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3.2 - ABSN NUR 405 STI, Visual, Prostate > Visual (Macular Degeneration & Glaucoma) > Flashcards

Visual (Macular Degeneration & Glaucoma) Flashcards

1
Q

Age-related Macular Degeneration (AMD) is related to:

a. retinal aging
b. retinal detachment
c. excessive glare
d. I really don’t know

A

a. retinal aging

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2
Q

A patient who has Macular degeneration will have a vision that looks like:

a. a loss of periphery
b. a loss of central vision
c. splotchy patches
d. a complete loss of vision

A

b. a loss of central vision

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3
Q

Name the 2 forms of AMD (Macular degeneration)

A
  1. Dry (non-exudative) - 90%

2. Wet (exudative) - 10%

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4
Q

Dry AMD is more threatening to vision loss than wet AMD:

True or False

A

False. Wet AMD is more threatening to vision loss

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5
Q

_______ may increase the risk of progression of AMD.

A

Smoking

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6
Q

What is causing an increased progression of Dry AMD?

A

Macular cells start to atrophy, which leads to progressive and painless vision loss. This can occur over many years. It is insidious.

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7
Q

Can dry AMD develop into wet AMD?

A

Yes. 7% over 5 years.

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8
Q

What is the treatment for dry AMD?

A

There is no proven effective treatment for dry AMD.

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9
Q

Wet AMD accounts for __% of cases of AMD-related blindness

A

90%

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10
Q

What is causing the progression of wet AMD?

A

a more rapid onset that is characterized by the development of abnormal blood vessels in or near the macula

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11
Q

Patients with wet AMD experienced dry AMD first:

True or False?

A

True. Patients with wet AMD had dry AMD first.

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12
Q

What type of care can help slow the progression of both dry and wet AMD?

A

Antioxidant vitamins and zinc

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13
Q

You should quit ______ if you have dry or wet AMD.

A

Smoking

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14
Q

What vision is lost in a patient with Glaucoma?

A

Peripheral vision is lost.

(Central vision is good).

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15
Q

What test can help determine if you have glaucoma?

A

Field of vision test

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16
Q

Why is glaucoma concerning?

A

It is painless and usually goes unnoticed because it is the periphery that is impacted.

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17
Q

What is glaucoma?

A

It is an eye disorder that increases IOP and is a major cause of blindness (second behind cataracts).

18
Q

What does IOP stand for?

A

Intraocular pressure

19
Q

What is IOP?

A

The pressure in the eye

20
Q

____-angle glaucoma is when the trabecular meshwork is clogged and causes a problem with the reabsorption of aqueous humor.

A

Open-angle glaucoma

21
Q

Is there a problem with the circulation of aqueous humor in open-angle glaucoma?

A

No, the problem is related to clogged trabecular meshwork. It is a faulty “pumper station”

22
Q

Another name for spongy tissue (relating to glaucoma)?

A

Trabecular meshwork

23
Q

Is Open-angle glaucoma symptomatic or asymptomatic?

A

usually asymptomatic

24
Q

Open-angle glaucoma is a structural problem:

True or False?

A

False. Closed-angle glaucoma is a structural problem.

25
Q

Describe what causes Closed-angle glaucoma:

A
  • Also known as Angle-closrure
  • It is a narrow angle between the cornea and iris that prevents aqueous humor from being reabsorbed.
  • The aqueous humor is unable to get to the trabecular meshwork
26
Q

How does closed-angle glaucoma patient present?

A

The patient has a painful red eye that must be treated within 24 hours or blindness may be permanent.

EMERGENCY

27
Q

What is the first line of care for a patient with chronic Open-angle glaucoma?

A

Medications (eye drops)

28
Q

How might the medications for open-angle glaucoma help the problem?

A

Medications/eye drops can:

  • decrease the aqueous humor production
  • can cause miosis/opening of the trabecular meshwork
29
Q

What is usually a problem associated with Chronic open-angle medication administration?

A

Compliance.

It is an asymptomatic disease, so patients often forget or don’t see the significance is taking it.

This is a great teaching opportunity!

30
Q

The alternative option if drug therapy does not work for a patient with Chronic Open-angle glaucoma is called:

A

Argon Laser Trabeculoplasty (ALT) (Out-patient procedure)

31
Q

How does the ALT procedure work?

A

The laser hits the damaged trabecular meshwork and opens the outflow channels.

32
Q

______ anesthesia is used during an ALT procedure for Chronic Open-angle glaucoma.

A

Topical

33
Q

Acute Angle-Closure Glaucoma is NOT an emergency:

True or False?

A

False. It is an ocular emergency. Head to the ED!

34
Q

This diagnostic test is considered the gold standard for Acute Angle-closure Glaucoma:

A

Gonioscopy

35
Q

The initial therapies you will have in the ED with acute angle-closure glaucoma consist of:

A
  • Beta-blocker topical agent
  • Carbonic anhydrase inhibitor (acetazolamide)- PO
  • Miotic eye drops (helps lower the IOP by constricting the pupils)

GOAL: immediate relief!

36
Q

Further care associated with Acute Angle-Closure Glaucoma that a patient may experience in the ED includes:

A
  • aggressive treatment of pain and nausea
  • measures to avoid activity and to keep calm
  • apply a patch or covering to the affected eye
  • Prepare for iridotomy once the IOP is stabilized
37
Q

Why does do pain and nausea need to be aggressively controlled in a patient with acute angle-closure glaucoma?

A

Pain and nausea can aggravate the situation and significantly increase the IOP

38
Q

Punching holes in the iris that allows for the aqueous humor to get to the other side is a procedure called:

A

Iridotomy

39
Q

The two types of surgical interventions for acute angle-closure glaucoma are:

A
  1. Laser Peripheral Iridotomy

2. Surgical Iridectomy

40
Q

Glaucoma

Early detection and treatment to prevent complications is important!

List the recommendations by the AAO for regular comprehensive ophthalmologic exams are recommended:

A
  • Every 3-5 years (40-60 y.o.)
  • Every 1-2 years (> 60 y.o.)
  • African American –> periodic exam for ages 20-39
41
Q

Acute Interventions for a patient with Acute Angle-closure Glaucoma:

A
  1. Quick and appropriate drug therapy
  2. For acute pain:
    • If light sensitive = darken room (after the eye is fully constricted)
    • Apply cool compress to forehead
    • Find a quiet/private environment
    • Keep the patient and family informed
  3. Ensure support and teaching for patient/family

3.2 - ABSN NUR 405 STI, Visual, Prostate (6 decks)

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