Showing posts with label eye disorder. Show all posts
Showing posts with label eye disorder. Show all posts

DISORDERS OF THE EYE

Thursday, May 22, 2008 | Labels: | 0 Comments  

Conjunctivitis

  1. General information: infection of membrane covering anterior surface of eye globe and inner surface of eyelid due to multiple causes (bacterial, viral, allergic)
  2. Medical management: ophthalmic antibiotics, steroids, anesthetics
  3. Assessment findings: weeping eye, reddened conjunctiva, sensitivity to light, eyelid stuck shut with exudate
  4. Nursing interventions
    1. Administer medications as ordered: apply ophthalmic antibiotic ointments from inner to outer canthus (do not let container touch eye).
    2. Provide client teaching and discharge planning concerning measures to prevent spread of infection
      1. Very contagious if bacterial or viral; no school until antibiotics have been taken for 24-48 hours
      2. Should not share pillows, tissues, toys
      3. Good hand-washing technique
      4. Medication regimen: schedule, dosage, desired and side effects

Tuesday, May 20, 2008 | Labels: , | 0 Comments  

Blindness

  1. Causes
    1. Genetic disorders: Tay-Sach's disease, inborn errors of metabolism
    2. Maternal infections during pregnancy: TORCH syndrome
    3. Perinatal: prematurity, retrolental fibroplasia
    4. Postnatal: trauma, childhood infections
  2. Medical management: treatment of causative disorders
  3. Assessment findings
    1. Vacant stare; obvious failure to look at objects
    2. Rubbing eyes, tilting head, examining objects very close to the eyes
    3. Does not reach for objects (over 4 months)
    4. Does not smile when mother smiles (over 3 months), but does smile in response to mother's voice
    5. Crawls or walks into furniture (over 12 months)
    6. Does not respond to the motions of others
    7. No concept of the look of an object, no concept of color or reflection of self
    8. Other senses become more keenly developed to compensate
    9. Unable to copy the actions of others; delayed motor milestones in accomplishing tasks but are not mentally handicapped
    10. Various degrees (20/200 O.U. and worse)
  4. Nursing interventions
    1. For hospitalized child, find out parents' usual method of care.
    2. Encourage infant to be active; use multisensory stimulation (rocking, water play, musical toys, touch).
    3. From ages 2-5 arrange environment for maximum autonomy and safety (e.g., avoid foods with seeds and bones).
    4. Speak before you touch the child, announce what you plan to do.
    5. Do not rearrange furniture without first telling child.
    6. For a partially sighted child
      1. Encourage child to sit in front of classroom.
      2. Speak directly to child's face; do not look down or turn back.
      3. Use large print and provide adequate nonglare lighting.
      4. Use contrasting colors to help locate areas.
    7. Provide client teaching and discharge planning concerning
      1. General child care, with adaptations for safety and developmental/ functional level
      2. Availability of support groups/community agencies
      3. Special education programs
      4. Interaction with peers; assist child as necessary

Tuesday, May 20, 2008 | Labels: | 0 Comments  

Eye Injuries/Emergency Care

  1. Removal of loose foreign body from conjunctiva
    1. Foreign bodies, e.g., sand, dust, may cause pain and lacrimation.
    2. Instruct client to look upward.
    3. Evert lower lid to expose the conjunctival sac.
    4. Gently remove the particle with a cotton applicator dipped in sterile normal saline using a twisting motion.
    5. If particle is not found, examine the upper lid.
    6. Place cotton applicator stick or tongue blade horizontally on outer surface of upper lid; grasp under eyelashes with fingers of other hand and pull the upper lid outward and upward over the applicator stick.
    7. Gently remove the particle as above.
  2. Penetrating injuries to the eye
    1. Examples: darts, scissors, flying metal
    2. Do not attempt to remove object.
    3. Do not allow client to apply pressure to the eye.
    4. Cover eye lightly with sterile eye patch for embedded objects, e.g., metal; apply protective shield, e.g., paper cup, for impaled objects such as darts.
    5. Cover uninjured eye to prevent excessive movement of injured eye.
    6. Refer the client to an emergency room immediately.
  3. Chemical burns
    1. Flush eye immediately with copious amounts of water for 15-20 minutes.
      1. Have client hold head under faucet to let water run over eye to thoroughly wash it out; may need to forcibly separate eyelids during flush
      2. If available, flush eye with syringe
    2. After flushing, refer client to an emergency room immediately

Monday, May 19, 2008 | Labels: | 0 Comments  

Detached Retina

  1. General information
    1. Detachment of the sensory retina from the pigment epithelium of the retina
    2. Caused by trauma, aging process, severe myopia, postcataract extraction, severe diabetic retinopathy
    3. Pathophysiology: tear in the retina allows vitreous humor to seep behind the sensory retina and separate it from the pigment epithelium
  2. Medical management
    1. Bed rest with eyes patched and detached areas dependent to prevent further detachment
    2. Surgery: necessary to repair detachment
      1. Photocoagulation: light beam (argon laser) through dilated pupil creates an inflammatory reaction and scarring to heal the area
      2. Cryosurgery or diathermy: application of extreme cold or heat to the external globe; inflammatory reaction causes scarring and healing of area
      3. Scleral buckling: shortening of sclera to force pigment epithelium close to retina
  3. Assessment findings
    1. Flashes of light, floaters
    2. Visual field loss, veil-like curtain coming across field of vision
    3. Diagnostic test: ophthalmoscopic examination confirms diagnosis.
  4. Nursing interventions: preoperative
    1. Maintain bed rest as ordered with head of bed flat and detached area in a dependent position.
    2. Use bilateral eye patches as ordered; elevate side rails to prevent injury.
    3. Identify yourself when entering the room.
    4. Orient the client frequently to time, date, and surroundings; explain procedures.
    5. Provide diversional activities to provide sensory stimulation.
  5. Nursing interventions: postoperative (see also Cataract Surgery)
    1. Check orders for positioning and activity level.
      1. May be on bed rest for 1-2 days.
      2. May need to position client so that detached area is in dependent position.
    2. Administer medications as ordered: topical mydriatics, analgesics as needed.
    3. Provide client teaching and discharge planning concerning
      1. Technique of eyedrop administration
      2. Use of eye shield at night
      3. No bending from waist; no heavy work or lifting for 6 weeks
      4. Restriction of reading for 3 weeks or more
      5. May watch television
      6. Need to check with physician regarding combing and shampooing hair and shaving
      7. Need to report complications such as recurrence of detachment

Monday, May 19, 2008 | Labels: | 0 Comments  

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