Eyes

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

• Preface ixAcknowledgements xi1 Anatomy and Physiology: The Eyes 1The Sense of Sight 1The Anatomy and Physiology of the Eye 4Conjunctiva 6Lacrimal Apparatus 7The Eye 8Organisation of the Retina 10Colour Vision and Retinal Structure 10Eye Chambers 12Focusing Images on the Retina 12Refraction 12Focal Length 13Myopia, Hyperopia and Presbyopia 14Processing of Visual Information 15Central Processing of Visual Information 15Conclusion 16Glossary of Terms 16Multiple Choice Questions 17References 192 Assessment of the Eyes 20Importance of Vision Assessment 20The Assessment 21Patient History in Ophthalmic Assessment 24Documentation of Findings 24Testing Visual Function 27LogMAR Vision Testing 29Tumbling ‘E’, ‘E’ Test 29Colour Vision Assessment 30Diagnostic Tests 31Conclusion 33Glossary of Terms 34Multiple Choice Questions 35References 363 Glaucoma 37Pathophysiological Changes Associated with Primary Open-angle Glaucoma 37Epidemiology 39Risk Factors 41Clinical Presentation 42Clinical Investigations and Diagnosis 43Management 44Health Teaching 47Conclusion 49Glossary of Terms 50Multiple Choice Questions 51References 524 Cataract 54Pathophysiological Changes Associated with Cataract 56Epidemiology 58Risk Factors 59Clinical Presentation 59Clinical Investigations and Diagnosis 61Management 64Surgical Management 65Cataract Surgery Procedure 65Types of Intra-optical Lenses 66Postoperative Care 66Health Teaching 66Conclusion 69Glossary of Terms 70Multiple Choice Questions 71References 725 Conjunctivitis 73Pink Eye 73Viral Conjunctivitis 73Bacterial Conjunctivitis 73Allergic Conjunctivitis 73Chemical Conjunctivitis 73Giant Papillary Conjunctivitis 74Neonatal Conjunctivitis 74Non-infectious Conjunctivitis 74Pathophysiological Changes Associated with Conjunctivitis 74Conjunctival Anatomy and Function 75Types of Conjunctivitis and Specific Pathophysiological Mechanisms 76Protective Mechanisms and Self-limiting Nature 77Epidemiology 78Ophthalmia Neonatorum 78Risk Factors 79General Risks Across All Types 80Populations at Higher Risk 80Clinical Presentation 81Clinical Investigations and Diagnosis 83Management 87Bacterial Conjunctivitis 87Viral Conjunctivitis 88Allergic Conjunctivitis 88Chemical Conjunctivitis 88Further Considerations 89Health Teaching 89Conclusion 90Glossary of Terms 91Multiple Choice Questions 92References 936 Age-related Macular Degeneration 94Macular Degeneration 94Pathophysiological Changes Associated with Age-related Macular Degeneration 95Dry (Non-exudative or Atrophic) 95Wet (Neovascular or Exudative) Age-related Macular Degeneration 97Epidemiology 99Risk Factors 99Clinical Presentation 100Dry Age-related Macular Degeneration (Atrophic) 101Wet Age-related Macular Degeneration (Neovascular or Exudative) 101General Symptoms of Age-related Macular Degeneration 102Clinical Investigations and Diagnosis 103Initial Consultation 103Symptom Inquiry 104Structured Interviews and Questionnaires 104Documentation and Follow-up 105Visual Acuity Test 106Amsler Grid Test 106Fundoscopic Examination (Ophthalmoscopy) 106Optical Coherence Tomography 106Fluorescein Angiography 107Indocyanine Green Angiography 107Fundus Autofluorescence 107Electroretinography 107Management 107Health Teaching 109Conclusion 110Glossary of Terms 111Multiple Choice Questions 112References 1137 Retinitis 114Retinal Dystrophies 114Types 114Symptoms 115Causes 115Pathophysiological Changes Associated with Retinitis Pigmentosa 116Genetic Mutations 116Photoreceptor Degeneration 116Retinal Pigment Epithelium Changes 117Vascular Changes 117Retinal Remodelling 117Inflammatory Responses 117Secondary Effects 117Clinical Implications 117Epidemiology 118Risk Factors 118Genetic Mutations 118Environmental and Lifestyle Factors 119Age of Onset 120Clinical Presentation 120Initial Symptoms 120Clinical Investigations and Diagnosis 122Patient History 122Symptom Onset and Progression 122Central Vision Changes 123Family History 123Previous Ocular and Medical History 123Visual Function Impact 124Psychosocial Aspects 124Examination and Investigations 125Clinical Examination 125Retinal Imaging 125Functional Tests 126Genetic Testing 126Additional Tests 126Visual Field Testing (Perimetry) 127Management 127Gene Therapy 128Health Teaching 129Conclusion 130Glossary of Terms 130Multiple Choice Questions 131References 1328 Presbyopia 134Myopia, Hyperopia and Presbyopia 134Emmetropia 134Refractive Error 134Pathophysiological Changes Associated with Presbyopia 134Epidemiology 137Risk Factors 138Clinical Presentation 140Clinical Investigations and Diagnosis 140Management 143Health Teaching 143Conclusion 145Glossary of Terms 146Multiple Choice Questions 147References 148MCQ Answers 150Index 151