eye

Assessment and Management of Clients With

Presented by: Mr. Jose L. Fernandez, RN, MAN

EXTERNAL EYE And RELATED STRUCTURES

Assessment • Visual Acuity • Ultrasonography

• External Eye Examination
• Direct and Indirect Opthalmoscopy • Slit-Lamp Examination

• Color Fundus Photography
• Fluorescein Angiography • Tonometry

• Gonioscopy
• Perimetry Testing

Assessment (con’t) • Color Vision Testing

• Amsler Grid

Glaucoma • Open-angle

• Angle-closure
• Medical management relies on systemic and topic ocular medications that lower IOP • Surgical management is laser trabeculoplasty, laser iridotomy, filtering procedures, drainage implants or shunts

Impaired Vision
• Refractive Errors

– emmetropia, myopia, hyperopia, and astigmatism
• Low Vision and Blindness – magnification and image enhancement

– multiple-unit artificial retinal chipset (MARC)

Cataracts • Lens opacity or cloudiness • Medical management may include antioxidants, glasses, contact lenses, bifocals or magnifying lenses to slow progression

• Surgical management is intracapsular cataract extraction, extracapsular surgery, phacoemulsification , and lens replacement

Corneal Disorders

• Corneal Dystrophies • Keratoconus • Corneal Surgeries –Phototherapeutic Keratectomy –Keratoplasty

Corneal Disorders

•Refractive Surgeries – Radial keratotomy (RK), Laser vision correction photorefractive keratectomy (PRK) – Laser-assisted in situ keratomileusis (LASIK)

Retinal Disorders • Retinal Detachment • Retinal Vascular Disorders – Central Retinal Vein Occlusion – Branch Retinal Vein Occlusion – Central Retinal Artery Occlusion • Macular Degeneration

Retinal detachment, tearing and fluid leak

MACULAR DEGENERATION

Orbital and Ocular Trauma
• Orbital Trauma
– Soft tissue injury and hemorrhage – Fractures

– Foreign bodies
• Ocular Trauma

– Penetrating injuries and contusions
– Intraocular foreign bodies

– Ocular burns

Infectious and Inflammatory Conditions

• Dry Eye Syndrome • Conjunctivitis • Uveitis • Orbital Cellulitis

Orbital and Ocular Tumors • Benign Tumors of the Orbit, Eyelids, and Conjunctiva • Malignant Tumors of the Orbit, Eyelids, and Conjunctiva • Malignant Tumors of the Globe: Ocular Melanoma

Surgical Procedures and Enucleation • Orbital Surgeries • Enucleation

• Ocular Protheses

Ocular Consequences of Systemic Disease

• Diabetic Retinopathy • Cytomegalovirus Retinitis

• Hypertension-Related Eye Changes

Commonly Used Ocular Medications
• Topical Anesthetics • Corticosteroids and Nonsteroidal AntiInflammatory Drugs • Antiallergy Medications • Ocular Irrigants • Ocular Lubricants

• Mydriatics and Cycloplegics
• Medications to Treat Glaucoma • Anti-Infectives