COMMON DISORDERS OF THE EYE

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COMMON DISORDERS OF THE EYE

• Presentation by
• Beverley Baily
• Clinical Nurse Specialist
• Central Coast Day Hospital
• 2012

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OBJECTIVES

• AT THE END OF THE SESSION
• PARTICIPANTS WILL BE ABLE TO
• ATTAIN KNOWLEDGE ON THE BASIC ANATOMY OF THE
  EYE
• UNDERSTAND SOME OF THE COMMON DISORDERS OF THE
  EYE

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OBJECTIVES contd

• DEVELOP AN INTEREST IN THE CURRENT TREATMENTS
  AVAILABLE FOR EYE DISORDERS
• ACQUIRE KNOWLEDGE OF SERVICES AVAILABLE FOR THE
  VISUAL IMPAIRED

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ANATOMY OF THE EYE
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ENJOY HEALTHY EYES FOR LIFE

• Eye changes occur as we get older.
• Permanent vision loss need not be a part of
  ageing.
• The majority of eye conditions that affect older
  people are painless and progress slowly over many
  years.
• Most eye conditions affecting older people can be
  treated.

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ENJOY HEALTHY EYES FOR LIFE

• Regular eye checks, early detection and medical
  intervention can help to restore vision or
  prevent further vision loss.
• People aged 35 and over are encouraged to have
  regular eye checks.

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ENJOY HEALTHY EYES FOR LIFE

• Your eyesight is your most valuable sense.
• Protect your eyes.
• If you experience a gradual or sudden loss of
  vision, seek medical advice immediately.

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CATARACT

• DEFINITION
• A cataract is a clouding of the normally clear
  lens inside the eye. When the lens becomes
  cloudy, light rays cannot pass easily through.

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CATARACT

• SYMPTOMS
• Vision becomes blurred, both for near and
  distance objects.
• Sensitivity to glare in bright sunlight.
• Distortion or ghosting of images may also occur.
• Colour vision can be decreased.

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CATARACTS
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CATARACT

• CAUSE
• Age is the most common cause, but cataracts can
  also occur in babies and children.
• They may develop as a result of injury or eye
  disease.
• They may be associated with medical conditions
  such as diabetes.

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CATARACT

• CAUSE
• Both smoking and exposure to sunlight increase
  the risk of cataracts.
• Cataracts are not a growth or film over the eye
  and are not caused as a result of overusing the
  eye or eyestrain.
• You generally cant see your cataract in the
  mirror.

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CATARACT

• TREATMENT
• In the early stages of cataract, glasses or
  contact lenses can help correct minor visual
  problems.
• When vision is seriously impaired, the most
  effective treatment is to surgically remove the
  affected lens and replace it with an artificial
  lens.

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CATARACT

• Most surgery is performed on a day-only basis
  under local anaesthesia, with sedation.
• There are many variations in technique, the most
  common being phacoemulsification surgery.
• The cataract is removed through a very small,
  secure opening about 3mm in length, with
  implantation of an intra-ocular lens specifically
  chosen to match your eye.

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CATARACT

• FOLLOW UP CARE
• Your eye may be covered or protected for one
  night.
• A plastic shield at night may be required for a
  few extra nights depending on the surgeon.
• You will have a follow up appointments for review
  by your surgeon, usually the next day and over
  the following weeks.

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CATARACT

• You will be able to function normally from
  Day 1, but strenuous activities
  must be avoided for some weeks.
• You will have eye drops prescribed to use as
  instructed by your surgeon.
• Your new intra-ocular lens will restore your
  distance vision that you had before the
  cataract developed.

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CATARACT

• Over the post-operative review period glasses
  will be prescribed for your new eye, particularly
  to help with reading vision.

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AGE RELATED MACULAR DEGENERATION

• DEFINITION
• Age Related Macular Degeneration causes loss of
  central, detailed vision. People may notice that
  straight lines appear distorted or wavy or that
  reading becomes increasingly difficult.

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AGE RELATED MACULAR DEGENERATION
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AGE RELATED MACULAR DEGENERATION

• SYMPTOMS
• Straight lines appear wavy or distorted.
• Reading and any activity that requires fine
  vision becomes increasingly difficult.
• Distinguishing faces becomes a problem.
• Dark patches or empty spaces appearing in the
  centre of vision.

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AGE RELATED MACULAR DEGENERATION

• EARLY DETECTION IS IMPORTANT
• In its early stages it may go unnoticed.
• Symptoms should never be dismissed as part of
  just getting older.
• Detecting changes early allows you to take
• steps to slow down the progression.

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AGE RELATED MACULAR DEGENERATION
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AGE RELATED MACULAR DEGENERATION

• TREATMENT
• Dry Macular Degeneration
• There are currently no treatments to reverse the
  macular degeneration. However, supplements, diet
  and lifestyle changes may be effective.

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AGE RELATED MACULAR DEGENERATION

• TREATMENT
• Wet Macular Degeneration.
• There is no cure, however the following methods
  are providing a greater opportunity for many in
  saving sight and keeping as much vision for as
  long as possible.

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AGE RELATED MACULAR DEGENERATION

• TREATMENT
• Anti-Vascular Endothelial Growth Factor (VEGF)
  intravitreal injections eg. Lucentis and
  Avastin.
• Laser photocoagulation.
• Diet, supplements and lifestyle.

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AGE RELATED MACULAR DEGENERATION

• Amsler Grid

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DIABETIC RETINOPATHY

• DEFINITION
• Diabetes causes damage to blood vessels in the
  retina, which may lead to loss of vision.

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DIABETIC RETINOPATHY

• RISK FACTORS
• People who have had diabetes for a long period.
• Diabetics with high blood pressure.
• People with high sugar levels.
• Poorly managed diabetes.
• Diabetics who become pregnant.

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DIABETIC RETINOPATHY

• SYMPTOMS
• Blurred, distorted or patchy vision that cant be
  corrected with glasses.
• Problems with balance, reading, watching
  television and recognizing people.
• Overly sensitive to glare.
• Difficulty seeing at night.

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DIABETIC RETINOPATHY

• TREATMENT
• Annual eye checks to pick up early signs of
  damage.
• Control blood-glucose levels and make sure the
  diet is low in fat.
• Once vision has been affected, seek treatment to
  prevent progression.

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GLAUCOMA

• DEFINITION
• Glaucoma is the name given to a group of eye
  diseases in which the optic nerve at the back of
  the eye is slowly destroyed.
• In most people this damage is due to increased
  pressure inside the eye.

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GLAUCOMA

• Other damage may be caused by poor blood supply
  to the optic nerve, a weakness in the structure
  of the nerve and/or a problem in the health of
  the nerve.

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GLAUCOMA
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GLAUCOMA

• SYMPTOMS
• Chronic glaucoma (primary open-angle)
• Is known as the sneak thief of sight and
  can result in a slow and painless loss
  of vision, with side vision being affected first.

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GLAUCOMA

• Acute glaucoma (angle-closure).
• Rapid increase of pressure inside the eye due
  to a blocked drainage system causing pain,
  nausea, blurred vision and redness of the eye.

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GLAUCOMA

• Measuring intraocular pressure

• Measuring Intraocular Pressure

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GLAUCOMA

• RISK FACTORS
• Family history of glaucoma
• Diabetes
• Migraine
• Short sightedness (myopia)
• Long sightedness (hyperopia)
• Eye injuries

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GLAUCOMA

• RISK FACTORS
• Blood pressure
• Past or present use of cortisone drugs (steroids)

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GLAUCOMA

• TREATMENT
• Regular eye checks from the age of 35
• Medication
• Laser
• Drainage surgery

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RETINAL DETACHMENT

• DEFINITION
• Retinal detachment is a separation of the retina
  from the back of the eye.

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RETINAL DETACHMENT

• RISK FACTORS
• Severe myopia (short sighted).
• Retinal tears.
• Trauma.
• Family history.
• Complications from cataract surgery.

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RETINAL DETACHMENT

• SYMPTOMS
• Decreased vision
• Feeling of looking through a veil or curtain
• Flashes and floaters

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RETINAL DETACHMENT

• TREATMENT
• Photocoagulation (Laser).
• Surgery.
• Vitrectomy.
• Indirect Laser or Cryotherapy.
• Insertion of Gas, Silicone Oil or Heavy Liquids.

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CENTRAL COAST DAY HOSPITAL NURSING AND
ADMINISTRATION
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REFERRAL AGENCIES

• Central Coast Day Hospital www.ccdhospital.com.au
  
• Telephone [phone]
• Sydney Eye Hospital
• Telephone [phone]

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REFERRAL AGENCIES

• Glaucoma Australia
• www.glaucoma.org.au
• Telephone [phone]
• Guide Dogs NSW/ACT
• www.guidedogs.com.au
• Telephone [phone]

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REFERRAL AGENCIES

• Macular Degeneration Foundation
• www.mdfoundation.com.au
• Telephone [phone]
• Vision Australia
• www.visionaustralia.org
• Telephone [phone]

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QUESTIONS
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REFERENCES

• Central Coast Day Hospital
• Diabetes Australia
• Glaucoma Australia
• International Journal of Ophthalmic Practice
• Macular Degeneration Foundation
• Ophthalmic Care Janet Marsden