Glaucoma risk factors
- CV Disease
- Hypertension
- Previous eye trauma
- Prednisone use
- Hx of migraine
- Family hx of glaucoma
- Diabetes
Glaucoma clinical signs
- Silent thief"; unaware of the condition until there is significant vision
loss
- Peripheral vision loss
- Halos
- Blurring
- Difficulty focusing
- Difficulty adjusting eyes to low lighting
- May also have aching or discomfort around eyes or headache
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Glaucoma treatment
,- First line - betablockers - Trimolol - contraindicated in pts with asthma,
COPD, HF, bradycardia (decreases humor production)
- Surgery and Laser procedures Trabeculectomy
Glaucoma nursing management
- Don't skip eyedrops and take meds correctly
- Vision care for the whole family!
- Medications used for glaucoma may cause vision alterations and other
side effects. The action and effects of medications need to be explained
to promote compliance
Cataracts risk factors
- Age (biggest risk factor)
- Smoking
- Increased blood sugar (Diabetes)
- Overweight
- Sun exposure
- Risk increased with multiple risk factors e.g. age and smoking and sun
exposure
Cataracts Nursing Management
Preoperative care
- ask pt if they take Alpha-antagonists - in particular Tamsulosin (Flomax)
- it can cause "floppy iris"
Postoperative
- wear eye shield at night for 1 week to prevent injury
Age-related macular degeneration
- Amsler Grid - pt uses grid several times a week to detect worsening of
condition
Wet Macular Degeneration
, - Medication to inhibit vascular growth (VEGF inhibitors) - usually
monthly or bimonthly injections of drugs called anti-VEGF — or
anti-vascular endothelial growth factor — into the ey
Ophthalmic medication steps
When giving more than one eyedrop: Wait 5-10 minutes between drops
Eye drop administration:
1. Wash hands
2. Tilt head back
3. pull lower lid down
4. Place dropper over eye
5. Look up, apply drop, look down
6. Release eyelid and press corner of eye for 3-5 minutes
Ophthalmic pt teaching
- Limit time reading and using computers
- Avoid eye strain
- Avoid exposure to dust and smoke
- Never use another persons' eye medications
- Don't drive at night after using eyedrops
- Don't use OTC eye drops for more than 3 days - if no improvement,
seek medical attn
Meningitis clinical manifestations
- Headache
- Fever
- Changes in LOC
- Behavioral changes
- Rigidity (stiff neck)
- Positive Kernig sign
- Positive Brudzinski sign
Meningitis medical management