1 Other visual disorders (escalante-saac)

1. Retinal detachment

Retinas innermost layer of the eye

Serious and sight threatening event but is painless
Retina becomes separated from its underlying supportive tissue

*Degenerative causes
*Trauma
*Inflammation
*Tumor
*Diabetic retinopathy
*Cataract as complication

CAUSES

Light flashes
Wavy/watery vision
Veil/curtain obstructing vision
Shower/floater that resembles
spots, spider webs

Clinical manifestation

Glaucoma
Infxn of area

Complications

RISK FACTORS:
*Extremely near sighted
*Retinal detachment of other eye
*Fam hx of retinal detachment
D/E

*Indirect opthalmoscopy
*Slit lamp exam
*3-mirror ginoscopy

Reattach the detached part of the

retina

TREATMENT

4 Surgical procedures:
1. Cryotherapy laser
procedure/freeze treatment
2. Scleral buckle
3. Electrodiathermy
4. Protocoagulation

Most used method; localizing the position of all retina break w/ cryopobe; supporting all retina
breaks w/ scleral buckle
Electrode needle passed through sclera to allow subretinal fluid escape
Method of treating detachments of retina w/ argon laser
The high intensity beam of light from laser is converted into heat w/c forces protein molecule
in affected . . .

NURSING INTER:
*Assess hx of trauma
Post op nsg inter:
*Assess visual acuity
*Avoid bumping of head
*Encourage ambulation and independence
*Avoid rapid eye movements
*dRIVING IS RESTICTED
*Avoid straining/bending
*Apply clean water to eyes for 10 min
2. Diabetic Retinopathy

Complication of DM
-Damage of tiny blood vessels in eyes
-Often affected by increased blood sugar lvls

PATHO

*Develops when increased blood sugar lvl damage capillaries of retina. Blood vessels weaken
and are prone to rapture.

Eye painless
Partial/total loss vision
Blurred vision/lens opacity

CM

Macular edema
Severe vision loss
Blindness

Complications

*Maintain safety
*Miantain blood sugar lvls
*Laser therapy

TREATMENT

1. Aspirin
2. ACE inhibitor

MEDS
prevent or delay dvpt of diabetic retinopathy
Reduce risk of progression of diabetic retinopathy

HPN

Its recognized for risk factor for progression of DM retinopathy and DM vascular edema

*Impaired visual perception

DX

3. Macular degeneration

Leading cause of central vision loss, cells result to breakdown

*Macular degeneration test

*Retinal exam
*Fluorescein angiography

D/E
Amsler grid is used

*Age
*Obesity
*Inactivity
*Heredity
*HPN
*Smoking
*Toxic effects of drugs

Risk factors

Gradual dec of central vision

Black spots around central vision
NO CURE

CM

2 Other visual disorders (escalante-saac)

TREATMENT
4. Central artery/vein occlusion

Sudden painless and complete loss of vision in the eye

Branch artery occlusion

Sudden, painless, partial loss of vision in the eye

*Opthalmoscope

D/E

NO TREATMENT

TREATMENT

HPN, DM, Inc cholesterol, heart

disease, atherosclerosis, glaucoma

INC RISK FACTORS

RETINITIS PIGMENTOSA

No cure
Grp of genetic d/os that affect retina to respond to light
Diagnosis during childhood
BONS SPICULE SHAPE PIGMENTS DEPOSITS

CM

*Diff seeing in dimlighting

*Trips easily/bump into object
*Eye fatigue
*Loss of night vision

*Opthalmoscope

D/E

NONE

Treatment

CORNEAL D/OS
1. Keratititis

Inflammation of cornea, a transparent membrane that covers the colored part of the eye
-Both children and adult

CM

*Photophobia
*Loss of vision
*Diff opening of eye
*Inc tearing

Causes

*Poor contact lenses

*Overuse of contact lense
*Viral infxns
*Poor hygiene and nutrition

Glaucoma
Ulceration of cornea
Blindness

Complications

*Fluorescent staining w/ slit lamp

*Microscope

D/E
Identify the abrasion

1. Topical antiinfectives,
eyedrops/ointment
2. Analgesics
3. Corticosteroid
*Corneal transplant/Keratoplasty

PHARMA

SURGERY
Replacement if diseased cornea by healthy corneal tissue

PREVENTION

1. Use sterile lens in cleaning and disinfecting soln

2. Dont overwear contact lenses
3. Warm compress if theres pain

HEALTH ED

1. Teach pt to approp way to use topical antibiotics

2. Iritis/uveitis

Inflammation of the uvea, consist of 3 structures: iris. Ciliary

Anterior uveitis

Inflamm of front part of the eye

PATHO:
1. Anterior- involves iris and ciliary body
2. Intermediate- Involves ciliary body, vitreous & retina
3. Posterior uveitis- Involves retina, chloroid and optic nerve
4. Diffused uveitis- Involves front and back of the eye
Cataracts, glaucoma

Compications

P/E
Opthalmoscopy
Tenometry

D/E

1. Atropine eyedrops
2. Corticosteroids
3. Analgesic

TREATMENT
Dilate pupil and relieve spasm
Prevents inflamm
Reduce pain

EYELID AND CONJUNCTIVAL D/OS

1. Ectropion

Eyelid turned outward and doesnt come in contact w/ eyebal & inner surface is exposed
-Age of 60
-Sagging down of eyelid
-Most common in lower eyelid

ETIOLOGY

*Aging process and weakening of the connective tissue

*Contraction of the scar tissue from burns/bells palsy/ down syndrome

CM:
Epipion?
Outward turning of eyelid
TREAMENT

Outward tearing of the eye

*Daily eye cleaning w/ boiled water (PNSS)

*Artificial tears- prevent drying

3 Other visual disorders (escalante-saac)

*Antibiotic drops- treat inffection
*Palpebral conjuntiva thickens and
keratinizes

COMPLICATION

NONE

PREVENTION

Disturbed body image r/t changes

in appearance

NSG DX

2. Entropion

Eyelids turned and against eyeball

-Edge of 1 eyelid turned in
-Pts over 50 y.o.

1. Senile
2. Congenital
3. Spastic
4. Cicatricial

CLASSIFICATIONS:
Most common, disinserted
Upper eyelid
-Fold of skin that overlaps eyelids
Secondary to neurologic inflammatory/irritative process
Result of scarcification of palpebral conjunctiva w/ consequent inward/rotation of eyelid
margin

CM

*Excessive tearing,
*eye irritation (sandy gritting eye)
*burning,
*eye pain

P.E.

D/E

*Artificial teardrops
*Antibiotic
*Senile-eyelid retraction via tapng

TREATMENT

3. Pterygium

Also called as winged growth

-Fibrovascular proliferation of bulbar conjuntiva that grows toward the cornea

PATHO:
-Nourished by tiny capillaries that supply blood to tissue
Sun exposure

CAUSE

*Growth of tissue
*Dec vision
*Irritation, redness and scarring

CM

Artificial tears
Eye drops

TREATMENT

4. Ptosis

Drooping of upper eyelids

Drip droop only slightly
Weakness of levator muscles

5. Lagopthalmos

Eyelids dont close to cover the eye completely

result to dry eyes
If untreated, can lead to blindness

Stroke, infxn, facial paralysis

CAUSES

Artificial tears
Surgical tape
Flexible goggles
Tarsorrhaphy

TREATMENT

6. Blepharitis

Inflammation of the entire eyelid, caused by excess growth of bacteria in the area of eyes

CM

*Feeling like something in the eye

*Blurring of eye
*Blurred vision

MGT

*Proper lid hygiene

*Removing all make-up before bedtime

7. Hordeolum/Stye

Acute inflam/abscess involving glandular structure pfeyelids

-CAUSE: Staphylococcus bacteria eye infection

Acute, tender swelling

CM

MGT

*Warm, moist compress 4x a day

*Lid scrub/hygiene
*Darken rm

8. Conjunctivitis(pink eye)

Inflammation of the conjunctiva

Virus, bacteria, irritates, allergies

CAUSES

CM

*Redness in sclera, inc amnts of tears

*Thick yellow discharge that crust over eyeglasses

Rare procedure that eyelids are sutured together to narrow opening

Eye trauma
-In the eyelids
Blunt contussion, hyphemia, orbital CONDITIONS IN EYE TRAUMA
fracture, laceration
Facial xrays
CT scan
Antibiotic:
erythromycin/sulfacetomide

Detect orbital fracture

*Surgery
*Cosmetic surgery

For optic nerve decompression

Myopia

Nearsightedness

D/E:

SURGERY

4 Other visual disorders (escalante-saac)

-Light in front of the retina
CONCAVE LENS- TREATMENT
Hyperopia

Farsightedness
CONVEX LENS-TREATMENT

Astigmatism

Light cant focused to retina

-Uneven curvature

LASIK(Laser assisted in sitsu

ketantomileusis)

TREATMENT