"window to the brain"
everyone eventually develops an eye condition called
cranial nerve that transports visual information from the retina to the brain and is therefore responsible for vision
with age, the vitreous humor changes from a ____ substance to a _____ and gradually shrinks, separating from the retina
changes from a gel-type substance to a liquid
when the vitreous humor changes to a liquid, people start seeing ___, or dark spots in their vision
allow differentiation between black, white, and gray and are responsible for the interpretation of the form or shape of an object
allow the processing of objects in color
refers to the bending of light and is critical to image formation
results from an eyeball that is too long or when the cornea has too much curve present, thus causing the focused image to fall in front of the retina
patients with ____ vision have blurred vision of distant objects and therefore have difficult seeing faraway objects
when the image falls behind the retina; these patients have trouble seeing near objects
patients with ______ have difficulty seeing fine details either close-up or from a distance
what are some important things to teach patients in regards to eye protection?
- protective eye equipment, including goggles and prescription protective glasses, should be used for selected contact sports and occupations
- UV protective eyewear should be worn with outdoor sun exposure and with occupations that occur in the outdoors
- a face shield should be used to protect eyes and face as needed; it should also be used with safety goggles
- eye goggles should be worn for grass cutting/trimming/weed whacking as well as chopping wood and using caustic substances that could potentially splash
what is the normal range for intraocular pressure (IOP)?
what teaching is important for patients having an intraocular pressure test?
- instruct pt that the test is most accurate when no more than 2 cups of liquid are consumed 4 hours before the test
- no alcoholic beverages for at least 12 hours prior to testing
- instruct pts receiving eye anesthetizing medication to refrain from rubbing their eyes for at least 30 minutes after the test or until eye sensation has returned to normal
eye symptoms needing further assessment?
- sudden loss of vision in any part of the visual field
- sudden onset of pain in the eye
- flashing lights present
- physical trauma/injury to the eye
- constant tearing of the eye with or without photophobia
what are some normal age related changes with the eyes?
- pupil becomes smaller and less reactive to light
- loss of lens elasticity (difficulty focusing on closely held objects)
- yellowing of lens-difficulty in differences of blue, green, and violet
- dullness in color perception
results from a misshaped cornea
occurs almost exclusively with aging and results from the loss of lens elasticity and occurs around age 45
may be inherited and is often detected in schoolchildren during routine vision examinations completed at school
medical tx available for myopia?
corrective lenses such as glasses or contact lenses
medical tx available for hyperopia?
convex corrective lenses in eyeglasses or contact lenses
medical tx available for presbyopia?
"reading glasses" or magnification
medical tx available for astigmatism?
eyeglasses, contact lenses, or orthokeratology
manifestations of myopia (nearsightedness)?
- blurred vision when looking @ distant objects
- feeling of eye strain
- squinting when looking at objects more than a few feet away
manifestations of hyperopia (farsightedness)?
- blurred vision when looking at close-up objects
- aching eyes or feeling of eye strain
- headache during reading
manifestations of presbyopia?
- holding reading material far away so that the letters are clear
- blurred vision at normal reading distance
- feeling of eye strain or headaches after reading or doing close work (may also occur w/ myopia and hyperopia)
manifestations of astigmatism?
- blurred vision @ all distances
- feeling of fatigue or eye strain
inflammation of the conjunctivae of the eye; most commonly known as pinkeye
conjunctivitis is/is not contagious
is; educate about hand washing
do we apply warm or cool compresses to the eyes to promote comfort?
conjunctivitis affects what age range?
contact lens wearers present with this condition more frequently than those who do not wear contact lenses
most common risk factors associated with corneal abrasion?
- contact lens wearers
- participation in contact sports
- presence outdoors in windy conditions without protective eyewear
- any abrasive eye injury
- dry eye syndrome
- abuse of topical eye anesthetics and steroids
- autoimmune disorders
- recent eye surgeries
manifestations of corneal abrasion?
- eye pain (sometimes severe)
- spasm causing squinting
- blurred vision
- sensation of a foreign body in the eye
inability to be in the presence of bright light
clouding of the eye's crystalline lens
risk factors for cataracts?
- exposure to UV light
- advanced age: >60
- family hx
- race and ethnicity: African Americans & Hispanic Americans
- DM & other chronic medical conditions
- smoking & alcohol use
- environmental factors: lead exposure & sunlight
clinical manifestations of cataracts?
- clouded, blurred or dim vision
- increasing night vision difficulty
- sensitivity to light and glare
- halo vision around light sources
- fading or yellowing of colors
- double vision in a single eye
mydriatic (dilating) and cycloplegic (paralyze ciliary muscles to keep the eye dilated) eye drops are often prescribed in ________
preparation for surgery
what precautions should our patients take during the first 24-48 hours following cataract surgery?
- do not rub or apply pressure to eye
- avoid sneezing, coughing, bending over, vomiting, or lifting objects heavier than 5lb
- prevent constipation
- contact the physician immediately for severe pain, visual change, or increase in eye discharge
- avoid eye straining
- wipe excess tearing from inner to outer canthus with a clean, soft tissue
- glasses must be worn if lens implant not inserted by the surgeon
group of eye conditions that present with increased IOP and result in damage to the optic nerve, leading to loss of vision
risk factors for glaucoma?
- African American individuals >40
- people with a family hx of glaucoma
- everyone >60, especially Mexican Americans
- medical conditions such as DM and hypothyroidism
- patients w/ myopia
- prolonged corticosteroid use
chronic form of glaucoma?
acute form of glaucoma in which the eye pressure rises very quickly?
clinical manifestations of angle-closure glaucoma?
- eye pain
- rainbows around lights @ night
- very blurred vision
angle-closure is/is not a medical emergency
is** & requires prompt medical intervention
____________ are usually instilled immediately in a pt w/ angle-closure to try to reduce the rising IOP
clinical manifestations of primary open-angle glaucoma?
- gradual loss of peripheral vision, usually in both eyes
- tunnel vision in advanced stages
best prevention for glaucoma?
regularly scheduled eye examinations
when instilling eye drops, the following precautions should be taken:
- instruct pt to tilt head back w/ eyes open and looking upward
- retract lower lid downward
- invert the medication bottle and gently rest wrist on pt's cheek
- gently squeeze bottle and instill prescribed number of eye drops into conjunctival sac, taking care not to contaminate the medication dropper/bottle by touching the eye sac or other foreign objects
- instruct pt to gently close eyes
- additional eye drops may be administered after 3-5 minutes to allow for absorption
- application of gentle pressure with a clean tissue on the pt's nasolacrimal duct for 30-60s decreases systemic absorption
RF of macular degeneration?
- high cholesterol
- decrease in zinc blood levels
- age (>60)
- family hx
- gender (women>men)
- race (Caucasian)
clinical manifestations of macular degeneration?
- straight lines that appear distorted
- absent or distorted central vision
- dark, blurry areas or whiteout on center vision
- diminished or changed color perception
there is/is not a cure for macular degeneration?
is not & despite treatment, the disease and vision loss may continue to progress
retinal detachment is considered a?
clinical manifestations of retinal detachment may be sudden or gradual and include?
- sudden or gradual increase in the # of floaters in the visual field
- light flashes
- appearance of a curtain over the field of vision
- painless change in visual acuity
risk factors for retinal detachment?
- pt's who suffer from extreme myopic refraction disturbances
- hx of retinal detachment in the other eye
- family hx of retinal detachment
- pt's who have had cataract surgery
- pt's who have suffered eye injuries
- pt's with other eye diseases or disorders
- presence of systemic disease such as DM, tumors, sickle cell disease, leukemia, eclampsia, and prematurity
possible clinical manifestation of "looking through a veil or cobwebs" is what?
treatment for retinal detachment?
immediate evaluation followed by surgical intervention
what is the goal of treatment for retinal detachment?
to stop any further progression of vision loss; in most cases, the damage that has already occurred cannot be reversed
risk factors for eye trauma?
- male gender
- participation in sports
- occupation (agricultural, construction, and manufacturing)
- age 18-45
- consumption of alcohol
function of the external ear?
to funnel sound waves
function of the middle ear?
- conducting sound waves from the outer to inner ear
- protecting the inner ear from loud sounds
- equalizing pressure in the middle ear
function of the inner ear?
- labryinth is located here
the pinna is pulled ______ on an infant or child younger than 3 years old