Impaired Vision and

Blindness
Original OR Group

Refractive Errors
Bararodin, Monique
Cagigas, Nessa
Soto, Denise

-vision problems that

happen when the shape
of the eye keeps you
from focusing well

Four Common Refractive

Errors:

Myopia
Presbyopia

Hyperopi
a

Astigmatism

Causes:
Myopia: inherited; discovered in
childhood and progresses; causes light
rays to focus at a point in front of the
retina, rather than directly in its surface.

Hyperopia:

distance between
the cornea and retina is not great enough.

Causes: (cont.)
Presbyopia: eye loses its
focusing ability and becomes difficult to read
at those range after the age of 40.

Astigmatism:

cornea has an
assymetric curvature and the surface of the
cornea is curved more in one direction than
the other.

Risk Factors:
Myopia & Hyperopia:
- stress is the eye strain from doing
detailed work

Astigmatism:
-usually inherited
-can be associated with diseases such as
keratoconus

Risk Factors: (cont.)

Presbyopia:
- Age (40 and above)
- Anemia
- Cardiovascular disease
- Diabetes
- Eye trauma or disease

Signs & Symptoms:

Myopia
difficulty reading road
signs
seeing distant objects
clearly
squinting
eye strain
Feeling fatigued when
driving or playing
sports

Hyperopia
blurred vision
eye strain
difficulty concentrating
or focusing on nearby
objects
fatigue or headache
after performing close
tasks such as reading

Signs & Symptoms:

Presbyopia

Astigmatism

Eyestrain, fatigue, or
distortion or blurring of
headache from doing
images at all distances
close works
headaches and fatigue
difficulty reading small
squinting and eye
print
discomfort or irritation
need for brighter
lighting when reading
need to hold material at
an arm's distance
squinting

Medical Managment:
Lenses
hyperopia, myopia and presbyopia.
Convex lenses are prescribed for patients
with hyperopia.
Corrective lenses for astigmatism and
presbyopia

Glasses

corrects myopia, presbyopia, astigmatism and

hyperopia

Medical Managment:
(cont.)
Orthokeratology
one wears special rigid gas permeable (rgp)
contact lenses at night that reshape your
cornea while you sleep.
cornea temporarily retains the new shape so
one can clearly see during the day without
glasses or lenses.

Surgical Managment:
Photorefractive Keratectomy
refractive surgery to correct myopia,
hyperopia, and astigmatism

Laser-Assisted in Situ Keratomile

(LASIK)
most common refractive procedure

Surgical Managment:
(cont.)
Phakic Intraocular lenses
for myopia
are alternative to PRK and LASIK

Low Vision
and Blindness
Ebajay, Coleen
Liboon, John Michael
Ubay-ubay, Charmaine

Blindness
Visual Impairment
vision impairment or
complete or nearly
vision loss
complete vision
decreased ability to see
loss
to a degree that causes
problems not fixable
by usual means
a best corrected visual
acuity of worse than
either 20/40 or 20/60

Classifications:
20/30 to 20/60: mild vision loss, or
near-normal vision
20/70 to 20/160: moderate visual
impairment, or moderate low vision
20/200 to 20/400: severe visual
impairment, or severe low vision

Classifications:

(cont.)

20/500 to 20/1,000: profound

visual impairment, or profound low
vision
More than 20/1,000: near-total
visual impairment, or near total blindness
No light perception: total visual
impairment, or total blindness

Causes:
Glaucoma

Cataract

Macular
Degeneration
Childhood Diabetic
Blindness retinopathy

Risk Factors:
People age over 50
Children age below 15
Lifestyle (Alcoholic, Smoker, Diabetic)
Exposed to teratogenic agents during
pregnancy
Bacterial and Viral Infection (Neisseria
gonorrhea)
Ocular trauma
Malignancies of the eye
Nutritional deficiency (Vit. A def.)
Vascular disease (stroke, ocular inflammation)

Signs & Symptoms:

Severe, sudden
eye pain

Hazy, blurred
Double vision

Seeing rainbows
Swollen, Red
or halos
around lights
Eyes

Assessment & Diagnostic

Testing

Refraction
Visual Field
Contrast Sensitivity
Glare Testing

Treatments & Drugs:

Optical
Devices

Environmental
Modifications

Techniques
Adaptive nonOptical
devices

Glaucoma
Almonte, Cleo
Regis, Pamela

 used to refer to a group of

ocular conditions characterized
by optic nerve damage
optic nerve damages is related
to the intraocular pressure
caused by the congestion of the
aqueous humor in the eye.

Classifications:
Open Angle

Usually bilateral but on eye

may be more severely
affected than the other;
anterior chamber angle is
open and appears normal.
3 types:
PRIMARY OPEN ANGLE
GLAUCOMA (POAG)
NORMAL TENSION
GLAUCOMA
OCULAR HYPERTENSION

Angle Closure
Obstruction in the aqueous
humor outflow due to the
complete or partial closure
of the angle from the
forward shift of the
peripheral iris to the
trabecular.

3 types:
ACUTE ANGLE CLOSURE
GLAUCOMA (AACG)
SUBACUTE ANGLE CLOSURE
GLAUCOMA
CHRONIC ANGLE CLOSURE
GLAUCOMA

Signs & Symptoms:

Headache

Hazy, blurred
Double vision

Loss of
peripheral
vision

Seeing rainbows
or halos
around lights

Assessment & Diagnostic

Testing
Ocular and Medical History Taking

- useful in identifying the predisposing factors

Tonometry

- essential in measuring the intraocular pressure

(Normal IOP: 11-21 mm Hg)

Opthalmoscopy

- used to inspect the optic nerves.

Central Visual Field Testing

- used to detect blind spots (scotomas), which

could be a sign of eye diseases.

Treatments & Drugs:

Eye Drops

Prostaglandins.
Beta blockers.
Alpha-adrenergic agonists.
Carbonic anhydrase inhibitors.
Miotic or cholinergic agents.

Oral Medications
Carbonic anhydrase inhibitors.

Surgical Managment:
Laser Therapy

Laser trabeculoplasty
an option for people with open-angle glaucoma.

Filtering Surgery
Draining Tubes
Electrocautery

minimally invasive procedure to remove

tissue from the trabecular meshwork
using a Trabecutome

Lifestyle & Home

Remedies:

Eat a Healthy Diet

Exercise Safely
Limit Your Caffeine
Sip Fluids Frequently
Sleep with your head
Elevated
Take Medications Prescribed

Cataract
Apa-ap, CK
Luton, Quennie
Silvano, Yobrem

 lens opacity or cloudiness.

Cataracts is a leading cause of
blindness in the world (Prevent
Blindness America, 2012).

Types:

posterior subcapsular
cataract
occur in front of the posterior capsule
at risk: People with diabetes or those taking high
doses of steroid medications

nuclear cataract
forms deep in the central zone (nucleus) of the
lens
tends to have a substantial genetic component that
causes a central opacity in the lens

Types: (cont.)
cortical cataract
involves the anterior, posterior, or equatorial cortex
of the lens.
Vision is worse in a very bright light.

Causes:
Age-related cataracts can affect your
vision in twoways:
Clumps of protein reduce the sharpness of the
image reaching the retina.
The clear lens slowly changes to a
yellowish/brownish color, adding a brownish tint to
vision.

Causes: (cont.)
Congenital
cataract

Radiation
cataract

Secondary Traumatic
cataract
cataract

Risk Factors:
Aging
Associated Ocular Conditions
Toxic factors
Nutritional factors
Physical factors
Systemic diseases and
syndromes

Signs & Symptoms:

Cloudy,
Blurry Vision

Multiple or
Double vision

Color Seems
Faded
Poor night
vision

halos
around lights

Diagnostic Testing
Degree of visual acuity is directly
proportional to density of the cataract
Snellen visual acuity test
Ophthalmoscopy
Slitlamp biomicroscopic examination

Medical Management:
No nonsurgical (medications, eye
drops, eyeglasses) treatment cures
cataracts or prevents age-related
cataracts.

Surgical Management:
Phacoemulsification
- Also called small incision
cataract surgery.

Extracapsular Surgery
- a longer incision on the side of the
cornea and removes the cloudy core of
the lens in one piece

NSG Dx & Managements:

Disturbed Sensory Perception

Orient patient to environment.

Recommend use of visual aids when appropriate.
Encourage use of sense of touch.

Risk for Injury r/t Visual

Impairment
Remove environmental barriers to ensure safety.
Guide patient when ambulating, if appropriate
Instruct patient to touch and feel for the seat of
chairs without arms.

NSG Dx & Managements:

(cont.)
Deficient Knowledge r/t the
proper management of the
disease
Involve caregiver in patients care and instructions.
Demonstrate the proper administration of eye
drops or ointments
Help family or caregiver identify and make
arrangements at home.