Retinal Detachment & Age-Related Macular Degeneration Flashcards
Separation of the retina and the underlying pigment epithelium, with fluid accumulation between the two layers
Retinal Detachment
May lead to blindness if untreated
Retinal Detachment
Rare case; 1 per 15,000 individuals each year
Retinal Detachment
What is Retinal Detachment?
-separation of the retina and the underlying pigment epithelium, with fluid accumulation between the two layers
- may lead to blindness if untreated
- rare case; 1 per 15, 000 individuals each year
Etiology of Retinal Detachment
-Retinal break
-aging
- infection
- tumors
- cataract or glaucoma surgery
an interruption in the full thickness of the retinal tissue, which creates tears or holes
retinal break
what is retinal break?
an interruption in the full thickness of the retinal tissue, which creates tears or holes
shrinking of vitreous humor and pulls on retina
aging
aging caused in retinal detachment
shrinking of vitreous humor and pulls on retina
Pathophysiology of Retinal Detachment
Retinal break causes liquid vitreous to enter the subretinal space and causes detachment
Clinical Manifestations of Retinal Detachment
-light flashes and floaters (Photopsia)
- ring in the field of vision
- painless loss of peripheral or central vision “like a curtain”
Diagnostics of Retinal Detachment
-History and physical examination
-Visual acuity measurement
- Ophthalmoscopy
- Slit-lamp microscopy
- Ultrasonography
if cornea, lens, or vitreous humor is hazy or opaque
Ultrasonography
Surgical Management of Retinal Detachment
-Retinal Laser Photocoagulation
- Retinal Cryopexy
- Scleral Buckling
-Vitrectomy
an intense, precisely focused light beam is used to create an inflammatory reaction
Retinal Laser Photocoagulation
Seals retinal breaks
Retinal Laser Photocoagulation
Involves the use of extreme cold to create the inflammatory reaction that produces the sealing scar
Retinal Cryopexy
Pain is felt post-surgery
Retinal Cryopexy
Health teaching in Post op Retinal Cyropexy
encourage patient to take prescribed analgesics
What is retinal laser photocoagulation
-an intense, precisely focused light beam is used to create an inflammatory reaction
- seals retinal breaks
What is retinal cryopexy
-involves the use of extreme cold to create the inflammatory reaction that produces the sealing scar
- pain is felt post-surgery
- encourage patient to take prescribed analgesics
an extraocular surgical procedure
scleral buckling
compressing of the globe so that the pigment epithelium, the choroid, and the sclera move toward the detached retina
scleral buckling
surgical removal of the vitreous
Vitrectomy
relieves traction on the retina, especially when the traction results from proliferative diabetic retinopathy
vitrectomy
combined with scleral buckling to provide dual effect in relieving traction
vitrectomy
What is vitrectomy?
-surgical removal of the vitreous
- relieves traction on the retina, especially when the traction results from proliferative diabetic retinopathy
- combined with scleral buckling to provide dual effect in relieving traction
Nursing Management of Retinal Detachment
-Keep head face down with chin lowered to chest for a long time
- Don’t straighten head for more than 10-15 mins at a time
- Place patient on bed rest
- Wear shield while sleeping; retina will take 6 to 8 weeks to heal
An eye disease that progressively destroys the macula
Age-related Macular Degeneration
Causes irreversible central vision loss
Age-related Macular Degeneration
2 types of Age-related Macular Degeneration
- Dry AMD
- Wet AMD
non-exudative
Dry Age-Related Macular Degeneration
Close-vision tasks become more difficult
Dry Age-Related Macular Degeneration
Macular cells start to atrophy
Dry Age-Related Macular Degeneration
Leading to progressive and painless vision loss
Dry Age-Related Macular Degeneration
exudative
Wet Age-Related Macular Degeneration
More severe form
Wet Age-Related Macular Degeneration
has a more rapid onset
Wet Age-Related Macular Degeneration
characterized by the development of abnormal blood vessels in or near the macula
Wet Age-Related Macular Degeneration
What is dry age-related macular degeneration?
-nonexudative
- more common
- close-vision tasks become more difficult
-macular cells start to atrophy
- leading to progressive and painless vision loss
What is Wet Age-Related Macular Degeneration
-exudative
-More severe form
- has a more rapid onset
- characterized by the development of abnormal blood vessels in or near the macula
Describe the characteristics of Dry MD
Unusual fuzzy or distorted vision
Describe the characteristics of Wet MD
Blind spot in center of field of vision
It contains fat & protein
Drusen
Yellow deposits around the retina
Drusen
What is drusen?
-It contains fat & proteins
-Yellow deposits around the retina
Etiology of Age-Related Macular Degeneration
-Retinal aging
- Genetic factors
- Smoking
- Ultraviolet light exposure
Pathophysiology of Dry AMD?
-Drusen
- Yellowish extracellular deposits
Pathophysiology of
Wet AMD?
-Growth of new, fragile blood vessels
- Scar formation
Drusen
Dry AMD
Yellowish extracellular deposits
Dry AMD
Growth of new, fragile blood vessels
Wet AMD
Scar Formation
Wet AMD
Clinical Manifestation of Age-Related Macular Degeneration
-Blurred & darkened vision
- Scotoma
- Metamorphopsia
Blind spots in the visual field
Scotoma
Distortion of vision
Metamorphopsia
What is Scotoma?
blind spots in the visual field
What is metamorphopsia?
distortion of vision
Diagnostics of Age-Related Macular Degeneration
-Ophthalmoscopy
-Amsler Grid Test
-Fundus Photography
The primary diagnostic procedure
Ophthalmoscopy
Presence of drusen is assessed
Ophthalmoscopy
What is Ophthalmoscopy?
-The primary diagnostic procedure
- Presence of drusen is assessed
Detects vision metamorphopsia
Amsler Grid Test
Result provides a baseline for future comparison
Amsler Grid Test
What is Amsler Grid Test?
-Detects vision metamorphopsia
-Result provides a baseline for future comparison
Determines extend and type of AMD
Fundus photography
What is fundus photography
Determines extend and type of AMD
What is the Drug Management for Age-Related Macular Degeneration?
Selective Inhibitors Of Endothelial Growth Factor
Slow vision loss in wet AMD
Selective Inhibitors Of Endothelial Growth Factor
Injection are given 4 to 6 weeks intervals
Selective Inhibitors Of Endothelial Growth Factor
After giving the injection, they perform Ocular Coherence Tomography
Selective Inhibitors Of Endothelial Growth Factor
Determine Retinal Stability
Ocular Coherence Tomography
Example of Selective Inhibitors of Endothelial Growth Factor drug
-Ranibizumab (Lucentis)
-Bevacizumab (Avastin)
What is Selective Inhibitors of Endothelial Growth Factor
-Slow vision loss in wet AMD
-Injections are given at 4 to 6 weeks intervals
- Ocular coherence Tomography
Medical Management of AMD
Photodynamic Therapy
Entails the use of verteporfin (visudyne) intravenously and a “cold” laser to excite the dye
Photodynamic Therapy
Destroys the abnormal blood vessel
Photodynamic Therapy
What is Photodynamic Therapy?
-entails the use of verteporfin (visudyne) intravenously and a “cold” laser to excite the dye.
- Destroys the abnormal blood vessels
Nursing Management of AMD
-Patient must be covered since exposure to sunlight could result in thermal burn
- Diet rich in zinc to increase the subretinal fluid and the thickness of the macula
- Smoking cessation
- Drive at daytime at lowered speeds.
What is scleral buckling?
-an extraocular surgical procedure
- compressing of the globe so that the pigment epithelium, the choroid, and the sclera move toward the detached retina
What is age-related macular degeneration?
- an eye disease that progressively destroys the macula
- causes irreversible central vision loss