Unit 4 - Brunner - Eye / Heparin

Front 1

three (3) layers of the eye

Back 1

Sclera
Choroid
Retina

Front 2

the thick white outermost layer of the eye: maintains the shape of the eye

Back 2

Sclera

Front 3

becomes transparent at the cornea: layer of the eye

Back 3

Sclera

Front 4

deeply pigmented middle layer that prevents light from scattering inside the eye

Back 4

Choroid

Front 5

the choroid has 5 main parts: namely . ..

Back 5

Iris
Pupil
Lens
Aqueous chamber
Vitreous Chamber

Front 6

lets light thru; smooth muscle fibers control its size

Back 6

pupil

Front 7

part of choroid that has a round opening called the pupil

Back 7

Iris

Front 8

is behind the pupil

Back 8

lens

Front 9

a colorless flexible crystal like structure dividing the aqueous and vitreous chamber

Back 9

lens

Front 10

focuses for near and far vision

Back 10

lens

Front 11

helps maintain the pressure inside the eye and provides nutrients to lens and cornea

Back 11

Aqueous chamber

Front 12

a free flowing fluid, secreted by ciliary process and reabsorbed into canal of Schlemm

Back 12

Aqueous humor

Front 13

is filled with VH w/c prevents the eyeball from collapsing inward

Back 13

Vitreous chamber

Front 14

inner most layer of the eye containing rods and cones

Back 14

retina

Front 15

special photoreceptors that convert light energy into nerve impulses

Back 15

Rods and cones

Front 16

night vision, low light vision photoreceptor

Back 16

Rods

Front 17

Bright light vision, color vision and detail = photoreceptor

Back 17

Cones

Front 18

area with no cones nor rods

Back 18

Blind spot aka "optic disk"

Front 19

Describe the visual pathway

Back 19

Optic nerve
Optim chiasm
Optic tracks
Lateral geniculate bodies
Optic radiations
Occipital Lobe

Front 20

a deviation of one eye (upwards, downwards, inward, outwards) from the other when a person is looking at an object, caused by weak or hypertonic muscle in one eye

Back 20

Strabismus

Front 21

involuntary unilateral or bilateral rhythmic movement of the eyes

Back 21

Nystagmus

Front 22

Paralysis of specific extraocular muscles : 2 rectus and 2 oblique muscles

Back 22

nystagmus

Front 23

4 rectus muscles

Back 23

lateral/medial rectus
inferior/superior rectus

Front 24

2 oblique muscles

Back 24

inferior / superior oblique

Front 25

the ability to see objects in sharp acuity, declines with age

Back 25

Visual Acuity (VA)

Front 26

Causes of decreased visual acuity

Back 26

Amblyopia
Cataracts
Glaucoma

Front 27

is a decreased or dimmness of vision; associated w/ disease (DM, ESRD, ETOH, tobacco)

Back 27

Amblyopia

Front 28

a cloudy or opaque area in the ocular lens

Back 28

cataract

Front 29

dec. in VA more common in persons living in sunny climates; drug use of corticosteroids, phenothiazines and some chemo drugs

Back 29

cataract

Front 30

no medications; should be removed when it interferes with ADLs

Back 30

cataract

Front 31

"everything is Tan colored"

Back 31

cataract

Front 32

s/s of cataract

Back 32

blurred vision
halos around lights
glare at night or bright light
< color perception
cloudy / white opacity on the pupil

Front 33

most common cataract: risk factors = cumulative exposure to UV light over the life span

Back 33

Degenerative cataract

Front 34

cataract due to infections, radiation, trauma, drugs or DM

Back 34

Congenital Cataract

Front 35

Tx of cataract

Back 35

surgery

Front 36

facts about cataract surgery

Back 36

success rate is 90-95%
cataracts are removed when it interferes with ADLs
Surgical removal of a portion of lens
done under IV conscious sedation (WHY?)

Front 37

what's a common cataract surgery procedure?

Back 37

ECCE = extracapsular cataract extraction = lens replacement (plexiglass or foldable lenses) via irrigation and aspiration and phacoemulsification (ultrasonic vibration to break up the lens)

Front 38

Complications of cataract operations

Back 38

Retrobulbar hemmorhage
infection and inflammation
elevated IOP
secondary glaucoma

Front 39

Nsg care of post op cataract surgery

Back 39

ambulatory pre op teaching
stop anticoagulant therapy for 5-7 days before surgery
Position on back or unoperated side
Side rails
place bedside table on unoperated eye side
Place call light w/in reach
Avoid actions that > IOP
Avoid sopa or water in the eye
Administer meds

Front 40

Actions that increase IOP

Back 40

sneezing,
coughing,
vomiting,
straining
sudden bending over with head below waits

Front 41

Eye medications post op cataract

Back 41

NSAIDS
antibiotics
cycloplegics
mydriatics

Front 42

facts about multiple eye drops

Back 42

wait till 1st drop get absorbed (2-5 mins)
eye ointment applied last

Front 43

why can't a patient be fully sedated while in cataract surgery

Back 43

sedation makes the eyes roll back

Front 44

Causes of decreased VA

Back 44

Papilledema
Dark adaptation
Glaucoma

Front 45

edema and inflammation of the optic nerve at its point of entrance into the eye

Back 45

Papilledema

Front 46

causes of papilledema

Back 46

increased IOP
retrobulbar neuritis
changes in retinal blood vessels

Front 47

cause of dark adaptation

Back 47

decreased Rhodopsin in the elderly
decreased Vit. A in all ages

Front 48

characterized by intraocular pressure increase of 12-20 mmHg; caused by optic nerve atrophy which is due from congestion of aqueous humor

Back 48

Glaucoma

Front 49

5x more prevealent in blacks between 45-65

Back 49

Glaucoma

Front 50

no cure; only management of the disease

Back 50

Glaucoma

Front 51

3 types of Glaucoma

Back 51

Open Angle
Angle closure
Congenital

Front 52

aka (Chronic); occurs when AH outflow thru the trabecular meschwork is impaired; most common, genetically inclined, slow to progress

Back 52

Open Angle

Front 53

s/s of open angle glaucoma

Back 53

no early warning
thief in the night
slow increase in IOP
loss of peripheral vision first leading to blindness

Front 54

Risk factors: Open angle Glaucoma:

Back 54

DM, cardio disease, obesity, HTN

Front 55

occurs when the root of the iris occluded

Back 55

Angle Closure

Front 56

s/s of angle closure glaucoma

Back 56

acute pain, blurred vision, loss of vision

Front 57

medical management of glaucoma

Back 57

improve the outlow of AH thru remaining channels and decreased IOP to WNL

Front 58

Meds for Glaucoma

Back 58

topical miotics
topical adrenergic
Topical beta blockers or A-adrenergics
ORal Carbonic Anhydrase Inhibitors

Front 59

what happens when you dilate the pupils of a patien with a closed angle glaucoma

Back 59

Pt might go into Acute Glaucoma

Front 60

Glaucoma surgical interventions

Back 60

laser trabeculoplasty
Trabeculectomy

Front 61

happens when fluid separates the photoreceptors from the retinal pigment epithelium and the separation deprives the outer retina of O2 and nutrients

Back 61

Retinal Detachment

Front 62

s/s of retinal detachment

Back 62

bright flashing lights, floaters, usually no pain

Front 63

Treatment of Retinal detachment

Back 63

scleral buckle
injection of gas bubbles and liquids to push the retina back in place

Front 64

loss of central vision R/T age more than 60 years. Loss of outer retina and retinal pigment epithelium

Back 64

AMD- age releted mac. deg.

Front 65

what is the primary causative factor in AMD?

Back 65

revascularization of new vessels -- they leak and bleed resulting to scar formation and retinal detachment

Front 66

risk factors to AMD

Back 66

HTN, cigarettes, DM

Front 67

s/s of AMD

Back 67

blurred vision
difficulty reading
poor night vision

Front 68

post op care - Glaucoma patients

Back 68

Routine post Anesthesia
Eye covers (plastic / metal)
Position back or unoperative side
Medication eye drops

Front 69

meds that contricts pupil

Back 69

MIOTICS

Front 70

Meds used in chronic glaucoma

Back 70

Beta Blocker

Front 71

Meds that dilate pupil

Back 71

Mydriatics

Front 72

Meds that reduces production of aqueous humor by inhibiting enzyme

Back 72

Carbonic Anhydrase inhibitor

Front 73

example of a miotic

Back 73

pilocarpine
prostigmine

Front 74

eye beta blocker

Back 74

timoptic

Front 75

example of a mydriatic

Back 75

atropine
epinephrine

Front 76

example of a carbonic anhydrase inhibitor

Back 76

Acetazolamide (Diamox)

Front 77

Indications of MIOTICS

Back 77

Lowers IOP pre-op
Glaucoma

Front 78

s/e of miotics

Back 78

eye irritation
redness
tearfuness
blurred vision
interferes with night vision

Front 79

action of miotics

Back 79

act indirectly on the iris by inhibiting sympathetic action on sphicter muscle

Front 80

Med used in chronic glaucoma - miotic

Back 80

Prostigmine

Front 81

Beta blocker to treat chronic glaucoma

Back 81

timoptic

Front 82

effects of B-blocker eye meds

Back 82

local irritation
bradycardia

Front 83

action of beta blocker

Back 83

decreases aqueous humor production

Front 84

action of mydriatics

Back 84

inhibits action of parasympathetic system w/c allows sympathetic to be dominant

Front 85

action of carbonic anhydrase inhibitor

Back 85

reduces production of aqueous humor by inhibiting the enzyme

Front 86

s/e of C.anhydrase inhibitor

Back 86

can cause fluid and electrolyte imbalance

Front 87

s/e of atropine

Back 87

blurred vision
dry mouth

Front 88

s/e of epinephrine

Back 88

hypertension

Front 89

2 types of muscles of the iris

Back 89

sphincter
radial

Front 90

cranial nerve that contricts the pupils

Back 90

3rd - III (oculomotor)

Front 91

what does sympathetic system do to pupils

Back 91

dilates

Front 92

what does parasympathetic do to pupils

Back 92

contricts

Front 93

group of meds that are contraindicated in Glaucoma

Back 93

Mydriatics

Front 94

How do optometrists check for glaucoma

Back 94

Ophthalmoscopy - checking the appearance of the optic disc (where the optic nerve joins the eye) using an ophthalmoscope, a special torch for looking into the eyes.

Visual field assessment - testing the field of vision using small points of light to check for blind spots.

Tonometry - measuring the pressure within the eye, either using an instrument that emits a small puff of air onto the surface of the eye, or placing a probe against the eye after it has been numbed with anaesthetic drops.

Other instruments

Front 95

the name for a group of eye conditions in which the optic nerve (the nerve at the back of the eye) is damaged, often in association with raised pressure within the eye. This leads to a reduction in the field of vision and in the ability to see clearly

Back 95

glaucoma

Front 96

is not a skin that grows over the eye but a clouding of part of the eye called the lens. Vision becomes blurred or dim because light cannot pass through the clouded lens to the back of the eye.

Back 96

cataract

Front 97

What causes a cataract

Back 97

?
Cataracts can form at any age, but most often are a natural consequence of getting older. They develop slowly and are painless. In younger people they can result from an injury, taking certain medication, long-standing inflammation, or illnesses such as diabetes.

Front 98

This may be caused by a hole or tear in the retina which allows fluid to get underneath, weakening the attachment of the retina which then becomes detached - rather like wallpaper peeling off a damp wall.

Back 98

detached retina

Front 99

common symptom is a shadow or curtain spreading across the vision of one eye. You may also experience bright flashes of light and/or showers of dark spots called floaters. These symptoms are never painful

Back 99

detached retina

Front 100

is the leading cause of vision loss for people over the age of 50 in the Western world. It occurs when the delicate cells of the macula – the small, central part of the retina responsible for the centre of our field of vision - become damaged and stop working

Back 100

macular degeneration