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Gero > Vision > Flashcards

Vision Flashcards

Exam 2

1
Q

What does visual function depend on

A

Visual function depends on a sequence of processes beginning with the perception of an external stimulus and ending with the processing of neural impulses into cerebral cortex.

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2
Q

What does the visual system consist of?

A

The visual system consists of the external tissues and structures surrounding the eye,

that play an important role in protecting the eye include the eyebrows, eyelids, eyelashes, lacrimal system, conjunctiva, and sclera.

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3
Q

The visual system consists of the external tissues and structures surrounding the eye, what role do they play?

What do they include?

A

The visual system consists of the external tissues and structures surrounding the eye,

that play an important role in protecting the eye include the eyebrows, eyelids, eyelashes, lacrimal system, conjunctiva, and sclera.

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4
Q

Internal eye structures include?

A

iris,

lens,

ciliary body

choroid

retina

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5
Q

What happens to light reflected from an object?

A

Light reflected from an object in the field of vision passes through the transparent structures of the eye and, in doing so, is refracted (bent) so that a clear image can fall on the retina.

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6
Q

From the retina, where does visual stimuli travel?

A

From the retina, the visual stimuli travel through the visual pathway to the occipital cortex, where they are perceived as an image.

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7
Q

What structures are subject to change with aging?

A

Every structure of visual system is subject to change with aging.

Age related changes in the nervous system and the eye support structures can reduce the visual acuity and visual function. Some changes are cosmetic- not effect vision.

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8
Q

Age-Related Changes in appearance and tear ducts

Changes in appearance include:

A

arcus senillis

loss of orbital fat,

diminished elasticity of eyelid muscles

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9
Q

Age-Related Changes in appearance and tear ducts

Changes in appearance include arcus senillis (photo bottom right), loss of orbital fat, and diminished elasticity of eyelid muscles

What is there impact on vision?

A

usually do not interfere with vision

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10
Q

Age-Related Changes in appearance and tear ducts

Changes in appearance include arcus senillis (photo bottom right), loss of orbital fat, and diminished elasticity of eyelid muscles

usually do not interfere with vision

What is the exception?

A

(*exception –Blepharochalasis-can eventually impair vision)

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11
Q

Age-Related Changes in appearance and tear ducts

What are other age related changes of the eye? What is treatment?

A

Diminished tear production (*Tx-use of artificial tears)

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12
Q

Age-Related Changes in appearance and tear ducts

What structures do degenerative changes of the eye effect?

A

Degenerative changes affect all structures of the eye, the retinal–neural pathway, and visual cortex of the brain

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13
Q

Age-Related Changes in appearance and tear ducts

What are corneal changes:

A

Changes in color of sclera

Less ability to dilate pupil

More light needed for reading)

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14
Q

Age-Related Changes in appearance and tear ducts

Arcus senilis: What is it?

A

Eventually, the arc may become a complete ring around the colored portion (iris) of the eye.

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15
Q

Age-Related Changes in appearance and tear ducts

Arcus senilis: What is it caused by?

A

It’s caused by fat (lipid) deposits deep in the edge of the cornea.

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16
Q

Age-Related Changes in appearance and tear ducts

Arcus senilis: What does it effect?

A

Arcus senilis doesn’t affect vision, nor does it require treatment.

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17
Q

Age related changes in the structure of the eye can affect the vision in older adults

Ciliary Body- What is it?

A

The ciliary body is a mass of muscles, connective tissue, and blood vessels surrounding the lens.

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18
Q

Age related changes in the structure of the eye can affect the vision in older adults

Ciliary Body- What do they regulate? What is there primary function?

A

These muscles regulate the passage of light rays through the lens by changing the shape of the lens.

Primary functions of the ciliary body are production of aqueous fluid and control of the ability to focus.

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19
Q

Age related changes in the structure of the eye can affect the vision in older adults

Ciliary Body- What happens with age?

A

Muscle cells are replaced with connective tissue, and the ciliary body gradually becomes smaller, stiffer, and less functional.

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20
Q

Age related changes in the structure of the eye can affect the vision in older adults

Ciliary Body-

With age, what happens with aqueous humor? What does this lead to?

A

With advanced age, diminished secretion of aqueous humor interferes with the nourishment and cleansing of the lens and cornea.

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21
Q

Age related changes in the structure of the eye can affect the vision in older adults

Vitreous- What is it?

A

The vitreous is a clear, gelatinous mass that forms the inner substance and maintains the spherical shape of the eye.

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22
Q

Age related changes in the structure of the eye can affect the vision in older adults

Vitreous- What happens with age?

A

With increasing age, the gelatinous substance shrinks, causing a proportionate increase in the liquid portion.

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23
Q

Age related changes in the structure of the eye can affect the vision in older adults

Vitreous-

With increasing age, the gelatinous substance shrinks, causing a proportionate increase in the liquid portion.

Because of these changes, what happens?

A

Because of these changes, the vitreous body pulls away from the retina, resulting in symptoms such as floaters, blurred vision, distorted images, or light flashes.

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24
Q

Age related changes in the structure of the eye can affect the vision in older adults

Retina: What is it composed of?

Because of these changes, what happens?

A

Composed of rods and cones which are required for color perception and acuity?

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25
Q

Age related changes in the structure of the eye can affect the vision in older adults

Retina:

What happens with age?

A

Although the number of cone cells diminishes with increasing age, the loss is primarily in the periphery rather than the fovea, and the effects are minimal.

The number of rod cells also declines, but the remaining rods increase in size and maintain their ability to capture light. Additional age-related changes in retinal structures include accumulation of lipofuscin and thinning and sclerosis of the blood vessels and pigment epithelium.

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26
Q

Age related changes in the structure of the eye can affect the vision in older adults

Cornea: What is it?

A

The cornea is a translucent covering over the eye that refracts light rays and provides 65% to 75% of the focusing power of the eye.

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27
Q

Age related changes in the structure of the eye can affect the vision in older adults

Cornea: What are characteristics of the cornea? What does it do? What part of the eye is it?

A

Smooth, clear, strong and durable;

Shields eyes from germs and dust

Outermost lens

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28
Q

Age related changes in the structure of the eye can affect the vision in older adults

Cornea: What happens to it with age?

A

Becomes opaque and yellow impairing passage of light

Lipid deposits lead to blurred vision

Altered curvature results in impaired refractility

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29
Q

Age related changes in the structure of the eye can affect the vision in older adults

Lens: Where is it? What does it do?

A

Situated behind the iris.

Focuses light onto the retina

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30
Q

Age related changes in the structure of the eye can affect the vision in older adults

Lens: What happens with age?

A

Becomes stiffer, denser, and more opaque

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31
Q

Age related changes in the structure of the eye can affect the vision in older adults

iris: What is it?

A

Colored part of the eye

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32
Q

Age related changes in the structure of the eye can affect the vision in older adults

iris: What does it control?

A

Controls light levels inside the eye (like aperture on camera)

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33
Q

Age related changes in the structure of the eye can affect the vision in older adults

iris: What is the round opening in the center?

A

pupil

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34
Q

Age related changes in the structure of the eye can affect the vision in older adults

iris: What is the iris embedded with? What does this do?

A

Iris embedded with tiny muscles that dilate and constrict pupil size?

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35
Q

Age related changes in the structure of the eye can affect the vision in older adults

iris: What happens with age?

A

Becomes less flexible and the pupil becomes smaller

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36
Q

Effects of age- related changes on vision

What is there a loss of:

A

Loss of accommodation

Diminished acuity

Reduced visual field

Diminished depth perception

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37
Q

Effects of age- related changes on vision

What is there a delay of? What is there an alteration of?

A

Delayed dark and light adaptation

Altered color vision:

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38
Q

Effects of age- related changes on vision

What is slower?

A

Slower visual information processing

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39
Q

Effects of age- related changes on vision

Loss of accommodation: What is the term?

A

presbyopia—

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40
Q

Effects of age- related changes on vision

Loss of accommodation: presbyopia—

What does this mean?

A

diminished ability to focus clearly on objects at various distances (far-sighted)

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41
Q

Effects of age- related changes on vision

Diminished acuity:

What does this mean?

A

diminished ability to detect details and discern objects

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42
Q

Effects of age- related changes on vision

Delayed dark and light adaptation:

What does this mean?

A

slower adaptive response to changes in lighting

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43
Q

Effects of age- related changes on vision

Altered color vision:

What does this mean?

A

perception blue objects look darker, and whites appear more yellowed

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44
Q

Effects of age- related changes on vision

What is visual impairment? What does it range from?

A

loss that cannot be corrected with glasses or contacts; ranges from mild to blindness

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45
Q

What is presbyopia?

A. The loss of accommodation
B. Diminished visual acuity
C. Delayed reaction to changes in light
D. A reduction in the visual field

A

A. The loss of accommodation

Presbyopia is the loss of accommodation, which is the ability to focus clearly on objects at various distances. Presbyopia is an initial and universal age-related vision change, which begins in early adulthood and affects all humans to some degree by their mid-fifties

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46
Q

Visual Impairment

Personal cost for older person with visual impairment

What occurs?

A

Loss of independence
Social isolation
Depression
Decreased quality of life

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47
Q

Risk Factors That affect Visual Wellness

A

Lifestyle, nutrition, environment: exacerbate age-related vision changes

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48
Q

Risk Factors That affect Visual Wellness

Factors that interfere with visual wellness:

A

Poor nutrition, smoking, sunlight exposure

Warmer environmental temperatures, wind, low humidity, secondhand smoke

Lighting, color contrast

Chronic conditions ( Hypertension, Diabetes, Parkinson’s LBD)

Medications

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49
Q

Functional Consequences Affecting Visual Wellness:

A

Effects on Safety, function and overall health ,QOL and Driving

Available lighting needs are three to five times more than previously required

Difficulty with Effect on driving in general

Night driving (Particularly with Glaucoma)

Increased risk for unsafe mobility and falls

Increased difficulty in performing usual activities

Anxiety, depression, and lower levels of psychological well-being

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50
Q

Common Disease Conditions Affecting Vision include:

A

Cataracts:

Age-related macular degeneration (AMD):

Glaucoma:

Diabetic retinopathy:

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51
Q

Common Disease Conditions Affecting Vision include:

Cataracts:

A

leading, reversible cause of vision impairment

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52
Q

Common Disease Conditions Affecting Vision include:

Cataracts: What would the patient report?

A

Pt. will report cloudy, hazy vision

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53
Q

Common Disease Conditions Affecting Vision include:

Cataracts: How does this happen?

A

The development of a Cataract occurs when the lens of the eye loses its transparency.

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54
Q

Common Disease Conditions Affecting Vision include:

Age-related macular degeneration (AMD):

A

leading cause of severe vision loss

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55
Q

Common Disease Conditions Affecting Vision include:

Age-related macular degeneration (AMD): How does this occur?

A

occur in the eye when the macula of the retina become damaged and impair the central vision-

56
Q

Common Disease Conditions Affecting Vision include:

Age-related macular degeneration (AMD): What does the patient report?

A

Loss of central vision

57
Q

Common Disease Conditions Affecting Vision include:

Glaucoma:

A

causes loss of peripheral vision leading to blindness if untreated

58
Q

Common Disease Conditions Affecting Vision include:

Glaucoma: What is it caused by? What does it result in?

A

caused by increased intraocular pressure that results in damage to the optic nerve.

59
Q

Common Disease Conditions Affecting Vision include:

Diabetic retinopathy:

A

blurred, hazy, spotted or fluctuating vision

60
Q

Common Disease Conditions Affecting Vision include:

Diabetic retinopathy: How does this occur?

A

This eye disorder occurs from uncontrolled high blood glucose levels which lead to retinal damage.

61
Q

Common Disease Conditions Affecting Vision include:

Diabetic retinopathy: What will the patient report?

A

Pt. will report: Black spots in vision

62
Q

What is the most common cause of irreversible severe central vision loss and blindness?

A

AMD is most common cause of irreversible sever central vision loss and blindness in people over 60

63
Q

Age-Related Macular Degeneration

What are the two forms?

A

Dry/atrophic AMD

Wet/ advanced neovascular AMD

64
Q

Age-Related Macular Degeneration

Dry/atrophic AMD

A

is slower to progress and more common (80%)

65
Q

Age-Related Macular Degeneration

Wet/ advanced neovascular AMD

A

is more severe and rapid (20%)

66
Q

Age-Related Macular Degeneration

Wet/ advanced neovascular AMD: What is the cause?

A

No one knows the exact cause of wet macular degeneration

67
Q

Age-Related Macular Degeneration

Wet/ advanced neovascular AMD: Who does it develop in?

A

it develops in people who have had dry macular degeneration

68
Q

Age-Related Macular Degeneration

What is it caused by?

A

Caucasian ,smoking, family Hx, obesity, exposure to sunlight

69
Q

Macular Degeneration Signs and Symptoms : Dry:

A

Blurred Vision

Scotomas

Metamorphpsia

blurring (trouble with street signs and fine newsprint, recognizing faces, haziness), colors aren’t as bright, “grey” spot in center of visual field (scotoma)

70
Q

Macular Degeneration Signs and Symptoms : Dry:

Scotomas

A

( Blind Spots) in central vision

71
Q

Macular Degeneration Signs and Symptoms : Dry:

Metamorphpsia

A

( Distortion of Vision –items appear larger/smaller than they usually are

72
Q

Macular Degeneration Signs and Symptoms : Dry:

Metamorphosia: What is required for it?

A

Require light for reading

73
Q

Macular Degeneration Signs and Symptoms : Dry:

Metamorphosia: What are other symptoms of it?

A

Other Symptoms: blurring (trouble with street signs and fine newsprint, recognizing faces, haziness), colors aren’t as bright, “grey” spot in center of visual field (scotoma)

74
Q

Macular Degeneration Signs and Symptoms : Dry:

How is progression of vision loss?

A

Slow and painless progression of visual loss

Straight lines appear crooked or wavy

75
Q

Macular Degeneration Signs and Symptoms :

Late stage DRY and WET:

How is progression of vision loss?

A

relatively sudden change in vision, blurred, distorted, and darkened vision

with visual field blind spots resulting in serious vision loss.

76
Q

Macular Degeneration Signs and Symptoms :

Dry
Does it effect one or both eyes?

A

Dry macular degeneration usually affects both eyes.

77
Q

Macular Degeneration Signs and Symptoms :

What kind of visual distortion occurs?
What type of vision impairment occurs? What is there difficulty with?

A

Visual distortions, such as straight lines seeming bent

Reduced central vision in one or both eyes.

Increased difficulty adapting to low light levels, such as when entering a dimly lit restaurant

Increased blurriness of printed words

Decreased intensity or brightness of colors

Difficulty recognizing faces

78
Q

Macular Degeneration Signs and Symptoms : Dry:

What test should be used and how often?

A

To use Amsler Test twice a week

79
Q

Macular Degeneration Signs and Symptoms : Dry:

Amsler Test twice a week: What does it provide?

A

An Amsler grid is a tool to assess macular degeneration that often provides the earliest sign of a worsening of the condition.

80
Q

Macular Degeneration Signs and Symptoms : Dry:

Amsler Test twice a week: What kind of results should you look for that are bad?

A

If the lines of the grid become distorted or faded, the client should call the ophthalmologist.

81
Q

Age-Related Macular Degeneration -Treatment

Dry and Wet AMD treatment

What treatment should be effective?

A

No effective treatment have been found. However, patient will benefit from taking these vitamins and minerals daily:
Vitamin C (500 mg)
Vitamin E (400 IU)
Lutein (10 mg)
Zeaxanthin (2 mg)
Zinc (80 mg)
Copper (2 mg)
Eating Eye-healthy foods

82
Q

Age-Related Macular Degeneration -Treatment

Dry and Wet AMD treatment

Eating Eye-healthy foods

A

Dark leafy greens, yellow fruits and vegetables, fish, and a balanced, nutrient-rich diet have been shown beneficial for people with AMD.

83
Q

Age-Related Macular Degeneration -Treatment

Dry and Wet AMD treatment

What can slow the progression?

A

Getting regular exercise, and quitting smoking can slow the progression.

84
Q

Age-Related Macular Degeneration -Treatment

Dry and Wet AMD treatment:

Which one (dry or wet) is more common and progresses at a faster rate among smokers?

A

Dry AMD is more common and progresses at a faster rate among smokers than among nonsmokers. Thus, quitting smoking can slow the rate of AMD progression.

85
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

A

Laser photocoagulation

Photodynamic Therapy ( PDT) -

Medications called anti-VEGF

86
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:
Laser photocoagulation: What does it do?

A

Laser photocoagulation destroys leaking blood vessels that have grown under the macula and halts the leakage.

87
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:
Laser photocoagulation: What percent of people with wet does it help?

A

Laser therapy helps treat about 10%-20% of people with wet macular degeneration.

88
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:
Laser photocoagulation:

What may occur when using this treatment? What do people who do this treatment need?

A

Some vision loss may occur, because this treatment creates scar tissue that is perceived as blind spots;

however, even more vision would be lost without any treatment at all. Up to half of patients who elect laser therapy may need repeat treatments.

89
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Photodynamic Therapy ( PDT) -

What is used together?

A

Verteporfin (Visudyne) IV & cold Laser are used together.

90
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Photodynamic Therapy ( PDT) -

How does PDT work?

A

PDTworks by using alight-sensitivemedicine called verteporfin that “turns on”when hit by aspecific type oflaser(sometimescalled a cold laser).

MDwill shinethe laser on a verysmall areain the back of the eye, causing the verteporfin to break down the blood vessels that are causing the vision loss.

91
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Photodynamic Therapy ( PDT) -

Pt teaching:

A

The medication become active when exposed to low levels of laser light waves –until it is totally excreted from the body it can be activated by sunlight and can cause the patient A chemical skin burn.

92
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Photodynamic Therapy ( PDT) -

Pt teaching: The medication become active when exposed to low levels of laser light waves –until it is totally excreted from the body it can be activated by sunlight and can cause the patient A chemical skin burn.

What do you tell patient?

A

Pt. to avoid sunlight and other forms of lights ( halogen ) for 5 days after Tx

Be fully covered head to toe when exposed to light.

93
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Photodynamic Therapy ( PDT) -

How common is it?

A

Photodynamic therapy (PDT) is a much less common treatment for wet AMD that doctors sometimes use along with anti-VEGF injections.

94
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Anti-VEGF (vascular endothelial growth factor):

What protein does the eye contain?

A

The eye contains a protein called vascular endothelial growth factor, or VEGF.

95
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Anti-VEGF (vascular endothelial growth factor):

ROle of VEGF

A

The role of VEGF is to help grow new blood vessels.

96
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

Anti-VEGF (vascular endothelial growth factor):

What causes wet AMD?

A

Wet AMD is caused by an excess of VEGF.

This leads to the abnormal blood vessel growth that can cause vision problems

97
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

What is the most common treatment doctorsuse toslow vision loss from wet AMD?

A

The most common iscalledanti-VEGF injections.

98
Q

Age-Related Macular Degeneration -Treatment

Wet AMD treatment ONLY:

What does anti-VEGF do?

A

These medicines help stop bleeding and leaking from blood vessels in the back of the eye.

Most people with wet AMD will get anti-VEGF injections as their only treatment.

99
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

LUCENTIS : What is it for? How often is it given?

A

It was approved in 2006 to treat wetage-related macular degeneration (wet AMD).

is recommended to be administered by intravitreal injection once a month (approximately 28 days)

100
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

LUCENTIS : What does it do?

A

administered by intravitreal injection once a month (approximately 28 days) is a prescription medicine that is designed to block vascular endothelial growth factor (VEGF) from inside the eye.

101
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

LUCENTIS : How successful is it?

A

**Clinical studies have documented a definite success of intraocular injections for wet macular degeneration. After one year of intraocular therapy, the vision improved by about 25-34% compared with 5% in those who did not choose intraocular injections. Sep 25, 2020

102
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

EYLEA: What does it do?

A

treatment that works by blocking the growth of abnormal blood vessels.

By blocking the growth of these additional blood vessels, regular treatments of EYLEA help to lessen or stop the causes of vision loss associated with Wet AMD.

103
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

EYLEA: How often is it given?

A

administered by intravitreal injection every 4 weeks

104
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

How long do eye injections last?

A

The frequency of the eye injections depends on the condition, the severity of retinal swelling, and the potency of the medication used.

Some can be repeated every 3 months while the most common ones must be administered every 4-6 weeks to maximize the efficiency of the therapy.

105
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

What are complications with treatments?

A

Complication: problems related to blood clots, such as heart attacks or strokes.

106
Q

Age-Related Macular Degeneration –Treatment ( Cont.-)

A

On October 22, 2021, the FDA approved Susvimo™ (ranibizumab injection) 100 mg/mL for intravitreal use via ocular implant for the treatment of people with wet AMD who have previously responded to at least two anti-vascular endothelial growth factor (VEGF) injections.

107
Q

Risk Factors for ARMD

And what is treatment?

A

Age (above the age of 50)

Cigarette smoking

Family history of ARMD

Obesity

Increased exposure to ultraviolet light

Caucasian race and light colored eyes

Hypertension or cardiovascular disease

Lack of dietary intake of antioxidants and zinc

Treatment: laser tx for wet ARMD
108
Q

ARMD Preventive Measures

Nurses should encourage

A

Wearing ultraviolet protective lenses in sun

Smoking cessation

Exercising routinely

Eating a healthy diet consisting of fruits and vegetables

109
Q

ARMD Preventive Measures

Treatment for macular degeneration focuses on supportive measures :

A

including large-print books,
use of public transportation,
magnifying devices used with activities.

Amsler grid use twice a week, any sudden changes in vision MUST be evaluated

an Org. called Low-vision centers will send representatives to the client’s home or work to make recommendations about improving lighting, thereby improving the client’s vision and safety.

Any intervention that can help increase vision should be included in the teaching such as bright lighting in the house

110
Q

Cataract

What are the steps to development?

A

Lens clouding –> decreased light to retina –> limited vision

111
Q

Cataract

How is development (speed)

A

Development is slow and painless

112
Q

Cataract

What makes it difficult to see?

A

Clouding and blurring of lens

Opacity makes it difficult to see

113
Q

Cataract

What is the most common surgical procedure for those over 65?

A

Most common surgical procedure for those aged over 65

114
Q

Cataract

Immature cataracts?

A

are not completely opaque and thus allow some light to pass providing the patient with some useful vision.

115
Q

Cataract

Mature cataracts?

A

Mature cataract occurs when the lenses are completely opaque, and vision is greatly reduced or absent.

116
Q

Clinical Manifestations

What is it a decline in?

A

Cataracts—decline in visual acuity :

117
Q

Clinical Manifestations

Common symptoms of cataracts include:

A

blurry vision.
trouble seeing at night.
seeing colors as faded.
increased sensitivity to glare.
halos surrounding lights.
double vision in the affected eye.
a need for frequent changes
in prescription glasses.

118
Q

Clinical Manifestations

Common symptoms of cataracts include:

What is helpful for detecting cataracts?

A

will be done by using a slit-lamp

119
Q

Clinical Manifestations

Common symptoms of cataracts include:

Why is slit-lamp helpful?

A

The slit-lamp is helpful with detecting cataracts because it enlarges the front area of the eye so the doctor can observe the cornea, iris, lens etc.. This is particularly useful with detecting cataracts (*because remember in cataract the lens has lost transparency) so with this type of exam the lens will appear cloudy.

120
Q

Cataracts

Surgery: What is given?

A

Prior to cataract surgery (day of procedure) eye drops from the Cycloplegic family are given
to paralyzes the ciliary muscle of the eye (which results in the loss of accommodation) and to dilate the pupil.

121
Q

Cataracts

Surgery: All cycloplegics are also…

A

All cycloplegics are also mydriatics (=pupil dilation)- (phenylephrine, cyclopentolate, and/or tropicamide) typically have sympathomimetic or anticholinergic properties, or both, and are frequently administered before and during cataract surgery to maintain adequate pupillary dilation and paralyzation of the ciliary muscle.

122
Q

Cataracts

Cycloplegics cause …

A

Cycloplegics cause cycloplegia (paralysis of the muscles that are responsible for accommodation)

*accommodation =to focus on nearby objects.

123
Q

Cataracts

Post surgery: What should patients avoid?

A

Lifting any heavy objects (over 10 LB)

Straining at stool

Blowing the nose forcefully

Bending at the waist

124
Q

What is the second leading cause of blindness in the US? and African Americans?

A

Glaucoma

Leading cause of blindness in African Americans

125
Q

Glaucoma:

Leading cause of blindness in African Americans - why

A

Many are unaware
Family Hx
Long term use of Corticosteroids
Incidence increases with age
Preventable
Genetic traits

126
Q

Glaucoma

What are the two types?

A

Chronic Glaucoma (open angle glaucoma)

Acute (closed or narrow angle)

127
Q

Glaucoma

Chronic Glaucoma (open angle glaucoma)

A

Slowed flow of aqueous humor through trabecular meshwork –> build up –> increased IOP –> damage to optic nerve fiber –> loss of vision

128
Q

Glaucoma

Chronic Glaucoma (open angle glaucoma)

A

Painless vision loss

Mid-peripheral visual field loss

129
Q

Glaucoma

Acute (closed or narrow angle)

A

Severe eye pain, headache, nausea, and vomiting
Rapid increase in tension and edema, dilated pupil
Sudden vision changes (halos around lights or blurred vision)
Need for early treatment to prevent blindness
Sever rapid increase in pressure in the eye - IPO >50 mm Hg

Eye pressure:
Diagnosis with tonometry to measure IOP
Normal range is 10-20 mm Hg

130
Q

Glaucoma

Important Nursing Care Implications:

What kind of drugs should be avoided?

A

Drugs with anticholinergic properties can exacerbate glaucoma due to their effects of dilating the pupil

131
Q

Glaucoma

Some commonly used drugs in older adults that have anticholinergic effects:

A

Tricyclic antidepressants

Lasix

Anti-Parkinson drugs

Antipsychotics

131
Q

Slide 23 bottom

A
132
Q

Diabetic Retinopathy: What are the steps?

A

Microvascular disease of the eye –> damage to the ocular microvascular system –> impairing transportation of oxygen and nutrients to the eye in diabetics

132
Q

Diabetic Retinopathy:

Symptoms

A

Gradual vision loss

Generalized blurring

Areas of focal vision loss

133
Q

Diabetic Retinopathy:

Treatment and therapy

A

Treatment: laser therapy

Manage hypertension and hyperlipidemia

134
Q

Diabetic Retinopathy:

Treatment and therapy: Nursing

A

Good control of diabetic and better Glycemic control

If not treated —Retinal detachment and Glaucoma

Gero (14 decks)

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