learning Objectives - Describe the disorder and diseases of eye Demonstrate skill in giving care for patients with various eye diseases and disorders.
Hours - 10
Teaching and Learning Activities - Lecture cum discussion Visit school for the blind Visit to eye bank Visit National Association for the blind Eye bank Demonstration
Assessment Methods - Short answer Objective type Essay Return demonstration
Content of the chapter
a) Review of anatomy and physiology of eye
b) Assessment of function of eyes.
– History
– Physical exam
– Diagnostic tests-tonometry, Snellen’s chart
c) Infections and Inflammations conditions
– Blepharitis
– Stye
– Chalazion
– Entropion
– Ectopion
– Dacrocystitis
– Conjunctivitis
– Trachoma
– Pterydium
– Keratitis
– Corneal ulcer
d) Degenerative Conditions
– Cataract
– Retinopathy
– Retinal detachment
e) Miscellaneous
– Strabismus
– Refractive errors
– Tumors
– Color blindness
– Nigh Blindness
– Total blindness
f) Preventive and Rehabilitative aspects
g) National programs on Blindness and trachoma
h) Current trends in Management of Ophthalmic
conditions
– Hospital corneal retrieval
– Grief counseling.
– Eye Collection
– Counselling
– Obtaining consent for eye donation
i) Eye banking in India
j) Ocular Emergencies
– Glaucoma
– Foreign body
– Acid / Alkali burns
– Trauma to the eye
k) Eye Immigration
l) Instillation of eye drops and ointment
m) Cold and hot compress
n) Eye dressing and bandage
o) Assisting for sac syringing
p) Assisting for removal of foreign body
q) Alternate therapies
r) Drugs used in treatment of eye disorders
Ophthalmology and Ophthalmic Nursing
Ophthalmic nursing focuses on promotion of eye health, prevention of blindness, early detection of eye diseases, care during medical and surgical interventions, and rehabilitation.
a) Review of Anatomy and Physiology of Eye
- Anatomy:
- External structures: eyelids, eyelashes, conjunctiva, lacrimal apparatus
- Internal structures: cornea, anterior chamber, iris, lens, vitreous body, retina, optic nerve
- Physiology:
- Vision: light enters through cornea → pupil → lens focuses on retina → optic nerve → brain
- Protective mechanisms: blinking, tear secretion, eyelid closure
- Accommodation: lens changes shape to focus on near/far objects
- Intraocular pressure regulation: aqueous humor production and drainage
b) Assessment of Eye Function
1. History
- Visual complaints: blurring, diplopia, decreased vision, halos
- Pain, discharge, redness, photophobia
- History of trauma or eye surgery
- Past systemic conditions: diabetes, hypertension
- Family history of eye disease
- Occupational hazards and UV exposure
2. Physical Examination
- Inspection: eyelids, conjunctiva, cornea, sclera, pupil size and reaction, ocular movements
- Palpation: orbital bones, lacrimal gland
- Functional tests: visual acuity, color vision, peripheral vision
3. Diagnostic Tests
- Tonometry: measures intraocular pressure (glaucoma detection)
- Snellen’s chart: measures visual acuity
- Ophthalmoscopy: evaluates retina, optic disc, and blood vessels
- Slit-lamp examination: assesses cornea, anterior chamber, lens
c) Infections and Inflammatory Conditions
1. Eyelid Disorders
- Blepharitis: inflammation of eyelid margins; care: hygiene, warm compress, topical antibiotics
- Stye (Hordeolum): localized infection of eyelash follicle; care: warm compress, antibiotic ointment
- Chalazion: chronic granulomatous inflammation; care: warm compress, surgical excision if needed
- Entropion: inward turning of eyelid; care: lubrication, surgical correction
- Ectropion: outward turning of eyelid; care: lubrication, surgical repair
2. Lacrimal Apparatus
- Dacrocystitis: infection of lacrimal sac; care: antibiotics, warm compress, possible surgery
3. Conjunctival Disorders
- Conjunctivitis: inflammation of conjunctiva; viral, bacterial, or allergic; care: hygiene, antibiotics, avoid eye rubbing
- Trachoma: chronic infectious disease; care: antibiotics, hygiene, lid surgery if needed
- Pterygium: fibrovascular growth; care: surgical excision if vision affected
4. Corneal Disorders
- Keratitis: inflammation; care: topical antibiotics, antivirals, lubricants
- Corneal ulcer: open sore on cornea; care: topical antibiotics, antifungals, prevent secondary infection
d) Degenerative Conditions
1. Cataract
- Lens opacity causing blurred vision; care: pre/postoperative nursing, patient education, eye protection
2. Retinopathy
- Diabetic or hypertensive changes; care: regular screening, control of systemic disease, laser therapy
3. Retinal Detachment
- Separation of retina from choroid; symptoms: flashes, floaters, visual curtain; care: surgical intervention, bed rest, eye protection
e) Miscellaneous Eye Disorders
- Strabismus: misalignment of eyes; care: patching, corrective lenses, surgery
- Refractive errors: myopia, hyperopia, astigmatism; care: corrective lenses, surgery
- Tumors: ocular melanoma, retinoblastoma; care: surgical removal, chemotherapy
- Color blindness: hereditary; care: counseling
- Night blindness: vitamin A deficiency; care: supplementation
- Total blindness: care: orientation, mobility training, rehabilitation
f) Preventive and Rehabilitative Aspects
- Routine eye exams
- Protective eyewear
- Nutrition and lifestyle counseling
- Vision rehabilitation: mobility training, assistive devices
g) National Programs
- National Program for Control of Blindness (NPCB): free cataract surgeries, awareness programs
- Trachoma elimination programs
- Community screening and health education
h) Current Trends in Ophthalmic Care
- Hospital-based corneal retrieval and eye banking
- Grief counseling for donors’ families
- Patient counseling for donation and post-surgery care
- Use of advanced diagnostics and microsurgeries
i) Eye Banking in India
- Collection, storage, and transplantation of corneas
- Nurses play key role in counseling, consent, transport, and post-operative care
j) Ocular Emergencies
- Acute glaucoma: pain, vision loss; care: medications to reduce IOP, emergency surgery
- Foreign body: removal under aseptic precautions
- Chemical burns (acid/alkali): immediate irrigation, emergency care
- Trauma: control bleeding, prevent infection, refer for surgical care
k) Eye Examination Procedures
- Instillation of eye drops/ointment: maintain asepsis, educate patient
- Cold and hot compress: reduce inflammation and edema
- Eye dressing and bandage: protect post-operative or injured eye
- Sac syringing: assess lacrimal duct patency
- Removal of foreign body: aseptic technique, patient cooperation
l) Alternate Therapies
- Eye exercises for minor strain
- Herbal compresses (under supervision)
- Acupuncture in some ocular conditions
m) Drugs Used in Ophthalmology
- Antibiotics: to treat bacterial infections (e.g., gentamicin, ciprofloxacin)
- Antivirals: acyclovir for herpes infections
- Anti-inflammatories: corticosteroid drops (prednisolone), NSAID drops
- Mydriatics & cycloplegics: atropine, homatropine for examination and treatment
- Antiglaucoma drugs: timolol, pilocarpine, prostaglandin analogs
- Lubricants: artificial tears for dry eyes
Conclusion
Ophthalmic nursing integrates assessment, prevention, treatment, emergency care, rehabilitation, and education. Nurses play a crucial role in early detection, assisting in surgeries, medication administration, eye banking, patient counselings, and preventive ophthalmology programs, ensuring preservation and improvement of vision and quality of life.