Astigmatism

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ASTIGMATISM

A common vision condition that causes


blurred vision. Occurs when the cornea is
irregularly shaped or sometimes because of
the curvature of the lens inside the eye.
Pathophysiology
• The front surface of the eye or the lens inside the eyes
has a slightly different surface curvature in one direction
from the other. Instead of being even smooth in all
directions, the surface may have some areas that are
flatter or steeper.
Causes
The eyes has two parts that focus images: cornea and lens. When these parts
aren’t evenly and smoothly curved, it causes light rays to be unevenly focused
which causes a refractive error.

CORNEAL ASTIGMATISM LENTICULAR ASTIGMATISM

The cornea has a distorted shape Lens in distorted


It may occur in combination with other refractive
errors which include:
 Nearsightedness or myopia- the cornea is curved
too much or the eye is longer than normal.
 Farsightedness or hyperopia- this occurs when
the cornea is curved too little or the eye is
shorter than normal
Signs and symptoms

• Blurred or distorted vision


• Difficulty seeingat night
• Eyestrain
• squinting
• Headaches
• Eye irritation
Treatment
Corrective lenses and glasses

• Corrective eyeglasses and lenses prescribed by a doctor are the most


common and least invasive treatments for astigmatism.
Orthokeratology (Ortho-K)

• Orthokeratology is a treatment that uses rigid contact


lenses to temporarily correct irregular curvature of your
cornea. You’ll wear rigid contact lenses for limited
periods of time. You may wear them during sleep and
then remove them during the day. Some people have
clear vision during the day without corrective lenses
when undergoing Ortho=K. The benefits of Ortho-K are
only present when using it. Your vision will return to its
previous state after stopping Ortho-K.
Surgery
• Your doctor may recommend refractive surgery if you have a severe case. This
type of surgery involves using lasers or small knives to reshape the cornea.
This will permanently correct your astigmatism. The three common surgeries
for astigmatism are:
a. laser in keratomileusis (LASIK)- the procedure involves using laser or
surgical blade to create a flap in the cornea. The flap is folded back on the
middle section of the cornea. Pulses from a computer-controlled laser
vaporize a part of the stroma. The flap is then repositioned, adhering on its
own without sutures in a few minutes.
b. photorefractive keratectomy (PRK)-only the epithelium is removed,
the laser sculps the cornea to correct the refractive error.
c. and radial keratotomy (RK)- cutting into the cornea of the eye
Nursing Diagnoses
WITH NURSING INTERVENTIONS
Fear and anxiety related to visual impairment manifested by
blurring of vision

Reduce fear and anxiety- Various physical examination and diagnostic


examination with the patient and explain about the diagnosis and treatment
plan are interventions that can increase patient participation care. In turn, the
patient will feel a sense of control and autonomy. Which can help reduce fear
and anxiety.
Risk for injury related to distorted vision

• Escort the patient around


• Provide adequate lighting for increased visibility
• Eliminates clutter, spills and glare from floor to prevent tripping
• Remove rugs
• Use of vision correcting device
Social isolation related to limited ability to participate in social
activities and diversion activities secondary to impaired vision
manifested by blurred vision and eyestrain

Encourage socialization and coping skills- Anxiety is usually suffered by


patients with eye disorders require the same needs with physical needs.
Dependence on patient’s vision becomes real when someone loses vital senses,
temporarily or permanently. Anxiety, fear, anger, denial, withdrawal can also
occur. The nurse gives the patient the opportunity to express feelings, then can
take steps to learn, cope and adjust.
Knowledge deficit related to visual impairment

• Provide patient education about his condition


including facts, the definition, signs and symptoms,
treatment and management.
Anxiety related to uncertainty of treatment outcome and threat of increased
vision loss as evidenced by patient’s statements expressing anxiety and grief
regarding threat of worsening vision

• Provide factual information concerning diagnosis, treatment, and


prognosis to enable patient to make informed decisions
• Encourage verbalization of feelings, perception, and fears to provide
support and identify coping strategies.
• Assist patient to articulate a realistic description of expected progress
to increase the patient’s coping skills.

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