Table Of ContentCare of the
Ophthalmie Patient
Care of the
Ophthalmie Patient
A guide for nurses and health professionals
Edited by
lOHN P. PERRY
Senior Nurse (Wards)
and
ANDREW B. TULLO
Consultant in Ophthalmology
Manchester Royal Eye Hospital
Springer-Science+Business Media, B.V
First edition 1990
© 1990 lohn Perry and Andrew Tullo
Originally published by Chapman and Hall in 1990.
Typeset in 101/2/12 pt Sabon by
Best-set Typesetter Ltd, Hong Kong
ISBN 978-0-412-32630-1 ISBN 978-1-4899-3378-2 (eBook)
DOI 10.1007/978-1-4899-3378-2
All rights reserved. No part of this publieation may be reprodueed or
transmitted, in any form or by any means, eleetronie, meehanieal,
photoeopying, reeording or otherwise, or stored in any retrieval system of
any nature, without the written permission of the copyright holder and the
publisher, applieation for whieh shall be made to the publisher.
British Library Cataloguing in Publieation Data
Perry, lohn P.
Care of the ophthalmie patient.
1. Eye patients. Nursing
I. Tide 11. Tullo, Andrew
610.73'677
Library of Congress Cataloging in Publication Data
Care of the ophthalmie patient: a guide for nurses and health
professionals / edited by]ohn P. Perry and Andrew B. Tullo.
p. em.
Includes bibliographical referenees.
1. Ophthalmie nursing. I. Perry,]ohn P., 1951- 11. Tullo,
Andrew B., 1951-
[DNLM: 1. Eye Diseases-nursing. WY 158 C271]
RE88.C37 1990
61O.73'677-de20
DNLMlDLC
for Library of Congress 89-70860
CIP
Contents
Colour plates appear between pp. 404 and 405
Contributors VB
Aeknowledgements IX
Prefaee Xl
Part One Prineiples of Ophthalmie Care 1
1 Models for ophthalmie nursing praetiee 3
Mary Rowell
2 Prineiples of eare of the visually handieapped
person 15
janet Bott
3 Examination of the eye 25
fan Rennie
4 Principles of patient eare in the (ophthalmie)
aecident and emergeney department 53
Lindsay Greenwood and janet Marsden
5 Prineiples of eare of ophthalmie outpatients 69
Deidre Donnelly
6 Care of the patient in the ophthalmie theatre 87
janie Grabham
7 Prineiples of inpatient eare 107
Linda Corrin
8 Aspeets of eommunity eare 131
lohn Perry
Part Two Specifie Ophthalmie Conditions 139
9 Eyelids and adnexa 141
David Etchells and jane Fox
10 The laerimal system 163
Michael Raines, Tim Ossei Berkoh and
Pat Lapworth
Contents
VI
11 Conjunctiva 181
Andrew Tullo and Diedre Donnelly
12 Cornea and sclera 199
Andrew Elliott and Gail Thomas
13 Uveal tract 231
josephine Duvall-Youngand Efty joannadu
14 Aqueous dynamics 245
Gordon Dutton and Meg Colligan
15 The lens 269
Steven Vernon and Linda Corrin
16 Vitreous and retina 289
Michael Cole and Karen Hertzog
17 Orbit, optic nerve and visual pathways 323
Robert Doran and Deidre Donnelly
18 Orthoptics 371
Rowena McNamara
Part Three Other Aspeets of Ophthalmie Care 401
19 Pharmacology 403
Patrick W. joyce
20 Optics 425
Peter Cole
21 Social aspects of visual handicap 441
Pamela C. Williams
22 Ophthalmology in developing countries 465
john Sandford-Smith
Appendix 480
Index 481
Contributors
Janet Bott, formerly Ward Sister, Manchester Royal Eye Hospital
Michael Cole, Consultant, Torbay Hospital, Devon
Peter Cole, Ophthalmie Optician, Manchester
Meg Colligan, Si ster, Manchester Royal Eye Hospital
Linda Corrin, Tutor, Manchester Royal Eye Hospital
Deidre Donnelly, formerly Research Sister, Manchester Royal Eye
Hospital
Robert Doran, Consultant, Leeds General Infirmary
Gordon Dutton, Senior Lecturer, University of Glasgow
Josephine Duvall-Young, Consultant, Walton Hospital, Liverpool
Andrew Elliott, Senior Registrar, Cambridge
David Etchells, Consultant, Bournemouth
Jane Fox, Si ster, Casualty Department, Bristol Eye Hospital
Janie Grabham, Senior Nurse (Theatres), Manchester Royal Eye
Hospital
Lindsay Greenwood, formerly Sister, Accident and Emergency Dept.,
Manchester Royal Eye Hospital
Karen Hertzog, Research Sister, Manchester Royal Eye Hospital
Efty Joannadu, formerly Tutor, Moorfields Eye Hospital
Pa trick Joyce, Research Registrar, Manchester Royal Eye Hospital
Pat Lapworth, formerly Clinical Teacher, Moorfields Eye Hospital
Rowena McNamara, Orthoptic Teacher, Manchester Royal Eye
Hospital
Janet Marsden, Sister, Manchester Royal Eye Hospital
Tim Ossei-Berkoh, Clinical Teacher, Moorfields Eye Hospital
John Perry, Senior Nurse (Wards), Manchester Royal Eye Hospital
Michael Raines, Senior Registrar, Birmingham and Midland Eye
Hospital
lan Rennie, Senior Lecturer, Royal Hallamshire Hospital, Sheffield
Mary Rowell, formerly Director of Education, Moorfields Eye Hospital
vtU Contributors
John Sandford-Smith, Consultant, Leicester Royal Infirmary
Gail Thomas, Sister, Manchester Royal Eye Hospital
Andrew Tullo, Consultant, Manchester Royal Eye Hospital
Steven Vemon, Senior Lecturer, Queen's Medical Centre, Nottingham
Pamela C. Williams, Social Worker, Manchester.
Acknowledgements
We are very grateful to the following for their help and support in pro
ducing this book: Smith & Nephew Pharmaceuticals, Pharmacia and
Merck, Sharpe & Dohme for funding the illustrations; Elizabeth Brodie,
Pru McVey and Shirley Evans for word processing; Richard Neave for
all the artwork; and the medical photographers, Manchester Royal Eye
Hospital, for all the photographs.
Preface
Whilst this book is primarily compiled for nurses who care for patients
with eye disease, it will be useful to other health professionals who are
also interested in the holistic ca re of such patients, e.g. opticians, orthop
tists, social workers and junior medical staff.
The care is presented as a systematic approach to the more common
actual and potential problems. Typically, a problem is identified with a
desired outcome and the nursing interventions possible to achieve this.
Evaluation has not been included as this is dependent on an identified
time limit for outcomes to be achieved which is individual to each
patient.
Part One covers the general aspects of ophthalmie care in the various
situations where patients are nursed, e.g. casualty, theatre, wards. Part
Two is based on a medical model, where each section of the eye is
studied separately; the applied physiology of that part of the eye; the
more common conditions affecting it; the possible medical management
of the condition and the nursing care of the patient taking into account
the medical prescription. The list of medical conditions is not exhaus
tive, and only a general guideline of medical management is given as far
as it influences nursing care. A list of widely available books for further
reference to ocular pathology and medical management is given in the
Appendix.
Nursing is only part of the total management of a patient and Part
Three covers other aspects which help a nurse understand the care she
is giving and the part played by other disciplines. The section concludes
with an introductory chapter on tropical ophthalmology.
The specialist knowledge and skills required to nurse children with
ophthalmie disease have been discussed where appropriate throughout
the book, in many instances the basic principles can be applied to caring
for such children; general aspects of nursing children in hospital or the
