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Assessment and Management of Patients With Eye and Vision Disorders

Terms in this set (13)

Nystagmus
is involuntary oscillation of the eyeball.
Strabismus
is a condition in which there is deviation from perfect ocular alignment
Assessment and Evaluation of Vision
Ocular history
Visual acuity
Snellen chart: distance
Rosenbaum pocket screener: near
Finger count or hand motion
Examination of the External Structures
Note any evidence of irritation, inflammatory process, discharge, and so on
Assess eyelids and sclera
Assess pupils and pupillary response; use darkened room
Note gaze and position of eyes
Assess extraocular movements
Ptosis: drooping eyelid
Nystagmus: oscillating movement of eyeball
Diagnostic Evaluation #1
Ophthalmoscopy
Direct and indirect
Slit-lamp examination
Color vision testing
Amsler grid
Ultrasonography
Optical coherence tomography
Diagnostic Evaluation #2
Fundus photography
Tonometry
Laser scanning
Angiography
Perimetry testing
Impaired Vision
Refractive errors
Can be corrected by lenses that focus light rays on the retina
Emmetropia: normal vision
Myopia: nearsighted
Hyperopia: farsighted
Astigmatism: distortion caused by irregularity of the cornea
Low vision
Visional impairment that requires devices and strategies in addition to corrective lenses
Best corrected visual acuity (BCVA) of 20/70 to 20/200
Blindness
BCVA 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 degrees or less
Impaired vision often is accompanied by functional impairment
Ophthalmic Medications #2
Topical anesthetics
Mydriatics (dilate) and cycloplegics (paralyze)
Contraindicated with narrow angles or shallow anterior chambers and inpatients on monoamine oxidase inhibitors or tricyclic antidepressant
May cause CNS symptoms and increased BP, especially in children or older adults
Anti-infective medications
Antibiotic, antifungal, or antiviral products
Atropine
The medication that is administered for glaucoma, uveitis, or after surgery is atropine. Cyclopentolate, phenylephrine, and tropicamide are administered for pupillary dilation for ophthalmoscopy and surgical procedures
Glaucoma
A group of ocular conditions in which damage to the optic nerve is related to increased intraocular pressure (IOP) caused by congestion of the aqueous humor
Incidence increases with age
Risk factors: Chart 63-5
Types of Glaucoma
Wide angle
Narrow angle
Congenital
Associated with other conditions
May be primary or secondary
Refer to Table 63-4
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