Assessment and Management Visual
Problems
7 bones of eye socket - ANSWER-Frontal, zygoma, maxilla, ethmoid, sphenoid, lacrimal, palatine
acute angle closure glaucoma - ANSWER--needs immediate intervention
-Miotics, oral or IV hyperosmotic agents, including glycerin liquid (Ophthalgan), isosorbide solution
(Ismotic), and mannitol solution (Osmitrol) usually successful in immediately lowering IOP
-Laser peripheral iridotomy or surgical iridectomy is necessary for long-term treatment and prevention
of more episodes
Acute care for cataracts - ANSWER--Before surgery, give accurate info about disease process and TX
options
-Be available to help make informed decision about TX
-Provide support & reassurance about surgical and postoperative experience to reduce anxiety
-Notify HCP of intense pain, may indicate hemorrhage, infection, or increased IOP
Acute Care: Surgical Therapy (Preoperative) - ANSWER--Mydriatic, a-adrenergic agonist (produces
pupillary dilation, contracts the iris dilator muscle)
-cycloplegic agents- (tropicamide/Mydriacyl-anticholinergic agent)
-Nonsteroidal anti-inflammatory drugs
-Topical antibiotics
-antianxiety medications
Age-related macular degeneration (AMD) - ANSWER--a condition in which the macula degenerates,
gradually causing central vision loss in people over the age 60
-classified as dry (nonexudative) or wet (exudative
-Dry AMD more common form
-Wet AMD more severe (more rapid onset of vision loss), dry AMD occur first in most cases
Ambulatory Care for cataracts - ANSWER--Written and verbal instructions before discharge to patient
and caregiver
-Suggest getting help with step, removing area rugs and other potential obstacles, preparing meals for
freezing before surgery, or obtaining audio books for diversion
-if patch is used, warn patient they will not have depth perception until the patch is removed
angle closure glaucoma - ANSWER--due to a reduction in outflow of aqueous humor that results from
angle closure
-caused by lens bulging forward due to aging, pupil dilation in patient w/anatomically narrow angles
, Assessment and Management Visual
Problems
-Acute ACG may occur due to drug-induced mydriasis, emotional excitement, or darkness
-drug induced mydriasis occur from topical eye preparations or systemic medications (prescription or
OTC)
-check medication records before giving to patient with ACG, teach patient not to take any mydriatic
meds
-S/S ocular pain, blurred vision, and a fixed mid-dilated pupil
-IOP maybe more than 50 mm Hg
Argon laser trabeculoplasty - ANSWER--noninvasive option to lower IOP when medications not
successful
-Outpatient procedure, requires only topical anesthetic
-Laser stimulates scarring and contraction of trabecular meshwork which opens outflow channels
-Use of topical corticosteroids for 3-5 days after procedure
-most common complication (acute rise in IOP)
-F/U @ 1 week and again 4-6 weeks post surgery
Care that has decreased graft rejection - ANSWER--Improved methods of tissue procurement and
preservation
-Postoperative topical corticosteroids
-Follow-up care
-Matching blood type of donor and recipient improves success rate
Cataract - ANSWER-clouding of the lens of the eye (opacity)
TX: Cataract surgery
Clinical Manifestations for a detaching retina - ANSWER--photopsia (light flashes), floaters, and a
(cobweb/hairnet or ring in the field of vision
Problems
7 bones of eye socket - ANSWER-Frontal, zygoma, maxilla, ethmoid, sphenoid, lacrimal, palatine
acute angle closure glaucoma - ANSWER--needs immediate intervention
-Miotics, oral or IV hyperosmotic agents, including glycerin liquid (Ophthalgan), isosorbide solution
(Ismotic), and mannitol solution (Osmitrol) usually successful in immediately lowering IOP
-Laser peripheral iridotomy or surgical iridectomy is necessary for long-term treatment and prevention
of more episodes
Acute care for cataracts - ANSWER--Before surgery, give accurate info about disease process and TX
options
-Be available to help make informed decision about TX
-Provide support & reassurance about surgical and postoperative experience to reduce anxiety
-Notify HCP of intense pain, may indicate hemorrhage, infection, or increased IOP
Acute Care: Surgical Therapy (Preoperative) - ANSWER--Mydriatic, a-adrenergic agonist (produces
pupillary dilation, contracts the iris dilator muscle)
-cycloplegic agents- (tropicamide/Mydriacyl-anticholinergic agent)
-Nonsteroidal anti-inflammatory drugs
-Topical antibiotics
-antianxiety medications
Age-related macular degeneration (AMD) - ANSWER--a condition in which the macula degenerates,
gradually causing central vision loss in people over the age 60
-classified as dry (nonexudative) or wet (exudative
-Dry AMD more common form
-Wet AMD more severe (more rapid onset of vision loss), dry AMD occur first in most cases
Ambulatory Care for cataracts - ANSWER--Written and verbal instructions before discharge to patient
and caregiver
-Suggest getting help with step, removing area rugs and other potential obstacles, preparing meals for
freezing before surgery, or obtaining audio books for diversion
-if patch is used, warn patient they will not have depth perception until the patch is removed
angle closure glaucoma - ANSWER--due to a reduction in outflow of aqueous humor that results from
angle closure
-caused by lens bulging forward due to aging, pupil dilation in patient w/anatomically narrow angles
, Assessment and Management Visual
Problems
-Acute ACG may occur due to drug-induced mydriasis, emotional excitement, or darkness
-drug induced mydriasis occur from topical eye preparations or systemic medications (prescription or
OTC)
-check medication records before giving to patient with ACG, teach patient not to take any mydriatic
meds
-S/S ocular pain, blurred vision, and a fixed mid-dilated pupil
-IOP maybe more than 50 mm Hg
Argon laser trabeculoplasty - ANSWER--noninvasive option to lower IOP when medications not
successful
-Outpatient procedure, requires only topical anesthetic
-Laser stimulates scarring and contraction of trabecular meshwork which opens outflow channels
-Use of topical corticosteroids for 3-5 days after procedure
-most common complication (acute rise in IOP)
-F/U @ 1 week and again 4-6 weeks post surgery
Care that has decreased graft rejection - ANSWER--Improved methods of tissue procurement and
preservation
-Postoperative topical corticosteroids
-Follow-up care
-Matching blood type of donor and recipient improves success rate
Cataract - ANSWER-clouding of the lens of the eye (opacity)
TX: Cataract surgery
Clinical Manifestations for a detaching retina - ANSWER--photopsia (light flashes), floaters, and a
(cobweb/hairnet or ring in the field of vision
