Med Surg

group of disorders that effect optic nerve--IOP--iris/lens

chronic, wide
slow drainage of aqueous humor
elderly
CM: slow vision disturbance-peripheral

acute
no drainage of aqueous humor
high IOP--N/V, halo's, headaches, pupils dilated-cornea blurred

check IOP, not to lie on operative side, report severe N/V, loss of peripheral vision, pupils nonreactive, halo's around lights, severe pain, photophobia

optometrist--
gonioscopy--drainage
tonometry--IOP

cloudiness of lens--light passes into the lens--lens focuses image on the retina--cataracts scatter the light when passes through lens--blurry image.
proteins in lens change and become less soluble

blurred vision that becomes darker with time

cigarette smoking, corticosteroids, diabetes, eye injury, sunlight and ionizing radiation, aging

Snellen visual acuity test (eye chart)
opthalmoscopy
slit lamp

lens opacity doesn't correlate to functional status; use magnifying glass, wear sunglasses, limit night driving, improve lighting

EMERGENCY
separation of retina from epithilium--losing blood supply and results in loss of vision field
rhegmatogenous-tear or hole allowing vitreous humor to seep between retina and epith.
traction--pulling force
combination--both of above
exudative--serous fluid under retina

shade or curtain across vision
cobwebs
flashing lights
floaters
NO pain

visual acuity
opthamalascope
ultrasound
slit lamp

education
supportive care

injury associated with head injury
penetrating-severe blow-optic nerve damage:sudden loss-permanent delayed loss-better prognosi
fracture-blowout
foreign bodies-tolerated unless copper, iron, vegetable matter-do not remove
ocular trauma-leading cause of blindess-chemical burn-irrigate with tap water

soft tissue injury, hemorrhage, tender, ecchymosis, lid swelling, protposis (downward placement of eyeball), black eye

x-ray--fracture and foreign body
CT-identify muscle foreign body
MRI-if not metal

cleaning, repair, cold/warm compress, protecting injured eye, reduce risk of further injury

a chronic eye disease that causes vision loss in the center of your field of vision; swelling caused by leaking blood vessels that affect the macula, which is in the center of the retina — the layer of tissue on the inside back wall of your eyeball--usually starts as dry macular degeneration

Visual distortions--straight lines appearing wavy or crooked, a doorway or street sign looking lopsided, or objects appearing smaller or farther away than they really are
Decreased central vision

vision field test (peripheral test)
amsler grid to test for defects in the center of your vision--look at the grid and some of the straight lines may seem faded, broken or distorted.
angiography-dye injected into vein and travels to blood vessels in eye for picture
--look for drusen--yellow deposits

peripheral vision isn't affected
magnifiers
amsler grid to use at home

chronic eye disease that causes vision loss in the center of your field of vision--marked by deterioration of the macula, which is in the center of the retina — the layer of tissue on the inside back wall of your eyeball.

# The need for increasingly bright light when reading or doing close work
# Increasing difficulty adapting to low light levels, such as when entering a dimly lit restaurant
# Increasing blurriness of printed words
# A decrease in the intensity or brightness of colors
# Difficulty recognizing faces
# A gradual increase in the haziness of your overall vision
# A blurred or blind spot in the center of your field of vision

unknown
nutrients are no longer passes into retina

vision field test
amsler grid
drusen
angiography

assess nutrition and antioxidants
amsler grid

lack of adequate tears; imbalance in the composition of their tears
scratchy or foreign body sensation
itching
excessive mucus secretion
inability to produce tears
a burning sensation
redness
pain
difficulty moving the lids.
Measuring the volume of your tears.
Determining the quality of your tears. Other tests use special dyes in eyedrops to determine the surface condition of your eyes. Your doctor looks for staining patterns on the cornea and measures how long it takes before your tears evaporate.
Apply warm compresses to eyes and wash with mild soap
eyedrops or ointments

pink eye
inflammation or infection of the transparent membrane (conjunctiva) that lines your eyelid and part of your eyeball.
Viral and bacterial conjunctivitis

inflammation of the uvea, the vascular layer of the eye sandwiched between the retina and the white of the eye (sclera)
Autoimmune disorders, such as rheumatoid arthritis or ankylosing spondylitis
Inflammatory disorders, such as Crohn's disease or ulcerative colitis
Infections such as cat-scratch disease, herpes, syphilis, toxoplasmosis, tuberculosis or West Nile virus
Eye injury
Certain cancers, such as lymphoma, that have an indirect effect on the eye ]
Eye redness
Eye pain
Light sensitivity
Blurred vision
Dark, floating spots in your field of vision (floaters)
Decreased vision
Whitish area (hypopyon) inside the lower part of the colored area of the eye (iris)
pt. should wear dark colored glasses