Sensory Flashcards
What is Cataracts
opacity in lens
age-related (senile cataracts)
•May be in one or both eyes
altered metabolic processes in lens cause water accumulation and changes in lens fiber structure altering transparency resulting in vision changes
Cataracts signs and diagnosis
decreased vision, abnormal color perception, and glare
- Diagnosis: Ophthalmoscope or slit lamp examination
- Nonsurgical therapy (temporary); prescription eyewear; visual aids; increased light; change lifestyle
Cataracts nursing care post op
Topical antibiotics
Topical corticosteroids
Mild analgesia
Eye patch or shield and activity as prescribed
Cataracts Surgical therapy (outpatient)
- Preoperative: H and P; give anti-inflammatory and pupillary dilating drops
- Mydriatic—alpha-adrenergic agonist dilation
- Cycloplegic -Anticholinergic—paralysis of accommodation and dilation
- Drug Alert: Patients wear dark glasses to reduce photophobia; monitor for systemic toxicity (tachycardia and CNS effects)
Cataracts surgery’s
- Phacoemulsification— dissolve lens ; fragments are removed
- Extracapsular cataract extraction procedure—remove lens in one piece; requires sutures
- Intraocular lens (IOL) implantation
- Administration of antibiotics and corticosteroids
Cataracts post op phase
Discharged after sedation wears off
•Postoperative medications: antibiotic and corticosteroids drops
- Activity restrictions: avoid IOP such as bending, stooping, coughing, or lifting
- Nighttime shielding
- Follow-up for visual acuity; may or may not need glasses/lenses
Cataracts nursing assessment
Assess: •Visual acuity; near and distant •Psychosocial impact •Need for teaching •Planning: Goals
- Preoperative: make informed decisions, minimal anxiety
- Postoperative: understand and adhere to therapy, physical and emotional comfort, no complications
Cataracts preventative care and acute care
- No specific preventative measures
- Wear sunglasses, avoid unnecessary radiation
- Antioxidant vitamins (C and E); adequate nutrition
- Acute care:
- Preoperative care and education
- Intraoperative: decrease lighting for photophobia
- Postoperative: Mild analgesia, monitor for complications
Cataracts ambulatory care
- Review instructions with patient and caregiver
- Most have little visual impairment
- If significant visual impairment—activity and environmental modifications
- Use of eye patch: altered depth perception; fall precautions
Cataracts evaluation of outcomes
- Improved vision and self-care
- Minimal or no pain
- Optimistic expectations
Retinopathy
Microvascular damage to the retina; blurred vision; progressive loss of vision
•Most common with HTN or diabetes mellitus
(Diabetic retinopathy)
- Nonproliferative—loss of central vision
- Proliferative—advanced disease; severe vision loss
•Treatment: laser photocoagulation
- Hypertensive retinopathy
- Treatment: lower BP to restore vision
Retinal Detachment
•Separation of retina and underlying epithelium; fluid accumulation between layers
Breaks—holes (spontaneous) or tears (aging)
photopsia (light flashes), floaters, and cobweb/hairnet or ring in field of vision
Retinal detachment risk factors
Age Cataracts surgery Eye trauma Family or personal history of retinal detachment Severe myopia (nearsightedness)
Retinal detachment diagnostic studies
- Visual acuity measurements
- ophthalmoscope or slit lamp
- ultrasound
Retinal detachment surgery
Surgical therapy—seal retinal breaks by inflammation/adhesion or scar
- Laser photocoagulation—inflammation
- Cryopexy—freezing scar
- Scleral Buckling—band placed around globe
Retinal detachment intraOCULAR procedures
- Pneumatic retinopexy—intravitreal injection of gas to form bubble to close retinal break
- Vitrectomy—removal of vitreous
- Postoperative considerations:
- Bedrest/Activity restrictions
- Medications: analgesia and topical
- Patient education
macular degeneration signs and test
acute vision loss; blurred or darkened vision, scotomas (blind spots) and metamorphopsia (visual distortion)
•Diagnostic studies: visual acuity measurements; *ophthalmoscopy; Amsler grid test
macular degeneration medication and care
- Medications injected every 4 to 6 weeks into vitreous cavity to stop new vessel formation and slow vision loss
- Photodynamic therapy (PDT) uses dye and laser to damage abnormal blood vessels
- Patients must avoid sunlight and intense light for 5 days
- Nutrition: vitamin C and E; beta-carotene, zinc, lutein
- Smoking cessation