OM VERMA MSc lecturer

1. TOPIC; REFFRACTIVE ERRORS
PRESENTED BY;
OM VERMA
Reliance NURSING INTITUTE

2. 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 )

3. 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 .

4. 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.

5. 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

6. 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 ..

7. 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 .

8. etiology

9. 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

10. 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

11. PATHOPHYSIOILOGY
Ydue 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

12. DIAGNOSTIC
 1. HISTORYTAKING
 2. CORNEALTOPOGRAPHY
 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 .

13.  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 .

14. 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

15. 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.



16. SURGICAL
 KERATOMILEUSIS
 IS AMETHOD OF RESHAPING THE
CORNEA SURFACE TO CHANGE ITS
OPTICAL POWER.

17. 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.

18.  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.

19. 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

20. PHOTO REFRACTIVE KERETOTOMY (PRK)
To correct myopia
The eye surgeon then gently removing the
surface corneal cells ( epithelium )

21. NURSING MANAGEMENT
 Safe administration of the prescribed fluid
 Right documentation
 Monitor the hemodynamic pressure, vital
sign, arterial blood gas

22. 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

23. THANK