Chapter 22: Visual and Auditory Problems
PROBLEMS OF THE EYE
Refractive errors are the most common visual problems. They occur when light rays do
not converge into a single focus on the retina.
Myopia, or nearsightedness, is the most prevalent refractive error.
Hyperopia refers to farsightedness.
Presbyopia is farsightedness due to decreased accommodative ability of the aging eye.
Most refractive errors are corrected by lenses (eyeglasses or contact lenses), refractive
surgery, or surgical implantation of an artificial lens.
A hordeolum (sty) is an infection of sebaceous glands in the lid margin.
A chalazion is a chronic inflammatory granuloma of meibomian (sebaceous) glands in
Blepharitis is a common chronic bilateral inflammation of the lid margins.
Conjunctivitis is infection or inflammation of the conjunctiva.
o Acute bacterial conjunctivitis (pinkeye) is common.
o It occurs initially in one eye and can spread rapidly to the unaffected eye.
o It is usually self-limiting, but antibiotic drops shorten the course of the disorder.
Trachoma is a chronic conjunctivitis caused by Chlamydia trachomatis.
o It is a global cause of blindness.
o It is preventable and transmitted mainly by hands and flies.
Keratitis is corneal inflammation or infection.
o The cornea can become infected by bacteria, viruses, or fungi.
o Topical antibiotics are generally effective, but eradicating infection may require
antibiotics administered by subconjunctival injection or IV.
o Other causes are chemical damage, contact lens wear, and contaminated products
(e.g., lens care solutions, cosmetics).
o Tissue loss due to infection produces corneal ulcers. o Treatment is aggressive to avoid permanent loss of vision. An untreated ulcer can
result in corneal scarring and perforation.
A cataract is an opacity within the lens.
Symptoms of cataracts are decreased vision, abnormal color perception, and glare.
Removal of the cataract is the most common surgery for older adults. Most patients
undergoing cataract removal have an intraocular lens implanted during surgery.
After cataract surgery, the eyes are temporarily covered with a patch and protective
Postoperative nursing goals include teaching about eye care, activity restrictions,
medications, follow-up visit schedule, and signs/symptoms of possible complications.
Healing is complete around 6 to 8 weeks postoperatively.
Retinopathy is microvascular damage to the retina that can lead to blurred and
progressive vision loss.
It is often associated with diabetes mellitus and hypertension.
Nonproliferative diabetic retinopathy is characterized by capillary microaneuryms, retinal
swelling, and hard exudates.
o Macular edema represents a worsening as plasma leaks from macular blood
o It may be treated with laser photocoagulation.