Reliance NURSING INTITUTE

TOPIC; REFFRACTIVE ERRORS

PRESENTED BY;
OM VERMA
 INTRODUCTION

 Refractive error means that the shape of eye does

not bend light correctly resulting in a blurred
image . The main types of refractive errors are
1.myopia ( near sightedness )
2. hyperopia (hypermetropia )( far sightedness )
( long sightedness )
3.presbyopia ( loss of near vision with age )
4. Astigmatisms ( both) ( near sightedness ) ( long
sightedness )
 DEFINITION

Refractive error also known as refraction error is

problem with focusing of light on the retina .

Refractive error means that the shape of the eye

does not bend light proper and correct resulting
in a blurred image .
 TYPES

 Myopia - near-sightedness also known as

short – sightedness and myopia is a condition
of the eye where light focuses in front of the
retina instead of on the retina this causes
distant objects to be blurred while close
objects appear normal.
 Hyperopia

 Far-sightedness also known as long

sightedness ….
 Hyperopia is a condition of the eye in which
light is focused behind the retina , instead of
on the retina . Resulting in an inability to seen
near objects clear . Causes abnormal shape of
cornea
 presbyopia

 Presbyopia is a common type of vision

disorder that occurs as you age . It is often
referred to as the aging eye condition . Result
in the inability to focus up close , a problem
associated with refraction in the eye ..
 ASTIGMATISM

 Iis a condition in which an abnormal

curvature of the cornea .
 Astigmatisms may cause eye strain and
may be combined with nearsightedness or
long-sightedness .
etiology
 Infection adenovirus
 Injury due to optic nerve damage
 Ultraviolet radiation
 eye disease
 Inherited
 Aging ( above 45year )
 Environmental factors
 Previous corneal injury
 Previous eye surgery
 Optic nerve hypoplasia
 symptoms

1. Double vision
2. Haziness ( unclearness )
3. Glare or halos around bright light
4. Squinting ( it is a condition where the eyes
do not look in the same direction )
5. Headaches
6. Eye strain fatigue pain in or around the eyes
blurred vision ,headache, occasional double
vision.
7. Eye irritation
 PATHOPHYSIOILOGY
Y
due to etiology factors such as infection

degenerative changes causes by gradual loss

of elasticity of lens

which leads to decreased ability to

accommodate

then lead to refractive errors

 DIAGNOSTIC

 1. HISTORY TAKING
 2. CORNEAL TOPOGRAPHY
 This computerized test maps the curve of
your eye cornea , it can show problem with eye
surface like swelling or scarring .

 3. SLIT LAMP EXAM – the doctor uses this

microscope to shine a beam of light shaped
like a small slit on effected eye .he may dilated
pupils during the test it help diagnose .
 TONOMETRY
 Test measures the pressure inside eye
.which is called intra ocular pressure
 RETINOSCOPY
 IS a technique obtain an objective
measurement of the refractive error of a
patients eye .
 MEDICAL MANAGEMENT
 Identify the cause & eliminate the cause
 Lens correction – a concave lens is used
to correct the problem
 Prevention foreign particles enter in eye
 Use of sunglasses
 Use of antibiotics prevention from
infection
 Pharmacological
management

 Cycloplegic drugs are used to refraction ( to paralyze the

ciliary muscle in order to determine the true refractive error of
eye )
 Cholinergics (Miotics): Pilocarpine, Carbachol
- It increases aqueous fluid outflow by contracting the ciliary
muscles
 Beta blockers : Betaxolol, Timolol
 Decreases aqueous humor production.



 SURGICAL

 KERATOMILEUSIS
 IS AMETHOD OF RESHAPING THE
CORNEA SURFACE TO CHANGE ITS
OPTICAL POWER.
 Surgical management

 LASIK- laser eye surgery

 ( laser assisted in situ kereto-mileusis )
 This procedure used to treat nearsightedness
,farsightedness
 A laser is used to reshape the cornea – the
clear ,round dome at the front of the eye ..
 To improve the way the eye focuses light
rays onto the retina at the back of the eye.
 AUTOMATIC LAME -LLAR
KERATOPLASTY (ALK)

 Keratoplasty is the procedure where by

abnormal corneal tissue is replaced by a
healthy donor cornea.

 Is a older type of vision surgery carried out

by making a flap in the cornea to help
correct severe short sightedness and long-
sightedness.
 LASEK

LASSER ASSISTED SUB EPITHELIAL

KERATOMILEUSIS
The hinged flap made in lasser assisted
epithelial keretomileusis surgery is created
in the epithelial layer of eye .
Inserted of creating a thicker corneal flap as
in lasser assisted epithelial keretomileusis
surgery
PHOTO REFRACTIVE KERETOTOMY (PRK)

To correct myopia
The eye surgeon then gently removing the
surface corneal cells ( epithelium )
 NURSING MANAGEMENT

 Safe administration of the prescribed fluid

 Right documentation
 Monitor the hemodynamic pressure, vital
sign, arterial blood gas
 NURSING MANAGEMENT

Assess the patient for any previous allergy

to medicine, fruits etc
When we administer any new medicine we
have to observe the side effect of it
We must have the knowledge about the
sign symptoms of shock
Observe the response to the treatment
THANK