Visual and Auditory Problems Flashcards
Correctable Refractive Errors
This defect prevents light rays from converging into a single focus on the retina Result of irregularities of the corneal curvature Focusing power of the lens Length of the eye Major symptom is blurred vision Additional symptoms: ocular discomfort, eyestrain, or headaches
Myopia
(nearsightedness) Inability to accommodate for objects at a distance Causes light rays to be focused in front of the retina May occur because of excessive light refraction by the cornea or lens or because of an abnormally long eye
Hyperopia
Hyperopia (farsightedness) Inability to accommodate for near objects Causes light rays to be focused behind the retina May occur because the cornea or lens does not have adequate focusing power or when the eyeball is too short
Presbyopia
(loss of accommodation due to age) As the eye ages, the lens becomes larger, firmer, & less elastic Inability to focus on near objects
Astigmatism
(an irregular corneal curvature) Causes the incoming light rays to be bent unequally Light rays do not come to a single point of focus on the retina Aphakia is the absence of the lens (absent congenitally or removed during cataract surgery) Replaced with an intraocular lens (IOL) implant
Corrective Glasses
Myopia, hyperopia, presbyopia (reading glasses) & astigmatism Combined corrective glasses (presbyopic correction is in the lower portion of the spectacle lens); “bifocals” Distance focusing in the top two thirds & near focus in the bottom one third of the lens
Contact Lens
Pattern of wear (daily versus extended) Microbial keratitis – poor hand or lens case hygiene Patient education key for the prevention of sight-threatening complications
Laser
(laser-assisted in situ keratomileusis – LASIK) Creates a flap in the cornea, flap is folded back on the middle section, or stroma of the cornea Laser pulses vaporize a part of the stroma Flap is then repositioned
Implant
Refractive intraocular lens implantation is an option for patients with a high degree of myopia or hyperopia Removal of the patient’s natural lens Risk of complications is higher Phakic intraocular lens implantation Implanted into the eye without removing the eye’s natural lens, placed in front of the eye’s lens Preserves the eye’s ability to focus for reading vision
Uncorrectable Visual Impairment
In the U.S., 6.5 million people over the age 65 have severe visual impairment inability to read newsprint even with glasses 9% have no useful vision 91% are partially sighted Total blindness – no light perception & no usable vision Functional blindness – some light perception & no usable vision Legal blindness – central visual acuity of 20/200 or less in the better eye with correction, or a peripheral visual field of 20 degrees or less 1.3 million people in the U.S. are legally blind
Assessment
How the patient’s visual impairment affects functioning Personal feelings & meaning Support System
Planning
Successful Adjustments Coping Strategies Goals
Implementation
Health Promotion Acute Intervention Patient & Family Respect & Communication Sight-guide technique Ambulatory & Home Care Rehabilitation services American Foundation for the Blind (www.afb.org) ADLs Optical Devices for Visual Enhancement Nonoptical Methods for Visual Enhancement
Evaluation
Expected outcomes No further loss of vision Use adaptive coping strategies Maintain self-esteem or social interactions (no decrease) Function safely within environment (personal & outside the home)
Gerontologic Considerations
Older adults is at increased risk for vision loss caused by eye disease Other deficits (cognitive impairment, limited mobility) may further affect the older adult’s function in usual ways Higher risk for falls Diminished self- esteem and independence Decreased manual dexterity may cause difficulty with eyedrops instillation
Eye Trauma
In the U.S. approximately 2.5 million eye injuries occur each year More than 10% will lose useful vision in the affected eye Most common ocular injuries occur in the home Followed by sport and work-related injuries Eye trauma often is a preventable injury Protective eyewear Role of Nursing – patient and community education
Herdeolum
(sty)- infection in sebaceous glands in lid margin Most common - Staph aureus May evolve into inflammation of gland → Chalazion Apply warm, moist compresses at least four times a day If no improvement refer to ophthalmologist for lancing or removal
Chalazion
chronic inflammatory granuloma of the meibomian (sebaceous) glands in the lid
Blepharitis
Bilateral infection of the lid margins Lids are red rimmed with scales or crusts on the lid margins and lashes May experience burning, irritation and photophobia Ophthalmic ointment Emphasize thorough cleaning practices of skin & scalp – baby shampoo
Bacterial Conjunctivitis
most common Commonly occurs in children due to poor hygienic habits Irritation, tearing, redness, drainage Antibiotics and hand washing
Viral Conjunctivitis
Tearing, foreign body sensation, redness Adenovirus conjunctivitis: contaminated swimming pools, direct contact Good hygiene and palliative care