Near-Far
For people over age 40, glaucoma testing should be done this often
every 1 to 3 years
What do corneal flattening, water loss from the lens, and occurrence of presbyopia and ectropion all have in common
Age related changes to the eye
an injury to the eye resulting from extensive contact lense usage
Corneal Abrasion
the excess formation of bone in the ears that impairs hearing
Otosclerosis
Collections of this in the outer ear can disrupt sound conduction and impair hearing in older populations
cerumen (ear wax)
Sustained exposure to noise levels of above _____ may result in hearing loss.
Sustained exposure to noise levels of above 85 dB may result in hearing loss.
Eye cosmetics should be discarded this often to prevent infection
every 2 to 4 months
This measures the pressure exerted by the aqueous humor in the anterior chamber of the eye
tonometer
In this procedure, a tube is inserted to drain the excess fluid in the middle ear and to equalize pressure while the eustachian tube is blocked
Myringoctomy
During an eye exam, visualization of this provides information about the pressure within the eye and within the skull
Optic Disc
The dog should not be distracted while it is working. The dog will seat the patient if possible; if not, the nurse can ask how best the patient can be directed.
The best way to orient a visually impaired patient to the food on their dinner plate
by position on an imaginary clock face
definition legally blind. This patient is able to see at 20 feet what the healthy eye can see at 200 feet
Signs of injury to the facial nerve include
inability to close the eyes, wrinkle the forehead, or pucker the lips.
A patient with Meniere's disease should be counseled to maintain this type of dietary restriction
A low-sodium diet and niacin (a water-soluble B vitamin)
Explain the following:
Blepharitis - Chalazion - Hordeolum - Conjunctivitis
Chalazion is an internal sty caused by infection of the Meibomian gland. Blepharitis is inflammation of the eyelids. Hordeolum is an infection of a gland of the eyelid. Conjunctivitis is the inflammation or infection of the lining of the eye.
Describe discharge education for a patient s/p cataract surgery
use sunglasses for outside wear and use an eye shield at night. The patient should maintain activity restrictions and designated head position. The patient or caregiver should instill only the number of drops prescribed and should change the eye patch dressing at least once a day.
Describe the following disorders:
Tinnitus - Nystagmus - Photophobia - Diplopia
tinnitus (ringing in the ears).
nystagmus (involuntary eye movements).
photophobia (sensitivity to light).
diplopia (double vision).
Explain the difference in causes of sensorineural and conductive hearing loss
Arteriosclerosis can cause decreased blood flow to the vestibulocochlear nerve (eighth cranial nerve), resulting in sensorineural hearing loss. This often contributes to hearing loss in older adults. Conductive hearing loss is caused by a problem transmitting sound impulses through the auditory canal, the tympanic membrane, or the bones of the middle ear.
Explain what the following tests are used for:
Snellen Eye Chart
Visual field assessments
Amsler Grid Test
Corneal Reflex Test
The corneal reflex test assesses blinking reflex with cotton on the cornea. The Amsler grid test assesses the extent of macular degeneration by noting the patient’s perception of missing or wavy lines on the grid. The Snellen eye chart is used to assess visual acuity. Visual field assessments may be used to assess peripheral vision.
How does diabetes affect the eyes/vision?
Prolonged periods of hyperglycemia cause damage to the retina from bleeding
Explain the function of the following eye structures:
pupil - ciliary body - retina - cornea
The cornea bends or refracts the light rays onto the retina. The pupil acts to regulate the entrance of light into the eye. The ciliary body helps to change the shape of the eye for far and near vision. The retina is the inner coat of the eyeball and is found in the posterior portion of it
How is the Snellen Eye chart used? What does each number indicate? How?
he Snellen eye chart is used to assess visual acuity. The chart is placed 20 feet from the patient, and first one eye is occluded and then the other eye is occluded. The person begins reading lines of letters that decrease in size. Visual acuity is expressed as a fraction for each eye. The numerator (first) figure indicates the distance between the patient and the chart. The denominator (second) figure expresses the distance at which a person with 20/20 vision could read that line. Visual acuity of 20/20 in each eye is normal.
Demonstrate conducting a Rhomberg test with a partner. What does a positive test indicate?
The Romberg test is a test of equilibrium. The patient stands with the feet together, the arms out to the sides, and the eyes open. Note the ability to maintain an upright posture without swaying. The patient is then asked to close the eyes, and posture is observed again. If the patient loses balance, it may indicate a problem with the inner ear or the cerebellum.
Nursing interventions for care of a blind patient
Speaking to the person by name, introduce yourself. Narrate actions, orient to surroundings, explain how to call for assistance, post sign outside door, offer assistance as needed, keep room clear of clutter, maintain fall precautions