Click to edit Master title style,Click to edit Master text styles,Second level,Third level,Fourth level,Fifth level,*,*,*,VISION II,S.Buckley RN,MSN,Copyright 2021,COMMON CAUSES OF VISION LOSS,Glaucoma,Cataracts,Diabetic Retinopathy,Macular Degeneration,GLAUCOMA,Glaucoma:Includes A Group Of Ocular Disorders Characterized By Increased Intraocular Pressure,Optic Nerve Atrophy,And Visual Field Loss.,Individual Patient Response,CLASSIFICATIONS,Primary Glaucoma,Secondary Glaucoma,Acute&Chronic,Open(Wide)&Closed(Narrow),ETIOLOGY,Primary Open Angle Glaucoma Occurs As A Result Of Aging.The Drainage Angle Of The Eye Becomes Less Efficient With Time.There Is A Degenerative Change In The Trabecular Meshwork,Resulting In Decreased Outflow Of Aqueous Humor.,90%Of Cases,Primary Angle Closure Glaucoma Is Caused By Pupillary Block.The Lens Blocks The Pupillary Opening,Preventing The Flow Of Aqueous Humor Into The Anterior Chamber And Draining Through The Trabecular Meshwork.,10%Of The Cases.,EYE EXAM,Eye Exams Must Include Tonometry And Assessment Of The Optic Nerve Head.,Normal Pressure is 10-21 mm hg.,Abnormal Pressure is 22-32 mm hg.,SECONDARY GLAUCOMA,Secondary Glaucoma May Occur As A Result Of,Trauma,In Which You Get Lens Displacement,Hemorrhage Into The Anterior Chamber,Lacerations,And Contusions Which Can Disrupt The Flow Pattern Of Aqueous Humor.,PATHOPHYSIOLOGY,Intraocular Pressure Is Determined By:,Intraocular Pressure Varies With:,Increased Pressure Inhibits Blood Supply To The Optic Nerve And Retina.Ischemia And Loss Of Function Follow.,DIAGNOSTIC FINDINGS,Increased Intraocular Pressure.,Cupping Or Indentation Of The Optic Nerve Head On Exam.,Visual Field Defects Usually Not Noticed Until Peripheral Vision Is Severely Compromised.,ACUTE ANGLE CLOSUREGLAUCOMA,In Acute Angle Closure Glaucoma The Aqueous Flow Is Obstructed And Intraocular Pressure Elevates Markedly.,Signs&Symptoms:Severe Pain,Blurring Or Loss Of Vision,Rain Bow Halos,Nausea/Vomiting And Corneal Edema.,Emergency Requiring Immediate Treatment.,MEDICAL MANAGEMENTOF GLAUCOMA,Eye Medications:Increase Outflow Of Or Suppress The Secretion Of Aqueous Humor.,Eye Drop Regimen And Delivery Method:,Sterile TechniqueConsistent Timing,3-5 Minutes Between Each Drop(Same Medication).,5-10 Minutes Between Drops(Different Medications).,ASSESSMENT,Demographic Data,Medication ListAllergies,Changes In Vision,Coping With Vision Changes/Loss,SURGICAL OPTIONSLIFESTYLE CHANGES,Laser Trabeculoplasty,Stop SmokingControl Hypertension,Maintain Weight,Avoid Alcohol And Caffeine Several Hours Before Eye Exams.,Avoid Prolonged Bending Over.,CATARACTS,Cataract:Opacity Of The Lens.,Causes:Aging,Half Of The Population Ages 65-74 Years Old Has Some Degree Of Cataract Formation.,Important Risk Factor:Cumulative Exposure To Ultraviolet Light Over The Life Span.,OTHER CATARACTS,Cataracts May Develop As A Result Of:,Intraocular Disorders:,Systemic Disorders:,Congenital Cataracts:,Blunt Trauma:,CLINICAL STAGES,Immature Cataracts:,Mature Cataracts:,Clinical Manifestations:,Secondary Glaucoma:,SURGICAL MANAGEMENT,Objective:Remove The Opacified Lens And Implant A New Lens.,Extracapsular Cataract Extraction Consists Of Removing The Lens And The Anterior Portion Of The Lens Capsule.The Posterior Lens Capsule Is Left Intact.A Posterior Chamber Intraocular Lens Is Inserted Inside The Remaining Capsule.,MEDICATIONS,During Surgery:IV Conscious Sedation And Local Anesthesia,Plus:,Mydriatics,Cycloplegics,Post-Op Medications:Antibiotics,Steroids,Decrease Intraocular Pressure.,POST OPERATIVE CARE,Monitor For:,InfectionBleeding,Macula EdemaWound Leaks/Drainage,Pain Nausea/Vomiting,Blurred/Cloudy Vision/Halos Around Light,Secondary Glaucoma,Retinal Detachment,POST OPERATIVE CARE,Assess Ability To Take Medications,Wear Eye Patch/Shield Overnight.,Avoid Bending,Stooping,Coughing,Or Lifting,Healing Takes 6-8 Weeks.,Glasses,RETINAL DISORDERS,Retinal Detachment:Characterized By A Retinal Hole And Subsequent Fluid Accumulation Between The Retina And The Retinal Pigment Epithelium.The Liquid Seeps Through The Hole And Separates The Retina From Its Blood Supply.,Result:,PREDISPOSING FACTORS,Factors Associated With Retinal Detachment:Aging,Cataract Surgery,Degeneration Of The Retina,Trauma,Severe Myopia,Retinal Detachment In The Other Eye,Family History.,If The Retina Is Separated From Its Choriodal Blood Supply,It Will Die.,CLINICAL MANIFESTATIONS,Signs&Symptoms:Shadow Or Curtain Falling Across The Field Of Vision.,Onset Sudden,Burst Of Black Spots Or Floaters,Flashes Of Light,Detached Area Blue/Gray,Ophthalmic Emergency,SURGICAL MANAGEMENT,Goal:To Place Retina Back In Contact With The Choroid And To Seal The Accompanying Holes And Breaks.,Laser:,Scleral Buckling:,Complications:,Post Operative Care,Expect Serious Not Bloody Drainage,Redness,Swelling,Ecchymosis Of Lids.,Activity Restrictions May Apply.,Pain Control,Nausea/Vomiting Control,Medications:Antibiotics,Steroids,Mydriatics,And Cycloplegics.,Eye Shield,