Unit 1
Visual
Eye accommodation – pupils will constrict when moving an object towards the nose
Light – pupils constrict
Dark –
... [Show More] pupils dilate
Cataract development
o Cataract = opacity within the lens
o Risk factors
Age (senile cataracts)
Blunt or penetrating trauma
Maternal rubella
Radiation or ultraviolet light exposure
Ocular inflammation
Medications – corticosteroids
Medical history – Diabetes
o Clinical manifestations
Decrease in vision
Gradual
Abnormal color perception
Glare
May be significantly worse at night when the pupil dilates
o Diagnosis
Decreased visual acuity
Visual dysfunction
Ophthalmoscopy – opacity is directly observable
o Nonsurgical Therapy
Changing eyewear prescription – temporarily improve visual acuity
Strong reading glasses/magnifiers – near vision
Increase amount of light to read
Lifestyle modification
o Surgical Therapy
Preoperative
History and physical examination
Outpatient surgical
Dilating drops
o Mydriatic
A-adrenergic agonist
Contraction of iris dilator muscle
o Cycloplegic
Anticholinergic
Blocks effect of acetylcholine on ciliary body muscles
o WEAR DARK GLASSES TO MINIMIZE PHOTOPHOBIA
Nonsteroidal anti-inflammatory eye drop – reduce inflammation
Intraoperative
Phacoemulsification – small incision is made in the surface of the eye in
or near the cornea, ultrasonic vibrations dissolve the clouded lens,
particles are suctioned out
Extracapsular cataract extraction procedure – cataract is removed in one
piece
o Advanced cataracts when lens is too dense
IOL lens – posterior chamber lens implanted in capsular bag behind iris
Postoperative
Antibiotic drops – prevent infection
Corticosteroid drops – decrease postoperative inflammatory response
Activity restrictions – bending, stooping, coughing, lifting
o Health Promotion
Wear sunglasses
Avoid extraneous or unnecessary radiation
Maintain appropriate intake of antioxidant vitamins – C and E
Macular degeneration development
o Most common cause of irreversible central vision loss
o 2 forms
Dry (nonexudative)
Most common
Close vision tasks difficult
Macular cells atrophy – slowly progressive and painless vision loss
Abnormal accumulation of yellowish extracellular deposits (drusen) in
retinal pigment epithelium
Acute vision loss
Wet (exudative)
More severe
Accounts for AMD-related blindness
More rapid onset of vision loss
Development of abnormal blood vessels in or near macula
o May leak fluid and bleed – scar tissue
Acute vision loss
o Risk factors
Retinal aging
Genetics and family history
White ethnicity
Chronic inflammation conditions
Smoking
Hypertension
o Reduce risk
Increase intake of dark green, leafy vegetables with lutein (kale/spinach)
Vitamin and mineral supplements
Smoking cessation [Show Less]