Treatment Blepharitis

1. Warm compresses
2. Eyelid hygiene
3. Antibiotics (topical and/or systemic)
4. Topical corticosteroids
5. Topical cyclosporine

1.An initial step in treating patients with blepharitis is to recommend warm compresses and eyelid hygiene Patients should be advised
that warm compress and eyelid hygiene treatment, if effective, may be required long term, because the symptoms often recur if
treatment is discontinued.

2.The frequency and duration of treatment should be guided by the severity of the blepharitis and response to treatment.

3.For patients with meibomian gland dysfunction (MGD), whose chronic symptoms and signs are not adequately controlled with
eyelid hygiene, oral tetracyclines can be prescribed. Alternatively, oral erythromycin (250 mg to 500 mg daily) or azithromycin (250
mg to 500 mg, one to three times a week) can be used.

4. A brief course of topical corticosteroids may be helpful for eyelid or ocular surface inflammation such as severe conjunctival
injection, marginal keratitis, or phlyctenules.  The minimal effective dose of corticosteroid should be utilized and long-term
corticosteroid therapy should be avoided if possible. Patients should be informed of the potential adverse effects of corticosteroid use,
including the risk for developing increased intraocular pressure and cataract.

5. Patients with atypical eyelid-margin inflammation or disease not responsive to medical therapy should be carefully re-evaluated.

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Treatments for Conjunctivitis

1. The first step in treating conjunctivitis is prevention. Prevention measures include avoiding touching the eyes, which can transmit
an infectious virus or bacteria from the hands into the eyes. It is also key to wash hands frequently with soap and water for at least 15
seconds, especially after having contact with anyone with conjunctivitis or any object that may be contaminated with a virus or
bacteria.

2. Do not share personal items that touch the face or eyes, such as pillowcases, towels or wash cloths with others. If possible, it is also
a good idea to avoid the use of large day care centers.

3. Treatment of bacterial conjunctivitis includes antibiotic eye drops or ointment. Antibiotics are not effective for treating viral
conjunctivitis. Viral conjunctivitis generally goes away on its own in seven to ten days.

4. Treatment of allergic conjunctivitis may include eye drops that minimize symptoms and avoiding the allergen that causes
symptoms. Allergy testing may need to be performed in some cases.

5. For all types of conjunctivitis, warm wet compresses may be recommended to soften and remove the crusty discharge. Cool
compresses may be soothing as well for discomfort.

It is important to seek regular follow-up medical care during and after conjunctivitis to re-evaluate the eyes and ensure that the
condition has cleared up and that a person with bacterial conjunctivitis or viral conjunctivitis is no longer contagious.

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Treatments for Keratitis

1. With acute keratitis due to herpes simplex virus, treatment consists of trifluridine eyedrops or vidarabine ointment. A broad-
spectrum antibiotic may prevent secondary bacterial infection.
2. Chronic dendritic keratitis may respond more quickly to vidarabine. Long-term topical therapy may be necessary. (Corticosteroid
therapy is contraindicated in patients with dendritic keratitis or another viral or fungal disease of the cornea.) Treatment of fungal
keratitis involves natamycin.

3. Keratitis due to exposure requires application of moisturizing ointment to the exposed cornea and of a plastic bubble eye shield or
eye patch. Treatment of severe corneal scarring may include keratoplasty (cornea transplantation).

4. Look for keratitis in the patient predisposed to cold sores. Explain that stress, trauma, fever, colds, and overexposure to the sun
may trigger flare-ups.

5. Protect the exposed corneas of unconscious patients by cleaning the eyes daily, applying moisturizing ointment, or covering the
eyes with an eye shield.

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Treatments for Trachoma

1. Antibiotics & Antibiotic eye creams

Antibiotics can prevent long-term complications if used early in the infection. Antibiotics include erythromycin and doxycycline.
Topical tetracycline (one percent eye ointment twice a day for six weeks).

2. Oral antibiotics

Azithromycin is preferred because it is used as a single oral dose. Although it is expensive, it is generally used as part of the
international donation program organized by Pfizer through the International Trachoma Initiative.[9] Azithromycin can be used in
children from the age of six months and in pregnancy. [2]

3. Environmental change to increase access to clean water and improved sanitation.

4. facial cleanliness: Children with grossly visible nasal discharge, ocular discharge, or flies on their faces are at least twice as
likely to have active trachoma as children with clean faces

5. Surgical correction of eyelid deformity - In certain cases, eyelid surgery may be needed to prevent long-term scarring, which
can lead to blindness if not corrected.

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Treatments for Glaucoma

Nursing Interventions:

1. Monitor for any pain or visual changes.

2. Monitor the patient’s compliance with medications and follow-up care.
3. Administer antiemetics as directed to prevent vomiting, which will increase IOP.
4. Administer medications I.V., orally or topically, as directed, and explain the importance of medications, the proper procedure
for administration of drops, and possible adverse reactions.
5. After surgery, elevate head of the bed 30 degrees to promote drainage of aqueous humor after a trabeculectomy.
6. Administer medications (steroids and cycloplegics) as directed after peripheral iridectomy to decrease inflammation and to
dilate the pupil.
7. Use an eye patch or shield in children for several days to protect the eye; in adults, patch is usually removed within several
hours.
8. Alert the patient to avoid prolonged coughing or vomiting, emotional upsets such as worry, fear, anger; exertion such as
pushing and heavy lifting.
Treatments for Cataract

Nursing Interventions

1. Before surgery, monitor for worsening of visual acuity, glare, and ability to perform usual activities.
2. Monitor pain level postoperatively. Sudden onset may be caused by a ruptured vessel or suture and may lead to hemorrhage.
Severe pain accompanied by nausea and vomiting may be caused by increased IOP.
3. Assess gradual adaptation to lens implant, contact lens, or glasses.
4. Keep the patient comfortable and advise him not to touch his eyes.
5. If eye patch or shield is in place, advise using it for several days as prescribed, to rest and protect eye, especially at night.
6. Caution the patient against coughing or sneezing, any rapid moment, bending from the waist to prevent increased IOP for
first 24 hour. Instruct the patient to avoid heavy lifting or straining for up to 6 weeks, as directed by surgeon.
7. Advise patient to increase activity gradually; can usually resume normal activity the day after the procedure.
8. Teach proper installation of the eye.
9. Encourage to follow up ophthalmologic examinations for corrective lenses and checking of IOP. Adjustment to eye glasses to
correct vision may take weeks.
10. Advise the patient not to get soap in the eyes.
11. Advise the patient to avoid tilting the head forward when washing hair, and to avoid vigorous hand shaking, to prevent
disruption of the lens until cleared by the surgeon.

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Treatments for Retinal Detachment

Nursing Interventions:

1. Prepare the patient for surgery.

 Instruct the patient to remain quiet in prescribed (dependent) position, to keep the detached area of the retina in dependent
position.
 Patch both eyes.
 Wash the patient’s face with antibacterial solution.
 Instruct the patient not to touch the eyes to avoid contamination.
 Administer preoperative medications as ordered.

2. Take measures to prevent postoperative complications.

 Caution the patient to avoid bumping head.

 Encourage the patient no to cough or sneeze or to perform other strain-inducing activities that will increase intraocular
pressure.

3. Encourage ambulation and independence as tolerated.

4. Administer medication for pain, nausea, and vomiting as directed.
5. Provide quiet diversional activities, such as listening to a radio or audio books.
6. Teach proper technique in giving eye medications.
7. Advise patient to avoid rapid eye movements for several weeks as well as straining or bending the head below the waist.
8. Advise patient that driving is restricted until cleared by ophthalmologist.
9. Teach the patient to recognize and immediately  report symptoms that indicate recurring detachment, such as floating spots, flashing
lights, and progressive shadows.
10. Advise patient to follow up.

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Treatments for Macular degeneration

There is no cure, but age-related macular degeneration treatments may prevent severe vision loss or slow the progression of the
disease considerably. Several treatment options are available, including:
  Vitamins. A large study performed by the National Eye Institute of the National Institutes of Health, called AREDS (Age-
Related Eye Disease Study), showed that for certain individuals, vitamins C, E, beta-carotene, zinc, and copper can decrease
the risk of vision loss in patients with intermediate to advanced dry age-related macular degeneration. Ask your eye doctor if
these vitamin supplements will benefit you before taking them.
 Laser therapy. High-energy laser light can sometimes be used to destroy actively growing abnormal blood vessels that occur
in age-related macular degeneration.
 Photodynamic laser therapy. A two-step treatment in which a light-sensitive drug is used to damage the abnormal blood
vessels. A doctor injects the drug into the bloodstream to be absorbed by the abnormal blood vessels in the eye. The doctor
then shines a cold laser into the eye to activate the drug, damaging the abnormal blood vessels.
 Anti-angiogenesis drugs. New drugs are being used to slow down or prevent the growth of the abnormal blood vessels within
the eye.
 Low vision aids. Devices that have special lenses or electronic systems that produce enlarged images of nearby objects. They
help people who have vision loss from macular degeneration make the most of their remaining vision.\
 Submacular surgery. Surgery to remove the abnormal blood vessels or blood
 Retinal translocation. A surgical procedure used to destroy abnormal blood vessels that are located directly under the center
of the macula, where a laser beam cannot be placed safely. In the procedure, the macular center is rotated away from the
abnormal blood vessels to a healthy area of the retina, thus preventing the formation of scar tissue and further damage to the
retina. Once moved away from the abnormal blood vessels, a laser is used to treat the abnormal blood vessels.

Treatments for Retinopathy

1. You may not need treatment for diabetic retinopathy unless it has affected the center (macula) of the retina or, in rare cases, if
your side (peripheral) vision has been severely damaged. But you do need to have your vision checked every year.

2. If the macula has been damaged by macular edema, you may need laser treatment. For more severe retinopathy, you may
need either laser treatment or vitrectomy. These procedures can help prevent, stabilize, or slow vision loss when they are
done before the retina has been severely damaged.

3. Surgical removal of the vitreous gel (vitrectomy) is done when there is bleeding (vitreous hemorrhage) or retinal detachment,
which are rare in people with early-stage retinopathy. Vitrectomy is also done when severe scar tissue has formed.

4. Treatment for diabetic retinopathy is often very effective in preventing, delaying, or reducing vision loss. But it is not a cure
for the disease. People who have been treated for diabetic retinopathy need to be monitored frequently by an eye doctor to
check for new changes in their eyes. Many people with diabetic retinopathy need to be treated more than once as the
condition gets worse.

5. Controlling your blood sugar levels is always important. This is true even if you have been treated for diabetic retinopathy
and your eyes are better. In fact, good blood sugar control is especially important in this case so that you can help keep your
retinopathy from getting worse.

6. Ideally, laser treatment should be done early in the course of the disease to prevent serious vision loss rather than to try to
treat serious vision loss after it has already developed.

7. People with diabetes who have any signs of retinopathy need to be examined as soon as possible by an ophthalmologist.

Treatments for Uveitis

1. Anti-inflammatory medication. Your doctor may prescribe anti-inflammatory medication, such as a corticosteroid, to treat
your uveitis. This medication may be given as eyedrops. Your doctor could also administer a corticosteroid by pill or by
injection into the eye. For people with difficult-to-treat posterior uveitis, a device that's implanted in your eye may be an
option. This device slowly releases corticosteroid medication into your eye for about 2 1/2 years.
2. Antibiotic or antiviral medication. If uveitis is caused by an infection, antibiotics, antiviral medications or other medicines
may be given with or without corticosteroids to bring the infection under control.
3. Immunosuppressive or cytotoxic medication. Immunosuppressive or cytotoxic agents may become necessary if your
uveitis responds poorly to corticosteroids or becomes severe enough to threaten your vision.
4. Surgery. Vitrectomy — surgery to remove some of the jelly-like material in your eye (vitreous) — may be necessary both
for diagnosis and management of your uveitis. A small sample of the vitreous can help identify a specific cause of eye
inflammation, such as a virus or bacterium. The procedure may also be used to remove developing scar tissue in the vitreous.
5. Uveitis can recur. Make an appointment with your doctor if any of your symptoms reappear after successful treatment.