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+ a, Provide bed rest y Ww
. aaa to the client beforefapproaching
. i Position the client’s head as prescribed te
* e. Protect the client fromfinjury. bs
* f. Avoid jerky head mov ements. ga 4
* g. Minimize eye stress. 3a
* h. Prepare the client for a surgical
procedure as prescribed. 9
—————
+ Management:
+ Basic intervention:
, close eye nt
+ Eye patching to limit the movement.
~
fasLmoving & fast bending.
= 2
* Avoid watching
oS
* Aspiration fro
fine heedle
fluid for the
* Instruct;
& using of mobile. y yx
using of
‘e subretinal
* Using -79 de
8ee cold probe.
* For the initi
ation of local ; ,
Which lead to ice nae routnation '
i “"'€810n through heal.” Rot
* Diathermy: 8h healing.
* Initiation of;
Nn of inf] ;
“Ss ation thr Le
Seleral buckling: ugh laser,
sine < adhesj ook
Using Sclera] buckling S10n of retinal by
r. Retina} \
Pheumopex. ; ioc Shiny
Bi 4 ex: ;
eS and Silicon oP ex: at.:
amm, ¢ g. Position the client as prescribed
(positioning depends on the location of
the detachment) #
¢ h. Administer_eye medications as
prescribed.
1 he client with activities of
daily living. 3+
« j. Avoid sudden head movements or
¢ k. Instruct the client to limit
3 to 5 weeks. 5%
Or s Age: Mor US Gee)
“ j 22
S
* Type: LS
+ A. Age-related Atrophic!
macular degenefe~—
: ive acular
¢ B. Exudative mac
degeneration
e
Healthy ey' Macula
* A. Age-related / Atrophic/ Dry
macular degeneration:
* Caused by gradual blocking of retinal
capillaries leading to an ischemic and
necrotic macula.
* Lead to rod and cone photoreceptors
die.
* Most common type of macular
degeneration
: +
* Most common cause Smoking
(Chronic) y+
* B. Exudative / Wet macular degener
ration:
* Serous detachme 1 1
» ectachment of pigment epithelium in
the macula occurs,
* Due to fluid
macula,
a. F
Resulting Scar formation & visu
* Also due 2
BUS tO'neo vase lasic.
& blood collect under the
al distortion, £ olo
CM: 4 (dk:
Central vision loss] Pooi{coloy differential yn Rott}
Poor bright light Vision
pv
Aimed} Maximizing the remaining| vision. =
oa,
stigation of choice:
Investig: e @ II
: . Ge
Fluorescein's angiography
Management: pv fo
Ne A
Antioxidant * or NO
Photocoagulation or(estruction df new ves veh e
prowl e
Ophthalmia neonatorum:~**
Inflammation offen ee (sy J28 day day
(neonate).
Characterised bs(waten) mucoid &
mucopurulent discharge. 44
itiology:
; Me as
Antenatal- most common cause — Neisseria
gonorrhoea (gonococci)e&sl—
Intranatal- chlamydia tre trachomatous : ad
Post natal- Common- herpes simplex v irusftt)
——"
1-2 day- 3-4 day-
day- chemical cause , 3-4 day gonorrhoed yp
7 day- cham trachomatis +~
2 > * AGNO3 (Silver nitrate}
. | Crede’s method +=
* Put in newborn eye
x
ce c = 7 had
. pause chemical conjunctivitis/ chemical
atorum, oe¢
*D/E: «
—>
* Management:
+ Eye cleaning finner to outer cantly
¢ Antibiotics —
* Gonorrhea — ceftriaxone
¢ Chlamydia- erythromycin , azithromycin
$e
Conjunctivitis:
. Inflammation of conjunctiva which is
characterized by hy yeremial mucoid,
watery & mucopurulent discharge. x#
. Also known as 7
. Red eye syndrome (Hyperemia)
. Pink eye syndrome | I lemopis cl
enovirus )**
: a Sli ip a
influenzas & ad TS « B. Allergie ey
F Autoimmune disorder o
+p. Other
eS
«A. Infectious: -
* Bacterial- staphylococcus aures
* Viral/Aseptic- adeno virus
* Chlamydia trachomatis
See i trachomatis —
* Ophthalmia neonatorum —
* Note: Bacteria & viral are highly
communicable, » —s
—————_—_—_—
Special Note: If
CDlar
Gnjunctivitiis due to
rachomatis & LONOCOCEj jn
that normally not tl
q hildren) ally ie Causative )
arent if present that indicat (Possible sexual
LF . “| «ee
+ Crowded place ++
-C/M:
* Hyperemia- redness of eye due to increase
local blood flow.
+ Excessive lacrimation (watery, mucoid &
mucopurulent)
* Sticky eye
* Excessive mucus collection
* Photophobia
* Chemosis- conjunctival edema (swelling of
the eye surface membranes because of
accumulation of fluid)
* Eye pain
|
palin 8 Sk Ee
*D/E:
History & Physical examination.
* Eye drainage Culture
. Manage
Ment:
e Eye cle;
aning
* Eye in r igation
* Antibioticg obramyc;
oo ite
_
Note: Never
“Isolate ~ e [nflammetve
+ Trachoma: eo .
« Trachome-
Iso known as rough eye. 2
¢ Also
>
stiva &
ynjunctly
ation of cc
+ It’s the inflamma
vitis).
cornea (kerato-con uncti
+ Etiology- A.
+ Chlamydia trachomatous wf
r 2-5 year Zz
* Common age group \2 a
C peri 21 days +*
* Incubation period — 5 to 21 days ye
————_—
ge
* Mode of transmission — Direct contact
* Blepharitis:
* Inflammation of the eyelid margin “
= . . x
* Common chronic ophthalmological problem
* Chronic Tecurrent varied Symptoms that
involve
both eyesead
*C/M:
“Red swollen
~~
. , Or itchy Cyelids
Witty or burning Sens
ation
poe tenting Bee
ar Ing »BI
ees 0 wed Vision
4~
or SCe alin y of t
Light sen. Sitvty EVE skin « Hordeotuim:
+ Also known as a “stye”.
+ Ared and painful lump on eyelid @
Caused by a gland on the edge of the
eyelid becoming infected or inflamed
© C/M:
* Red, painful lump on the edge of
eyelid (looks like a pimple)
¢ Tearing
+ Eyelid pain and swelling
+ Management:
* Apply warm, wet compress
* Wash hands frequently.
* Do not touch or rub the eye.
* Do not squeeze or attempt to “pop”
the stye.
* Do not wear makeup or contact
lenses.
* Chalazion:
+ Painless lump in eyelid caused by
blockage in lacrimal gland
*C/M:
* Firm, painless lump on eyelid
Red swollen lump on eyelid
Management:
Apply warm, wet pressure.
c
Do not squeeze or attempt to “pop.” pay pe
+ Presence of blood in theanter Pe
| secon ea aren Of :
chamber that occurs as a result of ¢
injury
eee 1: *
+ Usually resolves in 5 to 7 days.
+ Management:
+ Encourage rest in a semi-Fowler’s
4 — — =
position.
3
Avoid suddenleye movements fol 3 to
5 days to decrease the likelihood of
bleeding. +
stoma
a oo
+ Administer cycloplegic eye drops as
prescribed to relax the kye muscles
and place the eye at rest. yu?
* Instruct the client in the use of eye
shields or eye patches as prescribed y»
* Instruct the client to_restrict reading
and limit watching television.
—— [SSS
* Contus
0
wv
* Bleeding into the soft tissue as a result of
, eS
an injury. »
P a
* Acontusion causes a black eye, ** %
ae LYE.
* The discoloration disa ppears in about(0)
days.
ain, photophobia, edema, and
diplopia may occur.
* Mana gement:
° Place(ed on the eye immediately.
th miimediately.
* Instruct the client to receive
eye examination.4+4-
a thorough * In this malignancy 1
melanocyte. gets
*C/M: de
* Eye pain , Glaucoma Cs
* Decrease visual field. »#
° DE:
* Biopsy — confirmative ay
* USG , CT, MRI
. gl i ee
2. Retinoblastoma: * ¥
* A. Inherited
* B. Sporadic (€ ommon)
* In this type of malign
malignancy forn
*C/M:
* Eye pain Strabismus
* Glaucoma, 'gukocorial white pupil}
eo ee Ocoria
*DE:
* Biopsy ~ sensative 656) (FR)
i fe | ee:
ancy origin of
O_O yy +»
* Che ape , lati
c hemotherapy & fadiation therapy
+Surgical inte i
ou gical intervention:
° Evisceration- re
ball, except ou
* Enucleatio i
N= entire eve h, + OF
Nerve removal] seal —
=
: Exenteratj
yo ation- eve hal!
Neer. Post-enucleation (3 months)
+ After the eye is removed, a ball
_implantis_inserted to provide a
firm(base) for a socket[prosthesis |
and to facilitate the best cosmetic
result.+
+ A prosthesis is fitted about 1
month after surgerye
EE
Pre operative: ~ Jl
Provide emotional support to the client.
Encourage the client to{verbalize|
feelings
Mat
related to loss. ae
>
Encourage family support in@are)
Post operative:
Monitor vital signs:
Check pressure patch or dressing for the
presence of bright red blood or other drainage. oY
Report changes in vitaLsigns or the presence (2) ee er
bright red drainage on the pressure patch or
Foreign bodies:
or dirt that
, An object such as dirt thi
tses irritation.
enters the eye and ca
- Procedure:
¢ Client look u yward-
lid.
|
* Wet a cotton-tipped applicator with
sterile normal saline, gently twist the
swab over the particle, and remove okded
expose the lower ee
* If the particle cannot be seen - then client
look downward. ».y
|
* Place a cotton applicator horizontally on the
outer surface of the upper eye lid.
|
* Grasp the lashes, and pull the upper lid
outward and over the cotton applicator
+ If the particle is seen, gently twist a swab
Over it to remove. ~a-
+ Penetrating objects:
* An eye injury in which an object
penetrates the eye
* Procedure:
* Never remove the obj
be holding ocu
* The object must be removed by the
EeLOVER Dy.
_PHCP. gaa | Do Ay
* Cover the eye with aap paper paper or VA ™
plastic) and tape in place. O
* Also cover the nonaffected eye (to ft
decrease eye movements).
‘© not allow the client to bend over or lie
_flat- these Positions may move the object. xx
ure on the
seen by the PHCP
* Do not place pr
* The client is to be
immediately Clatelyrem | pdcre
$ and CT scans of th orbit
tained
is contr, licated because of
the possi ility ofmetal-containing | metal-
usually
metal-containing]
Projectile movement during the
<—evement |
RR CEIUS. 5.
a > * Chemical burns:
* An eye injury in which a caustic
substance enters the eye aa
CL
¢ Procedure: 4
¢ Eye was i 2diately(flushed
about 15 minutes with
¢ Then immediately come to
immediately come
emergency department. ¥4
* Care during hospital(emergency
department) :
* Quickly assesses the@lient)and
visual acuity. »#
* Checks the pH of the(ey& (Normal
PH is approximately 7.T- 141.5),
* Irrigates the eye continuously, until
> Mle eye conunuously
the pH is at an acceptable levely» > |
* Contacts the ophthalmologist.
ae ©
* Documents the even), actions taken,
‘ i pleat
and the client’s response. a
ee Oe. ae
occurs, treatment snows vee
‘mmediately.
Flush the eyes ith water
15 to 20 minutes at the sce!
for al least
yc of the
injury.
client 1S brought to the
Then the
ent.
gency) departm
emer
. sample of the
If possible, obtain <
chemical invol\ ed.
+ Eve (tissue) donation:
ye ation. _-——
+ Donor eyes-
* Donor eyes are obtained from
cadavers.xa ©
« Donor eyes must be.cnuc eated soon
after eath and stored in a
pres¢ ise of fapid
g soluuon becat
4
| dcatha®
re operative care to the re ipient of the + Donor eye
es are obtained from
* Donor ¢y
cadavers.7 ¥
r sated SOON
ust
j stored in @
cause of
+ Donor eyes
anc —
olution-be
eath #427
fapid
after deat
‘preservil
endothelial ce’
yinc-@
+ Pre operative care to the rec’ ient of 1 ne
cornea
+ Inform the patient ¢
+ Help in reduc
* Ass r
* Antibiotic di r f
mi anism: ¥
* Administer fluids and meds
cribed
Post op
erative car 4
— care to the recipient:
cxed with(patcl) & protective shield
lay «4
ssefOp sate Aid act
itic
¢
ompl
icat
ion: (
