NURS 1660 Lecture 9: Eyes
10 Jun 2018
School
Department
Course
Professor
Week Nine (November 13 - 17, 2017)
11-63-166
Health Assessment
Chapter Fifteen: Eyes Assessment
→ Every twelve minutes, someone in Canada starts losing their eyesight. 75% of vision loss can
be prevented.
Lifespan Considerations
-Pregnancy
- Hormonal fluctuations can cause refractive changes, which are typically minor.
- Dry eyes during pregnancy are usually temporary and resolve after childbirth.
-Infants
- Infants begin making tears at approximately 2 weeks old.
- Lack of tear production is a sign of blockages in the lacrimal apparatus - redness,
dry irritated eyes.
- Believed best acuity is distance from infant to parent’s face when being held.
- 3 months- follow objects, pupils are reactive to light, blink reflex is intact &
corneal reflex easily stimulated.
-Older Adults
- Eyelids may droop become wrinkled from loss of skin elasticity.
- Eyes sit deeper in orbits due to loss in subcutaneous fat.
- Eyebrows become thinner.
- Conjunctiva are thinner & may appear yellowish from decreased perfusion.
- Iris may have irregular pigmentation.
- Tearing decreases.
- Vision may decline, loss of accommodation (presbyopia), decreased night vision,
decreased depth perception.
- Lens enlarges & transparency decreases.
List of Eye Concerns/Cause
find more resources at oneclass.com
find more resources at oneclass.com
Week Nine (November 13 - 17, 2017)
11-63-166
- Macular Degeneration: loss of sharp central vision, needed for common daily
tasks (ie. drinking and reading). >60 years, smoking, obesity.
- Falls: due to visual impairment
- Cataracts: cloudiness of the lens - associated with increased age, smoking,
alcohol intake, and sunlight exposure. Risk factors for cataracts are primarily
environmental.
- Glaucoma: leading cause of irreversible blindness - disease of optic nerve;
impaired flow of aqueous humor leads to changes in central vision; tunnel vision.
- Presbyopia: natural effect of aging in which the availability to focus on close
objects decreases over time. Presbyopia can cause headaches, blurred vision
and the need for more light or sore eyes.
(Macular
Degeneration)
Subjective Assessment
- Upon entering the room always do the following four things:
- Introduce yourself.
- State your designation.
- Perform hand hygiene.
- Close door.
→ Don’t forget to clean materials (any piece of equipment that touches patient ie. tuning
fork)
Subjective Assessment
Every encounter:
-Demographic or Identifying Data
- Name, age, address, phone number, occupation, marital status, number of
children
If you ask the date and time this will be part of general survey (behaviour A & O x
4)
-Chief Concern/Reason for seeking care
find more resources at oneclass.com
find more resources at oneclass.com
Week Nine (November 13 - 17, 2017)
11-63-166
-“Tell me what brings you to the clinic today”
-Past Patient History
- General past health- cancer, blood disorders, arthritis, HTN, diabetes, CAD,
PVD
- Surgeries
- Injuries
-Relevant History to the Presenting Complaint (EYE)
- Long term Hypertension
- Diabetes
- Eye conditions (cataracts, glaucoma)\
- High blood pressure
- Trauma to the yes (occupational hazards)
-Family History
- Ask about illnesses that can be hereditary: Hypertension, diabetes (type II),
coronary artery disease, stroke, cancer, renal, asthma, seizure disorders, mental
illness, addictions.
- Examples:
- Retinitis pigmentosa - A form of retinal dystrophy, RP is caused by
abnormalities of the photoreceptors (rods and cones) or the retinal
pigment epithelium (RPE) of the retina leading to progressive sight
loss. Affected individuals may experience defective light to dark,
dark to light adaptation or nyctalopia (night blindness), as the
result of the degeneration of the peripheral visual field (known as
tunnel vision). Sometimes, central vision is lost first causing the
person to look sidelong at objects.
- Retinoblastoma (Rb) is a rapidly developing cancer that develops
from the immature cells of a retina and is the most common
malignant tumor of the eye in children
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Every twelve minutes, someone in canada starts losing their eyesight. Hormonal fluctuations can cause refractive changes, which are typically minor. Dry eyes during pregnancy are usually temporary and resolve after childbirth. Infants begin making tears at approximately 2 weeks old. Lack of tear production is a sign of blockages in the lacrimal apparatus - redness, dry irritated eyes. Believed best acuity is distance from infant to parent"s face when being held. 3 months- follow objects, pupils are reactive to light, blink reflex is intact & corneal reflex easily stimulated. Eyelids may droop become wrinkled from loss of skin elasticity. Eyes sit deeper in orbits due to loss in subcutaneous fat. Conjunctiva are thinner & may appear yellowish from decreased perfusion. Vision may decline, loss of accommodation (presbyopia), decreased night vision, Macular degeneration: loss of sharp central vision, needed for common daily tasks (ie. drinking and reading).
