EYES Types:

1. Conjunctivitis – inflammation of the 1. Epithelial – epithelial layer of the cornea

conjunctiva a. Meesman: occasional ‘foreign body’
- Inflammatory sensation at adulthood
- due to allergens b. Epithelial membrane (aka COGAN’s
- non-contagious dystrophy): painful ‘foreign body’
- treated with vasoconstrictors sensations and temporary blurring after
- Infectious 30
- due to Staph, Chlamydia, Neisseria c. Reiss buckler: light sensitivity and
- contagious ‘foreign body’ sensations; may require
- treated with broad-spectrum corneal transplant
antibiotics 2. Stromal Dystrophies
Signs & Symptoms: a. Granular: grey-ish dots can be seen
- itching, burning or scratchy eyelids through a microscope. Vision may be lost
- redness at 50
- conjunctival edema b. Macular: Irregular, cloudy areas appear
- discharges in both corneas which gradually merge
2. Blepharitis – inflammation of the eyelid together. Light sensitive, sight lost at 20 –
margins; characterized as itchy, red, burning 30 years old
eyes c. Lattice: ‘foreign body’ sensation and a
3. Hordeolum slight deterioration in vision. Under a
- a.k.a. stye, chalazion microscope, very fine, overlapping lines
- acute suppurative infection of the will be seen in the cornea
follicle of an eyelash 3. Endothelium – innermost layer of the cornea
- usually due to Staph a. Fuchs’:
- redness and pain
- purulent discharges
- antibiotics
4. Keratitis – inflammation of the cornea
- Pain, reduced vision, cloudy cornea,
photophobia
- Antibiotics
- Keratoplasty – a full-thickness
transplant procedure, in which a
trephine of an appropriate diameter is - more common in women, unlikely
used to make a full-thickness to be inherited
resection of the patient's cornea, - Begins at 40, painless deterioration
followed by placement of a full- of vision and glare
thickness donor corneal graft. - Next stage, painful episodes due to
tiny blisters on the cornea, which
Nursing Interventions: will gradually disappear as the
1. Instruct in infection control measures vision gets worse
2. Administer antibiotic or antiviral b. Keratoconus:
3. Administer antihistamines
4. Child should be kept home from school until
antibiotic eye drops have been administered
for 24 hours
5. Instruct in the use of cool compresses
6. Wear dark glasses for photophobia
7. Instruct the child to avoid rubbing the eye
8. Discontinue use of contact lenses and to
obtain new lenses to eliminate the chance of
re-infection
- Conical or cone-shaped cornea
CORNEAL DYSTROPHIES - Rarely appears until puberty or older
- rare conditions in which the cornea is altered - Cornea becomes stretched and thins
without the presence of any inflammation or at its center, and the thinned part of
other eye disease the cornea bulges making the vision
- runs in families more shortsighted and irregular
ERRORS OF REFRACTION - LASIK (Laser in Situ Keratomileusis) it
I. MYOPIA uses an excimer laser to cut/reshape the
cornea
- ICR (Intrastromal Corneal Ring) are
small devices implanted to correct vision
- Phakik Intraocular Lens, a lens that are
made of plastic/silicone; implanted
permanently

BLINDNESS AND LEGALLY BLIND

- nearsightedness
1. Total Blindness – no light perception and no
- has excessive refractive strength
usable vision
- focuses light in front of the retina
- treatment: concave lens
2. Functional Blindness – has light perception but
no usable vision
II. HYPEROPIA

3. Legally Blind – central visual acuity for distance

of 20/200; visual field no greater than 20 degrees

4. Partially sighted – has a corrected visual acuity

of 20/70 or less; greater than 20 degrees of visual
field

- farsightedness MANAGEMENT:
- focuses light at the back of the retina a. Assess how visual impairment can affect normal
- treatment: convex lens functioning
b. Provide emotional support for recent visual
III. ASTIGMATISM impairment
c. Orient to the environment
d. Sight guide technique (e.g. contact and grasp,
alternative grasp, stance, changing sides)

CATARACTS
- Is an opacity or cloudiness of the normally
transparent crystalline lens
- Lens protein dries out and forms crystals due
- unequal curvature of the cornea to density of the lens

IV. PRESBYOPIA Causes:

1. Senile – associated with aging
2. Congenital – may be hereditary
3. Traumatic – associated with injury
4. Secondary – sequelae of systemic disease, drug
ingestion

Signs and Symptoms:

Early:
• Painless blurred vision
- old sight
• Decreased color perception
- inability to accommodate for near vision
due to loss of elasticity of the crystalline Late:
lens • Opaque or cloudy white pupil
- treatment: bifocal lens • Vision that is better in dim light with pupil
dilation
• Gradual loss of vision progressing to
blindness
Surgery: • Absence of red reflex

Diagnostic Examinations:
NCM 104N | PERCEPTION AND COORDINATION
✓ Standard Ophthalmic Exam
✓ Visual Acuity Test
✓ Eye movement and peripheral vision
✓ Color blindness
✓ Pupil dilation
✓ Tonometry
✓ Slit-lamp exam

Medical/Surgical Management:
1. EXTRACAPSULAR CATARACT EXTRACTION
(ECCE)
- the lens is lifted out without removing the lens
capsule
- may be performed with: manual expression,
phacoemulsification
- The lens is broken up by ultrasonic
vibration and extracted through aspiration

2. INTRACAPSULAR CATARACT EXTRACTION

(ICCE)
- the lens is removed within its capsule
through a small incision

Pre-op Nursing Care:

➢ instruct measures to prevent or increase ICP
o avoid heavy lifting, bending lower than waist,
reading
o avoid prolonged anger
➢ administer pre-op eye medications including
mydriatics & cycloplegics as prescribed (e.g.
Atropine)

NCM 104N | PERCEPTION AND COORDINATION