Brunner Chapter 58 Eye

Front 1

Process by which the eye adjusts for near distance by changing the curvature of the lensto focus a clear image on the retina

Back 1

Accomidation

Front 2

Space in the eye bordered anteriorly by the cornea and posteriorly by the iris and pupil

Back 2

Anterior Chamber

Front 3

Absence of a natural lens

Back 3

Aphakia

Front 4

Refractive error in which light rays are spread over a diffuse area rather than sharply focused on the retina, a condition caused by differences in the curvature of the cornea and lens.

Back 4

Astigmatism

Front 5

Inability to see, ususally defined as corrected visual acuity of 20/400 or less, a visual field of no more than 20* in the better eye

Back 5

Blindness

Front 6

Edema of the conjunctiva

Back 6

Chemosis

Front 7

Retinal photoreceptor cells essential for visual acuity and color discrimination

Back 7

Cones

Front 8

Seeing one object as two; or double vision

Back 8

Diplopia

Front 9

Absence of refractive error

Back 9

Emmetropia

Front 10

Complete removal of the eyeball and part of the optic nerve

Back 10

Ennucleation

Front 11

Removal of the intraocular contents through a corneal or scleral incision, the optic nerve, sclera, extraocular muscles, and sometimes the cornea are left intact.

Back 11

Evisceration

Front 12

Surgical removal of the entire contents of the orbit, including the eyeball and lids

Back 12

Exenteration

Front 13

"Red eye" resulting from dilation of the vasculature of the conjunctiva

Back 13

Hyperemia

Front 14

Farsightedness, a refractive error in which the focus of light rays from a distant object is behind the retina

Back 14

Hyperopia

Front 15

Blood in the anterior chanber

Back 15

Hypema

Front 16

Collection of inflammatory cells that has the appearance of a pale layer in the inferior anterior chamber of the eye

Back 16

Hypopyon

Front 17

Conjestion of blood vessels

Back 17

Injection

Front 18

Cone shaped deformity of the cornea

Back 18

Keratoconus

Front 19

Corneal edema with painful blisters in the epithelium doe to excess corneal hydration

Back 19

Keratopathy, bullous

Front 20

Junction of the cornea and sclera

Back 20

Limbus

Front 21

Medications that cause pupillary constriction

Back 21

Miotics

Front 22

Medications that cause pupillary dilation

Back 22

Mydriatics

Front 23

Nearsightedness, a refractive error in which the focus of light rays from a distant object is in front of the retina

Back 23

Myopia

Front 24

Growth of abnormal new blood vessels

Back 24

Neovascularization

Front 25

Swelling of the optic disk due to IOP

Back 25

Papilledema

Front 26

Ocular pain on exposure to light

Back 26

Photophobia

Front 27

Space between the iris and vitreous

Back 27

Posterior chamber

Front 28

Downward displacement of the eyeball resulting from and inflammatory condition of the orbit or a mass with the orbital cavity

Back 28

Proptosis

Front 29

Drooping of an eyelid

Back 29

Ptosis

Front 30

Determination of the refractive errors of the eye and correction by lenses

Back 30

Refraction

Front 31

Retinal photoreceptor cells essential for bright and dim light

Back 31

Rods

Front 32

Blind or partially blind areas in the visual field.

Back 32

Scotomas

Front 33

A condition in which there is deviation from perfect ocular alignment

Back 33

Strabismus

Front 34

An inflammatory condition created in the fellow eye by the affected eye (without useful vision); the condition may become chronic and result in blindness (of the fellow eye)

Back 34

Sympathetic Ophthalmia

Front 35

A bilateral chronic follicular conjunctivitis of childhood that leads to blindness during adulthood if left untreated

Back 35

Trachmoa

Front 36

Abciximab

Back 36

Monoclonal antibody to fibrin receptor (glycoprotein IIb/IIIa) on platelets

Used to prevent clotting after coronary angioplasty and in acute coronary syndrome

also eptifibatide and tirofiban

Front 37

OD

Back 37

Right eye

Front 38

OS (sinister)

Back 38

Left Eye

Front 39

OU

Back 39

Both Eyes

Front 40

This is used to test peripheral vision

Back 40

Perimetry Testing

Front 41

Visulaizes the angle of the anterior chamber

Back 41

Gonioscopy

Front 42

Handheld tool to assess structures of the eye

Back 42

Direct Ophthalmoscopy

Front 43

Measures IOP

Back 43

Tonometry

Front 44

A binocular microscope mounted on a table which magnifies 10 to 40 times the real image

Back 44

Slit lamp exam

Front 45

Can be used to identify orbital tumors, retinal detachment, and changes in tissue composition.

Back 45

Ultra sonography

Front 46

Is used to evaluate abnormalities in the chorodial vasculature, conditions often seen in macular degeneration

Back 46

Indocyanine Green Angiography

Front 47

A screening test, such as the polychromatic plates can be used to assess this

Back 47

Color vision testing

Front 48

Age related changes of the eye are caused by

Back 48

Loss of skin elasticity and orbital fat and decreased muscle tone

Front 49

This test is used to identify macular problems

Back 49

Amsler Grid

Front 50

Normal vision

Back 50

Emmetropia

Front 51

A group of ocular conditions in which damage to the optic nerve is related to IOP caused by congestion of the aqueus humor

Back 51

Glaucoma

Front 52

The leading cause of blindness in the U.S, incidence increases with age

Back 52

Glaucoma

Front 53

A normal intraocular pressure is

Back 53

between 10 and 21 mmHg

Front 54

Production and drainage are not in balance.
When aqueus outflow is blocked pressure builds up in the eye
Increased IOP causes irreversible mechanical and or ischemic damage

Back 54

Glaucoma

Front 55

The silent theif, renders pt unaware until there is significant vision loss, including peripheral vision loss, blurring, halos, difficulty focusing and difficulty adjusting eyes to low lighting. May experience aching or discomfort around the eye or a headache

Back 55

Glaucoma

Front 56

Diagnostic test for Glaucoma

Back 56

Tonometry to assess IOP
Gonioscopy to assess the anterior chamber
Perimetry to assess vision loss

Front 57

Goals in treating glaucoma

Back 57

Prevent further optic nerve damage
Maintain IOP within a range unlikely to cause damage
Pharmacologic therapy
Surgery

Front 58

Surgeries for glaucoma

Back 58

Laser Trabeculoplasty
Laser Iridotomy
Filtering procedures
Trabeculectomy
Drainage implants or shunts

Front 59

Nursing Mgmt for Glaucoma

Back 59

Focus on maintaining therapeutic regimin for lifeling control
Emphasize the need for adherence to therapy and continued care to prevent further vision loss
Provide education regarding use and effects of meds
Meds may cause SE so stress the need for compliance
Provide support and interventions to aid pt in adjusting to vision loss

Front 60

This is an opacity of the lens
Increased incidence with aging by age 80 more than 1/2 of all americans have
A leading cause of disability in U.S.

Back 60

Cataracts

Front 61

Azithromycin

Back 61

Antibiotic

similar to erythromycin, but greater activity versus chlamydia, H influenzae, and streptococci; long half−life due to tissue accumulation. renal elimination.

Tox:
GI distress, but no inhibition of drug metabolism

Clarithromycin is similar but has a shorter half-life and inhibits drug metabolism

Front 62

What test is used to est. the degree of cataract formation

Back 62

Slit lamp biomicroscopic exam

Front 63

Intracapsular extraction (ICCE)
Extracapsular extraction (ECCE)
Phacoemulsifaction
Lens replacement

Back 63

Are all types of cataract surgeries

Front 64

Nursing mgmt pre op cataract surgery

Back 64

Dilating eye drops or other meds
Provide verbal and written instructions
Instruct to call dr immediately if:
Vision changes, flashing lights appear, redness or swelling or pain increases, type and amt of drainage increases, significant pain not relieved by tylenol

Front 65

Treatment for corneal disorders

Back 65

Phototherapeutic keratectomy
Keratoplasty
Donor tissue
Need for f/u and support
Potential graft failure, teach s/s

Front 66

These are elective procedures to recontour corneal tissue and correct refractive errors
Pts need counseling regarding potential benefits, risks, and complications

Back 66

Refractive Surgery

Front 67

List the different types of retinal disorders

Back 67

Detachment
Vascular disorders
Central, Branch, and central retinal vein occlusion
Macular degeneration

Front 68

Seperation of the sensory retina and the retinal pigment epithelium

Back 68

Retinal Detachment

Front 69

S/S of retinal detachment

Back 69

Shade/curtain across field of vision
Bright flashing lights
Sudden onset of floaters

Front 70

Diagnostic tests for retinal detachment

Back 70

Assess visual acuity, retina by ophthalmoscope
Slit lamp
stereo fundus photography
Fluroescein andiography, tomography, and ultrasound may also be used

Front 71

Surgical treatment for retinal detachment

Back 71

Scleral buckle
Pars plana vitrectomy
Pneumatic retinoplasty

Front 72

This type of surgery involves removal of the vitreous, locating the incisions at the pars plana

Back 72

Pars plana vitrectomy

Front 73

This surgery injects a gas bubble, liquid, or oil and it is used to flatten the sensory retina against the RPE. Post op positioning is critical

Back 73

Pneumatic retinoplexy

Front 74

Mursing management for post op retinal surgery

Back 74

Pt teaching: s/s of complications, esp increased IOP and infection
Promote comfort
Pt may need to lie in special position with pneumatic retinoplexy

Front 75

Loss of vision can occur from these occlusions

Back 75

Retinal vein or Artery occlusion

Front 76

Retinal vein or Artery occlusion may result from:

Back 76

Atherosclerosis
Cardiac valvular disease
venous stasis
HTN
Increased blood viscosity

Front 77

Associated risk factors for Retinal vein or Artery occlusion

Back 77

DM
glaucoma
Aging

Front 78

In this condition pts may report decreased visual acuity or sudden loss of vision

Back 78

Retinal vein or Artery occlusion

Front 79

This is the most common cause of vision loss in persons older than age 60

Back 79

Macular degeneration

Front 80

This type of macular degeneration involves the slow breakdown of the layers of the retina with the appearance of drusen

Back 80

Dry or non exudative
85-90% people have this type

Front 81

This type of macular degeneration my have an abrupt onset
Proliferation of abnormal blood vessels growing under the retinachoroidal revascularization (CNV)

Back 81

Wet type

Front 82

This type of therapy slows the progression of Macular degeneration dye is injected into vessels, a laser then activates the dye shutting down the vessels without damaging the retina

Back 82

Photodynamic therapy

Front 83

After photodynamic therapy pt must avoid:

Back 83

Exposure to sunlight or brightlight for 5 days after treatment, to avoid activation of dye in vessels near the surface of the skin

Front 84

Nursing management for pts who have had photodynamic therapy

Back 84

Pt teaching
Supportive care
Safety promotion
Recommendations include:
Improving lighting
magnification devices
refer pt to vision ctr to improve/promote function

Front 85

Emergency treatment for eye trauma

Back 85

Do not remove objects, protect using metal shield or cup
Flush chemical injuries

Front 86

This is classified by cause: bacterial, fungal, viral, parasitic, allergic or toxic

Back 86

Conjunctivitis "Pink eye"

Front 87

Ocular consequences of systemic disease are:

Back 87

Diabetic retinopathy (leading cause of blindness in people age 20-74)
Complications assoc with AIDS
Eye changes assoc with HTN

Front 88

Things to know about eye meds

Back 88

Ability to absorb is limited
Barries to this are size of conjunctival sac, corneal membrane barrier, blood-ocular barrier, tearing, blinking and drainage.
Topical are used most they are least invasive, fewer SE, and can self administer

Front 89

These dilate the eye

Back 89

Mydriatics

Front 90

These paralyze the eye

Back 90

cycloplegics

Front 91

These eye meds are contraindicated with narrow angles or shallow anterior chambers and for pts on MAOI's or tricyclic antidepressants
May cause CNS symptoms, increased BP (children/elderly)

Back 91

Mydriatics and cycloplegics

Front 92

These meds increase aqueous outflow or decrease aqeous production.
May constrict pupil and affect the ability to focus the lens, may also produce systemic effects

Back 92

Medications used for Glaucoma

Front 93

Side effects of anti-inflammatory, corticosteroid suspensions:

Back 93

Glaucoma
Cataracts
increased risk for infection
To avoid NSAID therapy may be used as an alternate

Front 94

Visual impairment that requires devices and stratigies in addition to corrective lenses
Best corrected visual acuity (BCVA) of 20/70 to 20/200

Back 94

Low Visionq

Front 95

BCVA of 20/400 to no light perception
Legal blindness is BCVA that does not exceed 20/200 in better eye or widest field of vision is 20* or less

Back 95

Blindness

Front 96

Impaired vision is often accompanied by:

Back 96

Functional impairment

Front 97

Assessment of low vision includes:

Back 97

Hx
Exam of distance and near visual acuity, visual field, contrast sensitivity, glare, color, perception and refraction
Special charts used
Functional ability, coping and adaption in emotional, physical and social areas

Front 98

Nursing mgmt for low vision

Back 98

Support coping stratigies, greif process and acceptance of visual loss
Stratigies for adaptation of environment, clock method for tray. Communication stratigies, collaborate with vision specialist, OT, braille or other methods for reading
Service animals

Front 99

Common causes of blindness and visual impairment among adults 40 or older include:

Back 99

Diabetic retinopathy
Glaucoma
Macular degeneration

Front 100

Back 100

Front 101

Back 101

Front 102

Back 102

Front 103

Glaucoma

Back 103

Glaucoma

Front 104

How to correctly instill eye drops

Back 104