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Mr. Manikandan.T,
RN., RM., M.Sc(N)., D.C.A .,(Ph.D)
Assistant Professor,
Dept. of Medical Surgical Nursing,
VMCON, Puducherry.
• In refractive errors, vision is impaired because
a shortened or elongated eyeball prevents
light rays from focusing sharply on the retina.
• Shape of the eye does not bend correctly,
resulting in blurred image.
• Myopia : Nearsightedness (parallel rays of light
coming from infinity are focused in front of
retina)
• Hyperopia : Farsightedness(parallel rays of light
coming from infinity are focused behind retina)
• Presbyopia: loss of near vision with age
• Astigmatism: front surface of the eye or the lens
inside the eye is curved differently in one
direction than the other.(near and long
sightedness)
• Infection – adeno virus
• Injury – optic nerve damage
• U-V Radiation
• Eye diseases
• Inherited
• Aging
• Environmental factors
• Previous corneal injury
• Previous eye surgery
• DM
• Double vision
• Haziness(unclearness)
• Glare (halos around bright light) bright circles
that surround a light source, like headlights
• Squinting (eyes do not look in same direction)
• Headache
• Eye strain – blurred vision, haeadche
• Eye irritation
DIAGNOSIS
• H.C
• P/E
• Corneal topogarphy: computerised test maps
the curve of cornea
• Slit lamp exam – dilated pupil
• Tonometry: IOP
• Ophthalmoscope : to view retina
• Retinoscopy: identify fall of rays on retina
• Use sunglasses
• Prevent foreign bodies
• Antibiotics
• Cycloplegic drugs to paralize ciliary muscles
• Cholinergic(miotics): pilocarpine, carbachol –
increases aqueous fluid outflow by contracting
ciliary muscles
• Beta blockers : betaxolol, timolol – decreases
aqueous fluid production
Lens correction
• Photo Refractive Keratotomy (PRK): A layer of cornea tissue is
removed with laser, which flattens cornea and allows light
rays to focus on retina
• Ortho keratology (Keratomileusis): special contact lenses must
be worn that slowly reshapes the cornea to correct myopia
Cont.,
• LASIK(Laser Assisted In situ Kerato-mileusis): this procedure
used to treat near and farsightedness. A laser is used to
reshape the cornea by making a flap in surface of cornea or
removing upper layer of cornea.
• Automatic Lame – LLAR keratoplasty (ALK): abnormal corneal
tissue is replaced by health donor
Cont.,
• Laser Assisted Sub Epithelial Keratomileusis(LASEK): A laser is
used to remove the epithelial layer of eye.
• Refractive IOL : implantation of small plastic lens after removal
of natural lens to correct myopia & Presbyopia
• Phakic IOL: implant the lens over natural lens to correct myopia
& hyperopia

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Refractory errors

  • 1. Mr. Manikandan.T, RN., RM., M.Sc(N)., D.C.A .,(Ph.D) Assistant Professor, Dept. of Medical Surgical Nursing, VMCON, Puducherry.
  • 2. • In refractive errors, vision is impaired because a shortened or elongated eyeball prevents light rays from focusing sharply on the retina. • Shape of the eye does not bend correctly, resulting in blurred image.
  • 3. • Myopia : Nearsightedness (parallel rays of light coming from infinity are focused in front of retina) • Hyperopia : Farsightedness(parallel rays of light coming from infinity are focused behind retina) • Presbyopia: loss of near vision with age • Astigmatism: front surface of the eye or the lens inside the eye is curved differently in one direction than the other.(near and long sightedness)
  • 4.
  • 5. • Infection – adeno virus • Injury – optic nerve damage • U-V Radiation • Eye diseases • Inherited • Aging • Environmental factors • Previous corneal injury • Previous eye surgery • DM
  • 6. • Double vision • Haziness(unclearness) • Glare (halos around bright light) bright circles that surround a light source, like headlights • Squinting (eyes do not look in same direction) • Headache • Eye strain – blurred vision, haeadche • Eye irritation
  • 7. DIAGNOSIS • H.C • P/E • Corneal topogarphy: computerised test maps the curve of cornea • Slit lamp exam – dilated pupil • Tonometry: IOP • Ophthalmoscope : to view retina • Retinoscopy: identify fall of rays on retina
  • 8. • Use sunglasses • Prevent foreign bodies • Antibiotics • Cycloplegic drugs to paralize ciliary muscles • Cholinergic(miotics): pilocarpine, carbachol – increases aqueous fluid outflow by contracting ciliary muscles • Beta blockers : betaxolol, timolol – decreases aqueous fluid production
  • 10. • Photo Refractive Keratotomy (PRK): A layer of cornea tissue is removed with laser, which flattens cornea and allows light rays to focus on retina • Ortho keratology (Keratomileusis): special contact lenses must be worn that slowly reshapes the cornea to correct myopia
  • 11. Cont., • LASIK(Laser Assisted In situ Kerato-mileusis): this procedure used to treat near and farsightedness. A laser is used to reshape the cornea by making a flap in surface of cornea or removing upper layer of cornea. • Automatic Lame – LLAR keratoplasty (ALK): abnormal corneal tissue is replaced by health donor
  • 12. Cont., • Laser Assisted Sub Epithelial Keratomileusis(LASEK): A laser is used to remove the epithelial layer of eye. • Refractive IOL : implantation of small plastic lens after removal of natural lens to correct myopia & Presbyopia • Phakic IOL: implant the lens over natural lens to correct myopia & hyperopia