early signs?
What gets clogged
This does what
Dx
Most common glaucoma
Slow progression
No early signs
Trabecular meshwork is clogged: blocks aqueous drainage
⬆️ pressure damages optic nerve
Dx: tonometry
Primary angle closure glaucoma
Reduction in outflow of aqueous humor from angle closure
Acute attack d/t prolonged pupil dilation
So…
Pupil dilation= ⬆️ IOP d/t this
Primary OPEN angle glaucoma CM
Said before:
S/s:
THEN
Acute angle CLOSURE causes what s/s:
Said before:
No early signs
Gradual visual field loss
Small blind spots develop
Tunnel vision
Blindness if entire optic nerve destroyed
Acute angle closure:
Several pain
N/V
Colored halos, blurred vision
Glaucoma tx
Goal
Tx for:
-constrict pupil
-reduce aqueous humor production=⬇️ IOP
Goal: reduce IOP
Constrict pupil:
-topical miotics (Pilocarpine) drops or Ocusert wafer
-Epinephrine
*avoid mydriatics (they dilate pupil) NO ATROPINE
Reduce aqueous humor production:
Topical beta blockers (Timolol)
Open glaucoma nursing diagnoses
Greving
Risk for blindness
Risk for ineffective therapeutic regimen management:
Mitics QID
Beta blockers eye drops Q12H
Teach how to administer eye drops
Hold lower eyelid, hold corner of eye
Meniere’s disease
Excess what where
Classic s/s
Excess of endolymph in vestibular and semicircular canals
Episodic
Classic s/s:
-vertigo
-tinnitis
-fluctuating hearing loss
-oral fullness
Meniere’s disease TX
Things to do
Risk
Avoid
Meds
Things to do or avoid:
-Bed rest during vertigo
-Risk of falls
-Dark room
-Avoid sudden head movement
-Avoid flourescent, flickering lights, TV off
MEDs:
-Antihistamines
-Antiemetics
-Benzodiazepines
-Meclizine (antivert): motion sickness
Meniere’s disease
Diet restrictions
NA
Caffeine
Alcohol
Foods w/ MSF during acute attacks
OD vs OS vs OU
OD right
OS left
OU both
