Eye disorder best ppt

1. COLLEGE OF MEDICINE AND HEALTH SCIENCE
DEPARTMENT OF NURSING 3’rd YEAR STUDENT
GROUPASSIGNMENT OF PEDIATRIC NURSING
SUB.TO:Mr.Mohammed.K
SUB.DATE:04/01/2016 EC.

2. PRESENTATION OUTLINE
 Objectives
 Introduction
 Definition of ptosis,types,Clinical manifestation,Diagnostic
process,Treatment and complication of it.
 Definition of orbital cellulities cause, types,Clinical
manifestation,Diagnostic process,Treatment and complication of it.
 Definition of Glaucoma,cause,types,clinical manifestation,diagnostic
process,Treatment and complication of it.

3. OBJECTIVES
 To understand about Eye disorder and its types.
 To understand the cause and clinical manifestation of Eye disorder.
 To understand the diagnostic process,Treatment and complication of Eye
disorder.

4. Eye Disorders
 Glaucoma
Ptosis
 Orbital Cellulites

5. Introduction:
Eye disorders encompass a range of conditions or abnormality that affect
the structures, function, or health of the eye, leading to visual
impairment, discomfort, pain, or abnormalities in the appearance of the
eye.
It can affect different parts of the eye, including the cornea, lens, retina,
optic nerve, eyelids, or surrounding tissues. They can be caused by a
range of factors, including genetic predisposition, trauma, infections,
inflammatory conditions, age-related changes, or systemic diseases
These disorders can vary in severity and may require medical attention
for diagnosis, treatment, and management. In this response, we will focus
on three specific eye disorders: Ptosis, Orbital cellulitis, and Glaucoma.

6. Pytosis
 Ptosis, commonly known as drooping eyelid, refers to the sagging or drooping
of the upper eyelid. It can occur due to issues with the muscles that control
eyelid movement or problems with the nerves involved. It may cause vision
obstruction, eye fatigue, or a decreased field of vision.
 Ptosis can occur in children or adults and can be classified as either congenital
(present at birth) or acquired (developing later in life).

7. Congenital Pytosis
 In congenital ptosis,the muscles responsible for lifting the eyelid are
underdeveloped or have weak function, leading to the eyelid appearing lower than
normal. Congenital ptosis may be caused by genetic factors, muscle or nerve
abnormalities, or problems with the eyelid's supporting structures. It can also
occur as a result of trauma or injury during childbirth.
Acquired pytosis
 Can develop due to various factors, including age-related changes, muscle
weakness, nerve damage, eye trauma, eye surgery, or certain medical conditions
such as myasthenia gravis, Horner syndrome, or tumors. Acquired ptosis can also
be a side effect of medication or from wearing heavy eyeglasses for an extended
period.

8. Common signs and symptoms associated with pytosis include:
 Drooping of the Eyelid: The most noticeable sign is the drooping of the upper
eyelid, which can vary in degree. In severe cases, the eyelid may completely cover
a portion of the eye, obstructing vision.
 Asymmetry: If pytosis affects only one eye, it can result in noticeable asymmetry
between the two eyes in terms of eyelid position and appearance.
 Difficulty Keeping the Eye Open: Individuals with ptosis may find it
challenging to keep the affected eye fully open. There may be a constant effort to
lift or raise the eyelid to maintain proper vision.
 Fatigue or Eye Strain: Constant muscle effort to raise the drooping eyelid can
lead to eye fatigue or strain, particularly when engaged in visually demanding
tasks or activities.

9. Tilting the Head Back: Some individuals with ptosis may tilt their head back or
arch their eyebrows to compensate for the drooping eyelid, attempting to improve
their field of vision.
Vision Obstruction: Depending on the severity of ptosis, the drooping eyelid may
obstruct part or all of the visual field. This can cause reduced or blurred vision,
especially in severe cases.
Excess Eyebrow Elevation: In some cases, ptosis may cause excessive elevation of
the eyebrow on the affected side as the individual attempts to lift the eyelid.

10. Diagnostic process of Ptosis
 Medical History: The ophthalmologist will ask questions about your medical
history, including any known conditions or previous eye surgeries, as well as
any symptoms you are experiencing.
 Visual Acuity Test: A visual acuity test is conducted to evaluate how well you
can see at various distances. This test involves reading letters or viewing
images on an eye chart.
 External Examination: The ophthalmologist will visually inspect the eyes and
surrounding structures, assessing the position, symmetry, and movement of the
eyelids.

11.  Levator Function Evaluation: To assess the muscles responsible for lifting the
eyelid (levator muscles), the ophthalmologist may perform a levator function
evaluation. This test measures the ability to lift the eyelid fully by measuring the
margin reflex distance (MRD), which is the distance between the upper eyelid
margin and the corneal light reflex.
 Visual Field Test: A visual field test may be conducted to evaluate the extent to
which the drooping eyelid is affecting your field of vision. This test helps
determine if ptosis is obstructing any portion of the visual field.
 Evaluation of Underlying Causes: The ophthalmologist may investigate
potential underlying causes of ptosis by assessing muscle function, nerve
function, or any other contributing factors. Additional tests or referrals to
specialists may be recommended based on your individual situation.

12. Eyeglasses: In some cases, specially designed eyeglass frames with an
upper eyelid prop or support mechanism can help raise the drooping
eyelid and improve vision temporarily.
Medications: Medications are not usually the primary treatment for
ptosis. However, in some cases where ptosis is associated with
underlying muscle weakness or certain medical conditions, medications
may be prescribed to manage the underlying cause.
Surgery: Surgical intervention is often recommended for moderate to
severe cases of ptosis, especially when it obstructs vision or significantly
affects daily functioning. Ptosis surgery involves: Levator Resection,
Müller Muscle Resection and Frontalis Sling Surgery.
Treatment of Ptosis
The options for ptosis treatment include;

13.  Levator Resection: This surgical procedure involves shortening the levator muscle to
lift the drooping eyelid.
 Müller Muscle Resection: Müller muscle is an additional muscle responsible for
eyelid elevation. In Müller muscle resection, this muscle is tightened or shortened to
lift the eyelid.
 Frontalis Sling Surgery: In cases of severe ptosis or weak levator muscle function, a
frontalis sling surgery may be performed. This procedure involves using a sling made
of synthetic material or the patient's own tissue to connect the forehead muscles to the
eyelid, allowing the forehead muscles to raise the eyelid.

14. Complications related with Ptosis
 Impaired Vision: Severe ptosis can obstruct the visual field, leading to
reduced or blurred vision. The drooping eyelid may cover part of the
pupil, affecting clarity and the ability to see objects clearly.
 Asthenopia (Eye Strain): Constant effort to raise the drooping eyelid
can cause eye strain and fatigue, particularly when individuals expend
extra muscle effort to compensate for the impaired vision.
 Amblyopia (Lazy Eye): In children, long-term untreated ptosis can
potentially lead to amblyopia, a condition where the brain favors one eye
over the other, resulting in decreased vision in the affected eye.

15.  Eyelid Complications: Ptosis can cause other eyelid-related issues, such as
lagophthalmos (inability to fully close the eyelid), exposure keratitis (corneal
damage due to inadequate eyelid closure), or secondary complications like
eyelid infections or inflammation.
 Functional Limitations: The drooping eyelid may limit activities that require
optimal visual function, such as driving, reading, or performing detailed
tasks.
 Psychological and Social Impact: Ptosis can affect an individual's self-
esteem, body image, and ability to engage in social interactions due to
concerns about appearance or self-consciousness.

16. Orbital cellulitis
 Orbital cellulitis is a serious infection that affects the soft tissues within the
orbit, which is the bony socket containing the eye, muscles, and surrounding
structures. It typically occurs as a result of a bacterial infection that spreads
from nearby structures such as the sinuses, teeth, or skin.
 Orbital cellulitis can occur in both children and adults, but it is more common
in children. It can be a potentially sight-threatening condition and requires
prompt medical attention.

17. Cause of orbital cellulitis
The most common cause of these types of cellulitis
stems from bacterial infection such as:
 Staphylococcus aureus
 Streptococcus pyogenes
 Haemophilus influenzae

18. The two most common ways the infection gets into the eye include:
 Trauma: Direct trauma to the eye can lead to infection from the bacteria.
 Spread from other areas: Most commonly, the infection begins in the
sinuses. The sinuses are cavities, or air-filled pockets, that are near the nasal
passage

19. Common signs and symptoms of orbital cellulitis include:
 Redness and Swelling: The affected eye and the surrounding
tissues appear red, swollen, and inflamed.
 Pain and Tenderness: The area around the eye can be painful,
especially when touch or pressure is applied.
 Proptosis: Proptosis refers to the protrusion or bulging of the
affected eye forward from its normal position due to increased
pressure from the infection.

20.  Eye Movement Impairment: The infection can limit the
movement of the affected eye due to pain or swelling, making it
difficult to move the eye in all directions.
 Fever and Systemic Symptoms: In some cases, systemic
symptoms like fever, fatigue, and general malaise may be present
 Decreased or Blurred Vision: Orbital cellulitis can impact
vision, causing decreased visual acuity or blurry vision.

21. Diagnostic process of Orbital cellulitis
 Medical History: The healthcare professional will inquire about the patient's
medical history, including any recent infections, sinusitis, dental issues, or
history of trauma.
 Physical Examination: A thorough physical examination will be conducted to
assess the signs and symptoms of orbital cellulitis. This includes examining the
affected eye and surrounding tissues for redness, swelling, tenderness, proptosis
(bulging of the eye), and limitations in eye movement.
 Visual Acuity Test: An assessment of visual acuity will be conducted to evaluate
any vision changes or impairment associated with the infection.

22.  Blood Tests: Blood tests, such as a complete blood count (CBC) and
inflammatory marker tests, may be performed to evaluate the severity of the
infection and the systemic response.
 Imaging Studies: Imaging studies, such as a computed tomography (CT)
scan or magnetic resonance imaging (MRI), may be ordered to obtain
detailed images of the orbit, sinuses, and surrounding structures. These tests
can help assess the extent of the infection, detect the presence of an abscess
(collection of pus), and identify any underlying anatomical abnormalities.
 Culture and Sensitivity Testing: In some cases, a sample may be collected
from the affected area, such as by aspirating pus or taking a swab, to analyze
the bacteria causing the infection. This allows for targeted antibiotic
treatment based on the specific microbial sensitivity.

23. Treatment
 Intravenous Antibiotics: The main stay of treatment for orbital cellulitis is the
administration of intravenous (IV) antibiotics to combat the infection
systemically. Broad-spectrum antibiotics are typically initiated initially to cover a
wide range of potential bacterial pathogens. The choice of antibiotics may be
adjusted based on the patient's clinical response, culture results, and specific
bacteria identified.
 You’ll be started on broad-spectrum IV antibiotics immediately, even if your
diagnostic test results haven’t yet confirmed the diagnosis. penicillin,
cephalosporins (e.g., cephalexin), dicloxacillin, or clindamycin
N.B.Broad-spectrum antibiotics are typically given as a first course of treatment
because they’re effective at treating many types of bacterial infections

24.  Pain Management and Symptom Relief: Medications such as analgesics
or appropriate pain medications may be prescribed to alleviate pain and
discomfort associated with orbital cellulitis. Warm compresses or cold
packs may be recommended to help reduce swelling and provide
symptomatic relief.
 Supportive Care and Monitoring: Supportive care includes close
monitoring of the patient's vital signs, regular eye examinations, and visual
acuity assessments. Elevating the head during sleep or rest and promoting
good hydration are important for patient comfort and overall well-being.
 Abscess Drainage or Surgical Intervention: In some cases, if an abscess
(collection of pus) forms within the orbit, surgical drainage may be
necessary. This procedure, performed by an ophthalmic surgeon, involves
making an incision to allow drainage of the accumulated pus, relieve
pressure on the eye, and aid in the resolution of the infection.

25. Complications related with orbital cellulities:
 Vision Loss: The infection and associated inflammation can damage the optic
nerve or obstruct blood flow to the retina, leading to vision impairment or even
permanent vision loss in severe cases.
 Abscess Formation: In some instances, orbital cellulitis may progress to the
formation of an abscess, which is a collection of pus within the orbital tissues.
An abscess requires surgical drainage to alleviate pressure, control the infection,
and prevent the spread of bacteria to other areas.
 Orbital Cellulitis Spread: If the infection is not properly managed, it can potentially
spread to adjacent structures within the orbit, such as the sinuses, eye muscles,
or brain. This can lead to serious complications, including meningitis (infection
of the meninges), cavernous sinus thrombosis (blood clot in the cavernous
sinus), or brain abscess.

26.  Optic Nerve Damage: Orbital cellulitis can cause damage to the optic nerve,
impairing vision and potentially leading to permanent vision loss.
 Functional Impairment: Orbital cellulitis can result in functional
impairments, such as restricted eye movement due to inflammation and
swelling, or eyelid abnormalities that affect blinking or closing the eye
properly.
 Recurrent Infections: In certain cases, orbital cellulitis may recur,
particularly if there is an underlying sinus or dental condition that continues to
contribute to the infection. Ongoing monitoring, infection control, and
appropriate treatment are necessary to prevent recurrent episodes.

27. Glaucoma
Glaucoma The word "glaucoma" originated from the Greek word (glaukos),
which means "to glow.
 It is a group of progressive eye conditions that primarily affect the optic
nerve, which is responsible for transmitting visual information from the
eye to the brain. It is characterized by ongoing damage to the optic nerve,
usually accompanied by elevated intraocular pressure (IOP).
 Glaucoma has been called the "silent thief of sight“especially open angle
glaucoma because the loss of vision usually occurs slowly over a long
period of time.

28. Cause of Glaucoma
 Your eye constantly makes aqueous hemuer As new aqueous flows into
your eye, the same amount should drain out. The fluid drains out through
an area called the dairanage angle. This process keeps pressure in the eye
(called intraocular pressure or IOP) stable. But if the drainage angle is not
working properly, fluid builds up. Pressure inside the eye rises, damaging
the optic nerve.
 As these nerve fibers die, you will develop blind spots in your vision. You
may not notice these blind spots until most of your optic nerve fibers have
died. If all of the fibers die, you will become blind.

29. How Do You Get Glaucoma?
There are Three major types of glaucoma:
1.Open-angle glaucoma
 This is the most common type of glaucoma. It happens gradually, where the
eye does not drain fluid as well as it should (like a clogged drain). As a
result, eye pressure builds and starts to damage the optic nerve. This type of
glaucoma is painless and causes no vision changes at first and characterized
by gradual and progressive damage to the optic nerve.
 Some people can have optic nerves that are sensitive to normal eye
pressure. This means their risk of getting glaucoma is higher than normal.
Regular eye exams are important to find early signs of damage to their optic
nerve.

30.  Congenital (Infantile) Glaucoma: It is uncommon and inherited type of
open-angle glaucoma. It results because of improper development of
drainage area before birth.
 Consequently, the pressure in eye is increased that lead to vision loss
In this condition the increased pressure and optic nerve damage lead to loss
of visions

31. Cilinical manifestation of Open-angle glaucoma
 Gradual Loss of Peripheral Vision: Open-angle glaucoma primarily affects
the peripheral vision (side or peripheral visual field) initially. This means that
individuals may not notice any changes in their central vision, which is
responsible for sharp and detailed vision.
 Tunnel Vision: As the disease progresses, individuals may start to develop
tunnel vision, where their field of vision narrows, resulting in a reduced ability
to see objects in their side or peripheral vision.

32. Difficulty with Low Light/Contrast: Open-angle glaucoma can lead to
difficulty seeing in low-light conditions or distinguishing objects with low
contrast, such as objects against a similar background or faded colors.
 Optic Nerve Damage: Damage to the optic nerve caused by open-angle
glaucoma can result in changes that may be detected during an eye
examination. These changes include a thinning of the nerve fibers, cupping
of the optic disc (the area where the optic nerve enters the eye), and
characteristic changes seen in visual field tests.
NOTE: It's important to note that open-angle glaucoma often progresses
without noticeable symptoms until significant vision loss occurs. Regular
eye examinations, including tonometry (to measure eye pressure), optic
nerve evaluation, and visual field testing, are critical for early detection and
monitoring of open-angle glaucoma

33. 2.Angle-closure glaucoma (also called “closed-angle glaucoma” or
“narrow-angle glaucoma”)
 This type happens when someone’s iris is very close to the drainage angle
in their eye. The iris can end up blocking the drainage angle. You can think
of it like a piece of paper sliding over a sink drain.
 When the drainage angle gets completely blocked, eye pressure rises very
quickly. This is called an acute attack. It is a true eye emergency, and you
should call your ophthalmologist right away or you might go blind.

34. Cilinical manifestation of acute angle-closure glaucoma attack:
 Your vision is suddenly blurry
 You have severe eye pain
 You have a headache
 You feel sick to your stomach (nausea)
 You throw up (vomit)
 You see rainbow-colored rings or halos around lights
 Redness and Tearing
NOTE: Many people with angle-closure glaucoma develop it slowly. This is
called chronic angle-closure glaucoma. There are no symptoms at first, so they
don’t know they have it until the damage is severe or they have an attack.
Angle-closure glaucoma can cause blindness if not treated right away.

35. 3.Normal Tension (Pressure) Glaucoma or Low-Tension
Glaucoma
 It may be caused by decreased flow of blood to the optic nerve fibers of
the eye.
 This situation is specified as the continuous damage to opticnerve and
lack of peripheral vision (visual field)

36. Early diagnostic process of Glaucoma
Regular comprehensive eye examinations including:
 Medical History: The healthcare professional will begin by taking your
medical history, including any previous eye conditions, family history of
glaucoma, and other relevant medical information. This helps in understanding
your risk factors and potential underlying causes.
 Visual Acuity Test: This test measures your ability to see clearly at different
distances using an eye chart. It evaluates your visual acuity and helps identify
any significant vision loss or refractive errors (such as nearsightedness or
farsightedness) that may contribute to your symptoms.

37.  Tonometry: Tonometry is a test used to measure the intraocular pressure
(IOP), which is a key risk factor for glaucoma. It can be done through various
methods, including:
 Goldmann Applanation Tonometry: This is a standard method where a small
instrument gently touches the surface of the eye to measure the eye's resistance
to indentation. It requires the use of numbing eye drops.
 Non-Contact Tonometry: Also known as "air puff" tonometry, this method
measures the eye's resistance by using a quick puff of air. It is a painless and
non-invasive test, but it may provide slightly less accurate IOP measurements
compared to applanation tonometry.

38.  Perimetry (Visual Field Test): This test evaluates your peripheral vision to
detect any compromised areas that may indicate damage to the optic nerve, a key
indicator of glaucoma. It involves staring at a central fixation point and
responding whenever you see a moving object or a light flash in your peripheral
vision.
 Gonioscopy: Gonioscopy is used to examine the drainage angle of the eye. It
involves the use of a specialized lens to visualize the drainage structures at the
front of the eye (the angle between the iris and cornea) to determine if there are
any blockages or abnormalities that may contribute to glaucoma.
 Pachymetry: This test measures the thickness of the cornea. Corneal thickness
can influence intraocular pressure measurements and may be considered when
diagnosing and managing glaucoma.

39.  Optical Coherence Tomography (OCT): OCT is a non-invasive imaging
technique that provides detailed cross-sectional images of the retina, optic
nerve, and other structures within the eye. It helps assess the thickness and
integrity of the retinal nerve fiber layer, which can be affected by glaucoma.
 Optic Nerve Evaluation: A thorough examination of the optic nerve is
essential to assess any signs of damage or changes associated with glaucoma.
An ophthalmoscope or a slit-lamp biomicroscope is typically used to visualize
the optic nerve head and assess its appearance, cup-to-disc ratio, and any signs
of nerve fiber layer loss.

40. Treatment options for glaucoma include:
 Eye Drops: Medications in the form of eye drops are often prescribed to reduce
intraocular pressure by increasing fluid drainage or decreasing fluid production in
the eye. Some are:
 Prostaglandin analogs: These eye drops increase the outflow of fluid from the eye,
thus lowering IOP. Examples include latanoprost, bimatoprost, and travoprost.
 Beta-Blockers: These eye drops reduce the production of fluid in the eye.
Common beta-blockers used for glaucoma treatment include timolol and
betaxolol.

41.  Alpha-Adrenergic Agonists: These eye drops decrease fluid production and
increase drainage. Brimonidine is an example of an alpha-adrenergic agonist.
 Carbonic Anhydrase Inhibitors: These eye drops reduce fluid production in the
eye. Dorzolamide and brinzolamide are examples of carbonic anhydrase
inhibitors.

42.  Laser Therapy: Laser treatment, such as selective laser trabeculoplasty (SLT)
or laser peripheral iridotomy (LPI), can be used to enhance drainage or reduce
fluid production in the eye, helping to lower intraocular pressure.
 Oral Medications: In some cases, oral medications may be prescribed to
manage IOP or improve fluid drainage.
 Surgical Procedures: If eye drops or laser therapy are insufficient to control
intraocular pressure, surgical intervention, such as trabeculectomy, glaucoma
drainage devices, or minimally invasive glaucoma surgery (MIGS), may be
recommended to enhance fluid drainage from the eye.

43. Complications related with Glaucoma
 Vision Loss: The most significant complication of glaucoma is progressive
vision loss, primarily affecting the peripheral visual field initially. Without
appropriate treatment and management, glaucoma can eventually lead to
permanent vision impairment or blindness.
 Optic Nerve Damage: Glaucoma causes damage to the optic nerve, which is
responsible for transmitting visual information to the brain. Ongoing damage to
the optic nerve can result in irreversible vision loss if not effectively treated.
 Blind Spots and Visual Field Defects: As glaucoma progresses, individuals
may experience blind spots or areas of decreased vision in their visual field.
Over time, these blind spots can enlarge and overlap, further impairing visual
function.

44.  Reduced Contrast Sensitivity: Glaucoma can impact the ability to discern
subtle differences in contrast, making it challenging to distinguish objects,
especially in low light conditions or areas with poor contrast.
 Difficulty with Daily Activities: Advanced glaucoma can affect an
individual's ability to perform daily activities requiring good vision, such as
driving, reading, navigating stairs, or recognizing faces.
 Negative Impact on Quality of Life: Glaucoma can significantly impact an
individual's quality of life due to functional limitations, vision-related
concerns, increased dependence on others, and emotional or psychological
effects.

46. REFERENCES
 Chandler, J. R., Langenbrunner, D. J., Stevens, E. R. (1970). The pathogenesis of
orbital complications in acute sinusitis. The Laryngoscope, 80(9), 1414-1428.
 Doan, T., Sabbagh, L., Young, S., & Donaldson, A. (2019). Orbital Cellulitis. In
StatPearls. Treasure Island (FL): StatPearls Publishing. Retrieved from
https://www.ncbi.nlm.nih.gov/books/NBK499959/
 Quigley, H. A. (2011). Glaucoma. The Lancet, 377(9774), 1367-137
 American Academy of Ophthalmology. (2019). Ptosis: Causes, Symptoms,
Diagnosis and Treatment. Retrieved from https://www.aao.org/eye-
health/diseases/drooping-eyelids-ptosis
 https://www.huhs.edu/literature/Eye Disorders.pdf

47. GROUP MEMBERS
NAME ID.NO
1. EDEN MELKE………………………………………...1302592
2. FETENA BELECHEW…………………………….......1302755
3. GETANEH LIKNAW…………………………………. 1200455
4. HASSEN KASIM……………………………………... 1302996
5. BIRUK WOLDE……………………………………….
6. LETA LEMESSA………………………………………1303283