This book provides nurses with the ability to acquire knowledge and to use it to enhance their power to care for patients with eye problems. It looks at the nature of the patients seen in ophthalmic or in primary care settings and explores the role of the nurse caring for the ophthalmic patient.

Ophthalmic Nursing provides an overview for those just setting out in a role within ophthalmic nursing. It includes basic and comprehensible anatomy and physiology – the foundations for understanding how the eye functions and why and how problems occur – and relates them to the care and needs of the patient.

This accessible text includes evidence-based procedure guidelines and the inclusion of reflective activities in most chapters allows readers to apply their knowledge to the realities of the care setting. Also covered are the most recent National Institute for Health and Care Excellence (NICE) guidelines for glaucoma and age-related macular degeneration.

Since the publication of the fourth edition, there have been many advances in the care and management of the ophthalmic patient. The authors have updated the chapters accordingly and included new colour images and diagrams. References, further reading and websites have also been updated to reflect current trends. A valuable resource for nurses in practice and training, this book continues to be the ‘go-to’ source for those caring for the ophthalmic patient.

Table of Contents

The Ophthalmic Patient

Introduction

Registration for the Sight-Impaired or Severely Sight-Impaired

Severely Sight Impaired

Sight Impaired

Assistance and Rehabilitation

Voluntary Organisations

The Ophthalmic Nurse

Introduction

Assessment of Patients

Patient Information and Teaching

Professional Issues

The Nurse in the Outpatient Department

The Nurse in the Accident and Emergency Department

The Day Case and Ward Nurse

The Nurse in the Theatre

Ophthalmic Nursing Procedures and Investigations

General Principles

Recording Visual Acuity

General Considerations When Performing Visual Acuity

Ophthalmic Procedures Utilising Antt Principles

Principles and Protocol for Ophthalmic Medication Instillation/Application

Clinical Practice Guidelines

Ocular History Taking and Slit-Lamp Examination

Ocular History Taking

Slit-Lamp Examination

Goldmann Applanation Tonometry

Examining the Eye

Removing a Conjunctival or Corneal Foreign Body

Removing a Corneal Rust Ring

Testing for Tear Film Break-Up Rime: Assessing the Quality of Tears

Irrigating the Eye

The Globe: A Brief Overview

Introduction

Nerve Supply to the Eye

Blood Supply to the Eye

The Protective Structures, Including Removal of an Eye

The Orbit

The Eyelids

Conditions of the Orbit

Removal of an Eye

Patient’s Needs

The Lacrimal System and Tear Film

Introduction

Lacrimal Gland

Lacrimal Drainage System

Tear Film

Conditions of the Lacrimal System

The Conjunctiva and Sclera

The Conjunctiva

Conditions of the Conjunctiva

The Sclera

Conditions Affecting the Sclera

The Cornea

Introduction

Measurements

Five Layers of the Cornea

Function of the Cornea

Physiology of Corneal Symptoms

Conditions of the Cornea

Eye Donors

Human Amniotic Membrane Transplantation

Osteo-Odonto-Keraprosthesis Surgery

Corneal Topography

Astigmatic Keratotomy

Pachymetry and Specular Photomicroscopy

Management of Corneal Pain

The Uveal Tract

Introduction

The Choroid

The Ciliary Body

The Iris

Conditions of the Uveal Tract

Glaucoma

Introduction

Methods of Measuring Intraocular Pressure

Anatomy and Physiology

Related Disorders – Glaucoma

The Crystalline Lens

Introduction

Cataract

Complications of Cataract Extraction

Cataract Operations

Aphakia

Dislocated Lens

The Retina, Optic Nerve and Vitreous Humour

The Retina

Optic Nerve

The Vitreous Humour

Colour Vision

Rhodopsin

Conditions of the Retina

Retinal Haemorrhage

Retinopathies

Retinal Tumour: Retinoblastoma

Cytomegalovirus Retinitis

Toxoplasmosis

Toxocariasis

Conditions of the Macula

Central Serous Retinopathy

Cystoid Macular Oedema/Degeneration

Conditions of the Optic Nerve

Retrobulbar Neuritis

Optic Nerve Atrophy

Conditions of the Vitreous Humour

Posterior Vitreous Detachment

The Extraocular Muscles

Introduction

Eye Movements

Strabismus or Squint

Paralytic Squint

Ophthalmic Trauma

Introduction

Ocular Manifestations of Systemic Disease

Diabetes Mellitus

Acquired Immune Deficiency Syndrome

Thyroid Disease

Hypertension

Giant Cell Arteritis

Herpes Simplex Virus

Herpes Zoster Virus

Tuberculosis

Sarcoid

Behçet’s Disease

Syphilis

Toxoplasmosis

Toxocara

Rheumatoid Arthritis

Still’s Disease

Ankylosing Spondylitis

Ulcerative Colitis and Crohn’s Disease

Neurofibromatosis

Migraine

Ophthalmic Drugs

Mydriatics

Notes on Mydriatics

Miotics

Drugs of Choice Used in the Treatment of Glaucoma

Antibiotics

Antiviral Agents

Corticosteroids

Local Anaesthetics

Diagnostic Drops

Tear Replacement

Miscellaneous

General Note

Appendix 1: Correction of Refractive Errors

Appendix 2: Contact Lenses

Appendix 3: Competency Assessment Tools

Appendix 4: Competency Frameworks