eye tests
Snellen scale used. Person stands 20 ft from chart and covers one eye at a time and reads letters. Results given as a fraction; numerator= distance from chart, denominator= how far away a person with normal vision would see as you see.
Visual acuity test
Common in african americans and those with diabetes, this disorder causes blindness as optic disc is damaged by optic neuropathy causes atrophy. Blindness is preventable if caught early. Cornea may be flattened and IOP measured with slit-lamp biomicroscope during screening
Glaucoma
Surgical removal of the lens and replacement with a prosthetic one
cataract
Watch TV from 10 feet away, ride in car as passenger, head-down or semi-prone position may need to be maintained if gas bubble used. Outdoor walking with companion, tub bath/shower (avoid soap or water in the eye)
Activities
Announce your presence and let the patient know when you are leaving
avoid startling; doesn't leave them talking to no one
Patient given a Jager-type card with different sizes of print. one eye occluded at a time, and lines are read. Tests near vision
Near-vision test
Most often caused by diabetes and hypertension as blood supply to retina is decreased. Excessive use of caffeine, nicotine, and high stress are contributing factors
Retinopathy
Patch both eyes to prevent movement and get the patient to the ER or ophthalmologist
penetrating injury
Driving, heavy lifting, , use stool softeners to prevent straining for bowel movement, do not try to hold back sneezes, keep head upright and bend at the knees
restrictions/precautions
Present food and describe location in clockwise fashion
Enhance nutrition
patient looks into examiner's eye and examiner mover hand from outside of visual field back to line of sight. This test can be used to assess for macular degeneration or glaucoma
Visual fields (confromtation) test
Characterized by loss of central vision while peripheral vision remains intact. In early stages, the person may have inability to see vividness of colors,/details. Objects may appear larger or smaller
macular degeneration
Irrigation for 30-60 minutes with saline (preferred) or tap water
debris in the eye/ chemical injury
Wait 3-5 mins between different types of eye drops to prevent them washing each other away; Have someone else administer eye medication,; patch eye after each set of medication is administered. check movement of eye each time patch is changed
eye care
Do not raise voice. Speak in a normal tone
Patient is blind, not deaf.
Uses a handheld, printed card with grid. Patient fixates on dot in the middle and records abnormalities such as waving, missing, distorted lines
Amsler grid test
Characterized by flashes of colored light and floaters, feeling as if a curtain is drawn over portion of visual field.
Retinal detachment
Glasses or eye surgery
Errors of refraction (myopia, hyperopia, astigmatism)
take prescribed analgesic or extra strength tylenol. Cool washcloth or ice pack to forehead may reduce discomfort. Report pain that either gets markedly worse or is accompanied by nausea/vomiting
Comfort
Keep walkways clear, do not rearrange furniture. Door completely open or completely closed
prevention of falls or injury
Series of lenses used to determine of lens correction needed. can be used for both near and far vision
Refraction
Cigarette smoking, heavy drinking, and chronic use of steroids are are risk factors of this problem. frequent need to change eyeglasses, diplopia and difficulty with night vision are signs and symptoms. Cloudy appearance of the eye may be noted
cataract
treated with medications that either decrease production of, or increase outflow of aqueous humor. Surgery to create evenly spaced openings to facilitate drainage (trabeculoplasty)
Glaucoma
reorient patient to place, time, and surroundings
Prevention of confusion, agitation and falls
The working dog
Allowed in the hospital. Do not pet, play with or feed. Ensure dog has its own mat near the patients bed on the side staff is less likely to use