Developmental problems
Handicapped is a condition in which the child’s normal function is altered and the child remains dependent on another person. Handicapped is a condition in which a child has physical, social, mental and sensory developmental impairment due to which the child cannot perform his daily routine activities and remains dependent on another person.
A handicapped child is a child who is physically, mentally and socially impaired due to which the child needs special care, treatment and education.
Explain the Concept of the Handicapped.
Injury or Disease
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Impairment
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Disability
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Handicapped
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Injury or Disease
Due to any kind of injury to the child, the child is psychologically physically, anatomically structurally and emotionally impaired.
A child having some kind of disease like cleft lip, cleft palate, arthritis, congenital heart disease, has a serious influence in the child’s life.
Impairment
An impairment is a condition characterized by psychological, physiological, and anatomical structural and functional abnormalities such as
loss of vision,
loss of hearing,
Lower limb impairment is seen due to accident due to any reason. Disabilities are seen due to this impairment.
Disability
Disability is usually caused by an impairment. Disability is a condition in which a human being is unable to perform an activity at his or her normal age. It is called disabilities.
For example, due to loss of limb there are difficulties in walking.
Handicapped
Handicapped is defined as a disadvantage to a human being due to impairments and disabilities, which, based on age, social and cultural factors, result in inabilities to fulfill the functions and roles that are normal for that human being. .
Explain the Classification of the Handicapped Children.
There are three classifications of handicapped child.
1) Physically Handicapped Children,
2) Mentally Handicapped Children,
3) Socially Handicapped Children.
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1) Physically Handicapped Children,
Physically handicapped children ma group depends on its affected part.
like ,
A) Orthopedically handicapped child,
B) Sensory Handicapped Child,
c) Neurologically Handicapped Child,
D) Handicapped child due to chronic diseases,
A) Orthopedically handicapped child,
Orthopedically handicapped child involves children who have congenital bony defects such as club foot, mutation due to accidental injury,
Bony defect after rickets, fracture, arthritis, leprosy,
B) Sensory Handicapped Child,
Sensory Handicapped Child Ma
visual problems,
auditory problem,
Includes speech problems.
visual problems,
Visual problems include partial and complete blindness and refractory errors.
auditory problem,
Auditory problems include partial hearing loss and deafness and dumbness.
Speech problem
Speech problems include stuttering and dysphonia.
c) Neurologically Handicapped Child,
Involvement of cerebral palsy, mental retardation, convulsive disorder, hydrocephalus, spina bifida etc. in neurologically handicapped child.
D) Handicapped child due to chronic diseases,
Handicapped child due to chronic diseases include heart disease, bronchial asthma, diabetes mellitus, muscular dystrophy.
2) Mentally Handicapped Children,
Mentally handicapped children are called mentally retarded children.
A mentally retarded child is a child whose brain is not properly developed and due to this the child is impaired in thinking, cognitive, learning, academic achievement.
3) Socially Handicapped Children.
Socially Handicapped Children are those children who have not been able to properly develop their healthy personality which is usually due to broken family, parental inadequacy, loss of parents, poverty, lack of educational opportunity,
Seen due to environmental deprivation, and lack of love.
Explain the Etiology/cause of the Handicapped Children
Due to congenital anomalies,
Due to genetic disorder,
Due to polio myelitis,
Due to certain types of communicable diseases,
Due to perimetal condition,
Due to malnutrition,
Due to accidental injury,
Due to socio cultural factors,
1) Physical causes
Due to arthritis, fasciitis and rickets,
2) Neurologic causes
Mental retardation
, behavioral and learning disorders, due to meningitis, due to encephalitis, due to cerebral palsy, due to birth defects.
3) Sensory Cause
visual blindness,
Refractory errors,
Auditory dysfunction like hearing loss, deaf, speech disorder like stuttering.
4) Due to chronic systemic disease
Heart disease, bronchial asthma, malabsorption syndrome, muscular dystrophy.
5) Social Cause
Child abuse and neglect,
drug addiction,
battered child syndrome,
6) Due to perinatal factors
Birth asphyxia,
Prolonged and Difficult Birth,
pre maturity,
carnicterus,
Due to head injury to the child due to instrumental delivery,
7) Due to genetic factor
genetic mutation,
chromosomal disorders,
8) Postnatal factor
Due to CNS infection,
accident,
Due to iodine deficiency,
Due to severe protein energy malnutrition,
Due to metabolic disorders,
9) Due to environment and social factors
Due to poverty,
Because of Broken Family,
Due to faulty parenting,
Due to child abuse and neglect,
Due to environmental deprivation.
Explain the Clinical manifestation/ Sign and symptoms of the Handicapped Children
Having physical disabilities,
Having an intellectual disability,
Sensory impairment,
having a developmental disorder,
Having a chronic health condition.
Explain the Diagnostic evaluation of the Handicapped Children
History Collection,
Physical Examination,
Developmental Screening,
city scan,
M.R. I.
Psychological Assessment,
Functional assessment.
Explain the Medical Management of the Handicapped Children
There is a need for a multidisciplinary approach in the management of a handicapped child.
Early diagnosis and prompt treatment of handicapped children.
Careful history collection and complete physical examination of the handicapped child.
Regular supervision of the child and careful evaluation of how effective the treatment is.
To provide proper medical and surgical management to the handicapped child.
Ex:= Providing proper treatment to the child of cataract, otitis media, leprosy, accidental injury, rickets, congenital anamolis etc.
Proper correction of child’s disabilities.
Advising the child to do proper physiotherapy and exercise to improve the physical condition of the child.
Provide occupational therapy to the child according to the child’s ability, such as music, painting, wood work.
Providing speech therapy to the child properly to improve the child’s communication ability.
If the child’s leg is amputated, providing the child with proper prosthetics.
If the child is mentally handicapped, provide proper love, affection, patience, tolerance, discipline to the child and avoid criticism.
To provide proper education and guidance to the child’s parents, his family members, and his caregivers or to provide proper emotional and psychological support to the child.
To provide proper work and comfortable environment to the child.
To provide proper rehabilitation therapy to the child.
Providing artificial limb and prosthesis to improve child’s function in medical rehabilitation.
Restoration of family and social relationship by restoring family in social rehabilitation.
To provide proper psychological rehabilitation to the child.
Explain the Nursing management of the Handicapped Children
To provide proper holistic and comprehensive care to the child.
Continuous assessment and monitoring of children.
To monitor the child’s vital signs properly.
Properly monitoring the physical emotional and psychological status of the child.
To provide proper and continuous education to the parents of the child.
Advise the child to provide food with adequate nutrition.
Giving advice to the parents of the child to maintain the hygienic condition of the child.
Providing proper skincare to the child.
Providing a properly assistive device to the child.
Provide nutritious support to the child.
Providing proper emotional support to the child.
Collaborate with other healthcare personnel for proper care of the child.
Explain the Preventive measures of the Handicapped Children
To provide proper genetic counseling to the parents of the child.
Get the child to have regular medical checkups.
Providing proper immunization to the child.
Advising the child to maintain a properly healthy life style.
To provide adequate nutrition support to the child.
Advise the child to exercise regularly.
Advise the child to do adequate exercise and get adequate sleep.
To provide proper safety measures to the child.
Provide proper skin care to the child.
Properly maintain the child’s hydration and nutrition status.
Advising the child to do regular physical activity.
Provide proper social and emotional support to the child.
Parents to provide proper medication to the child.
Giving advice to provide proper work and comfortable environment to the child.
Mental retardation is also called “intellectual disabilities”. Mental retardation is the most severe condition in which the child’s cognitive and problem solving skills are low. Also known as cognitive developmental delay.
Mental retardation is a condition in which the child has difficulties in learning, thinking, problem solving, reasoning and understanding concepts relative to other children.
These limitations can range from mild to profound. Due to this, there is impairment in the child’s communication, socialization and daily routine activities. Such a child needs continuous care and support to survive.
Explain the Classification of mental Retardation.
There are four classifications of mental retardation.
1) Mild mental retardation,
2) Moderately Mental Retardation,
3) Severe mental retardation,
4) Profound mental retardation.
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1) Mild mental retardation,
A child with mild mental retardation has an IQ level of 51 to 70.
Such a child is capable of doing his own work under supervision.
He is also able to do school work.
In mild mental retardation, if he is provided with proper training, he can do simple jobs and earn.
2) Moderately Mental Retardation,
A child with moderate mental retardation has an IQ level of 39 to 50.
In moderate mental retardation, if properly trained, a child can eat by himself, wear clothes by himself and by providing toilet training, he can perform his daily routine activities.
A child with moderate mental retardation has difficulty in communication. In this, if proper training is provided to the child, the child is able to do his own work under supervision.
3) Severe mental retardation,
A child with severe mental retardation has an IQ level of 21 to 35.
In this the child is not able to fulfill his physical needs.
Thus, if training is provided to the child, he can do the simplest work.
In this, the child needs more supervision.
Severe mental retardation is identified during the child’s early life. In which the child’s motor development is poor, speech is delayed and there is impairment in communication skills.
4) Profound mental retardation.
A child with profound mental retardation
Iq level is below 20.
Explain the Etiology/cause of mental retardation.
Biomedical factor
A) Prenatal factors
Metabolic
amino acid urea,
galactosemia,
Inherited degenerative disorder of central nervous system,
Due to chromosomal disorders like Down syndrome, Turner syndrome.
Due to developmental defects like microcephaly, cranial stenosis, cretinism, porencephaly.
B) Due to maternal factor
Due to the use of drugs,
Due to infection such as rubella, toxoplasmosis,
Cytomegaly Inclusions,
Herpes and shingles.
Due to placental insufficiency,
Due to toxemia of pregnancy,
Due to antepartum haemorrhage,
Due to exposure to radiation during pregnancy.
C) Due to natal factors
Due to birth injury,
Due to prematurity,
Due to low birth weight
Due to birth trauma,
Due to birth asphyxia,
Due to perinatal asphyxia,
Due to long and difficult births,
Due to prematurity,
Due to kernicterus.
Due to intra cerebral hemorrhage,
due to preeclampsia.
D) Due to post natal factors
Due to infection in the central nervous system, such as meningitis, encephalitis,
Due to head injury,
Due to cerebro vascular thrombosis of cerebral vessels,
Due to kernicterus,
Due to hypoglycemia,
Due to hypoxia,
2) Social factor
Due to socio economic factors,
Due to environmental conditions,
Due to psychological factors,
Due to mother’s advanced age,
Explain the clinical manifestation/ sign and symptoms of mental retardation.
Failure to achieve developmental milestones,
Impairment in cognitive function,
Not being able to follow commands,
Impairment in achieving intellectual development,
Failure to achieve academic demands,
Difficulty in learning,
Finding a psychomotor skill deficit sheet,
Impairment in self-esteem,
Irritability,
get frustrated,
Depression,
Decreased curiosity,
Lack of appropriate development,
Poor feeding is observed,
Poor weight gain,
Spontaneous activity is reduced,
Head and trunk control deal,
Finding hypotonia,
Difficulty seeing spastic muscle tone,
Delay in speech and language development,
Short attention span,
Finding distributability,
Having hyperactivity,
Memory is poor,
Concentration being poor,
Emotional instability will be observed.
Having sleep problem,
Impulsiveness is observed,
Seeing vision and hearing problems,
And physical symptoms like microcephaly, down syndrome, cretinism.
Explain the Diagnostic evaluation of mental Retardation.
History Collection,
Physical Examination,
Neurological examination,
Milestone Development Assessment,
Urine and blood examination,
Amniosynthesis for assessing the chromosomal disorder,
Chorionic villi sampling,
Hearing and Speech Evaluation,
EEG (Electroencephalogram) test,
city scan,
MRI,
thyroid function test,
genetic screening,
Urine Chromatography,
Chromosomal Studies,
hormonal assay,
Enzyme Estimation,
serological test,
C.S.F Studies,
Angiography.
Explain the management of mental retardation.
Early identification of mental retardation and providing early intervention against it.
Complete medical examination of the child.
Genetic testing, metabolic screening, properly assessing the child.
To provide proper education to the child and his parents.
Providing proper behavioral therapy to the child.
To provide proper medical treatment to the child according to his condition.
Child should be given proper speech therapy, occupation therapy, physical therapy,
to provide
To provide complete education about the child’s condition to the child’s family members and caregivers.
Provide routine basic care to the child like immunization, growth monitoring, nutritional support.
To provide adequate emotional support to the child’s parents and caregivers.
Explain the nursing management of mental retardation.
To provide comprehensive and holistic care to mentally retarded children.
To properly and completely assess the child to identify the child’s strengths, needs, and abilities.
Properly assess the child’s developmental milestones, communication skills, behavioral patterns, and other medical conditions.
Taking proper measures to improve the health condition of the child.
To provide adequate nutritional support, excise, hygiene and preventive care to the child.
Providing proper medication to the child as per the need of the child.
Helping the child to provide adequate supportive care like bathing, toileting, feeding.
Providing complete education to the child’s parents about the child’s condition, its causes, symptoms and signs, and its treatment.
To properly collaborate with other health care personnel for proper care of the child, and properly maintain nurse patient interaction with the child.
To provide proper emotional support to the child and his family members.
Taking measures to maintain continuity in child care.
Explain the Preventive measures of mental Retardation.
Preventive measures of mental retardation include early identification of children with the condition of mental retardation and early identification and prompt treatment to prevent it from becoming more complicated.
Provide comprehensive and holistic care to the mother while the child is during intrauterine life to prevent mental retardation of the child.
Regular prenatal checkup of the mother.
Advise mother to avoid harmful substances and take adequate nutritious diet.
Genetic counseling can prevent genetic and chromosomal abnormalities.
Identifying high-risk children and providing early intervention.
To provide adequate nutritious diet to the child.
Child does not get brain injury and take appropriate measures to prevent it.
Providing proper immunization to prevent the child from infectious diseases.
To provide a properly safe, working and comfortable environment to the child.
Giving advice to the child and his family members or providing adequate love and affection to the child.
Advising the parents to provide proper emotional and psychological support to the child.
Dyslexia is a Greek word which,
Dish Mince “Poor and Inadequate”,
and lexia means “word or language”.
Dyslexia is a learning disability that impairs a child’s reading, writing, spelling and sometimes speaking abilities. Dyslexia is a specific learning disorder.
In which there is impairment in recognizing words accurately and fluently. It is a common learning disability that affects the brain’s processing of written and spoken language.
A child with dyslexia may struggle in reading, writing and spelling despite having normal intelligence and adequate educational opportunities.
Children with the condition of dyslexia have difficulties in reading, writing, spelling and learning. Dyslexia can be mild to severe.
Explain the Etiology/cause of the Dyslexia Children
Due to congenital anomalies,
Due to genetic disorder,
Due to certain types of neurological diseases,
Due to perinatal conditions,
Due to malnutrition,
Due to accidental injury,
Due to socio cultural factors,
Due to environment and social factors,
Due to hereditary factors,
Due to brain injury,
Explain the Clinical manifestation/ Sign and symptoms of the Dyslexia Children
Difficulty in reading,
Not reading fluently and accurately,
Having problems in spelling,
Having problems in language,
Problems in writing,
Finding intellectual impairment,
Low self-esteem,
festation,
Finding learning problems.
Explain the Diagnostic evaluation of the dyslexia in children
History Collection,
Physical Examination,
Developmental Screening,
Education Skinning,
Intellectual Assessment
Speech and Language
assessment.
Explain the Medical Management of the Dyslexia in Children
The management of dyslexia requires a multidisciplinary approach.
Early diagnosis and prompt treatment of children with dyslexia.
Careful history collection and complete physical examination of dyslexia Wada child.
Regular supervision of the child and careful evaluation of how effective the treatment is.
Proper correction of child’s deformities.
Providing proper medical care to the child to improve the child’s condition.
Provide occupational therapy to the child according to the child’s ability, such as music, painting, wood work.
Providing speech therapy to the child properly to improve the child’s communication ability.
If the child is mentally handicapped, provide proper love, affection, patience, tolerance, discipline to the child and avoid criticism.
To provide proper education and guidance to the child’s parents, his family members, and his caregivers or to provide proper emotional and psychological support to the child.
To provide proper work and comfortable environment to the child.
To provide proper rehabilitation therapy to the child.
To provide proper psychological rehabilitation to the child.
Provide cognitive behavioral therapy (CBT) to the child properly.
To provide proper education and support to the parents of the child.
Proper collaboration with other health care personnel for proper care of child
Explain the Nursing management of the Dyslexia
To provide properly holistic and comprehensive care to the child.
Continuous assessment and monitoring of children.
To monitor the child’s vital signs properly.
Properly monitoring the physical emotional and psychological status of the child.
To provide proper and continuous education to the parents of the child.
Advise the child to provide food with adequate nutrition.
Giving advice to the parents of the child to maintain the hygienic condition of the child.
Providing proper skincare to the child.
Provide nutritious support to the child.
Providing proper emotional support to the child.
Collaborate with other healthcare personnel for proper care of the child.
Explain the Preventive measures of the Dyslexia
To provide proper genetic counseling to the parents of the child.
Get the child to have regular medical checkups.
Providing proper immunization to the child.
Advising the child to maintain a properly healthy life style.
To provide adequate nutrition support to the child.
Advise the child to exercise regularly.
Advise the child to do adequate exercise and get adequate sleep.
To provide proper safety measures to the child.
Provide proper skin care to the child.
Properly maintain the child’s hydration and nutrition status.
Provide proper social and emotional support to the child.
Parents to provide proper medication to the child.
Giving advice to provide proper work and comfortable environment to the child.
Hearing impairment includes partial or complete hearing impairment.
Mild Difficulties in Hearing Impairment in Mild Hearing
Rhythm and total loss of hearing also occurs. Hearing impairment also affects communication, social activities, and work activities.
Hearing impairment impairs a child’s quality of life.
Most of hearing loss is due to otitis media and it mainly affects young children.
Hearing loss can also be caused by noisy congenital anomalies and toxins, and centennial hearing loss is a genetic condition.
Explain the qualification of hearing impairment
Severity of hearing impairment is measured based on loudness and is measured in decibel units.
1)Mild:= Between 25 and 40 dB.
2) Moderate := Between 41 to 55 dB.
3) Moderately loud:= Between 56 to 70 dB.
4) Loudness:= Between 71 and 90 dB.
5)Profound:=91 dB or greater.
Explain the classification of hearing impairment
1) Conductive hearing loss,
2) Sensorineural hearing loss
3) Mixed hearing loss
1) Conductive hearing loss:=
Conductive hearing loss is an impairment in any of the normal mechanisms that transmit sound waves from the outer ear to the inner ear, such as the outer ear, ear drum and bones of the middle ear.
2) Sensorineural hearing loss
Sensorineural hearing loss is caused by damage to the inner ear (cochlea) and the auditory nerve that travels from the inner ear to the brain. This is the most common type of permanent hearing loss.
Sensory neuron hearing loss is caused by dysfunction of the inner ear.
Sensory neural hearing impairment is caused by any abnormality in the cochlea and the vestibulocochlear nerve that transmits hearing to the brain and can range from mild, moderate and severe to total deafness.
3) Mixed hearing loss
Mixed hearing loss includes both conductive hearing loss and sensorineural hearing loss.
Means includes inner ear (cochlea) and auditory nerve (sensory neural) and outer and middle ear (conductive).
Some types of hearing impairment include both sensorineural hearing loss and conductive hearing loss.
Both types of hearing loss are called mixed hearing loss.
Explain the Etiology/cause of the hearing impairment.
External ear
Have an impacted ceriumen.
otitis externa,
Due to congenital factor,
Due to genetic factors,
Foreign body in external auditory canal.
Congenital atresia,
Tumors in the ear canal,
Due to pre-mature birth.
Middle Years
Acute otitis media,
serous otitis media,
Collection of fluid in the middle ear,
Perforation in the tympanic membrane,
tympanosclerosis,
Massage of the ossicular,
Middle ear tumor,
Temporal bone trauma,
Inner ear
severe auto otosclerosis,
Another Cause
Sensorineural hearing loss can be congenital or acquired.
As the cochlea is not properly developed,
Due to any chromosomal abnormality,
Due to genetic hearing loss,
Due to any benign or malignant tumor,
Due to certain drugs,
Due to childhood infections such as measles, mumps and meningitis,
Due to any congenital infection eg
Toxoplasmosis, rubella, cytomegalovirus, herpes, and syphilis,
premature birth,
Due to mal nutrition during pregnancy,
Due to any loud noise,
Due to Meniere’s disease,
Due to any kind of viral infection,
otosclerosis,
Due to physical trauma such as fracture of the temporal bone,
Due to any type of auto immune disease,
Due to HIV or AIDS,
Due to exposure to chemicals.
Explain the clinical manifestation / Sign and symptoms of the hearing impairment.
Due to progressive hearing loss in this,
dizziness,
have difficulty speaking,
Difficulty understanding any kind of words,
have difficulty speaking,
To tell someone very slowly clearly and loudly,
have difficulty hearing,
speech delay,
Difficulties in understanding spoken language,
Impairment in sound response,
Impairment in speech and language,
Having difficulties in pronouncing certain types of words.
to observe behavioral changes,
get frustrated,
Explain the medical management of hearing impairment
1) Removing wax blockage
Gently remove ear wax with a scoop or suction.
2) Hearing aid
Hearing loss is caused by damage to the inner ear so it helps to make sound stronger and easier to hear.
3) Cochlear implants
A cochlear implant is a great option for severe hearing loss. A cochlear implant consists of an electrical device implanted in the cochlea that transmits sound to the inner ear and stimulates the cochlea so that the child can hear. .
4) Oral rehabilitation
Oral rehabilitation is a process in which hearing loss is identified and diagnosed and various types of treatment are provided.
type of aural rehabilitation therapies
auditory training,
speech reading,
Hearing Aid Orientation,
Listening Strategies,
speech reading,
auditory training,
Total Communication,
Explain the surgical management of the hearing impairment
1) Restore conductive hearing.
myringotomy,
Stapedectomy.
2) Assisted hearing in profound deafness.
cochlear implants,
Temporal Bone Stimulator.
3) Middle ear implant,
4) Tumor excision.
Explain the Nursing management of the hearing impairment
Early identification of children with hearing impairment and immediate treatment.
To provide complete education to the child and his parents about the child’s condition, its causes, its symptoms and signs and its treatment.
Providing properly supportive care to the child.
Properly maintaining therapeutic communication with the child.
To provide proper speech and language therapy of the child.
Speak clearly and communicate in pure and simple language.
Moving closer to the speaker and trying to hear clearly,
Protecting the inner from any work place,
To see how many amounts are heard,
Do not go to any kind of loud noise.
To provide a comfortable environment for the child to work optimally.
Visual impairment is a condition in which a child cannot visualize properly i.e. there is an impairment in his vision.
Visual impairment can range from mild to severe forms. It also affects one or both eyes.
Visual impairment occurs due to refractive error. Visual impairment is seen due to genetic conditions, prematurity, retinopathy and postnatal infection.
Refractive error
Refractive error means abnormality in refraction.
Refractive error is a common eye condition in which the eye fails to focus the image on the retina, resulting in blurred vision. This refractive error is caused by the shape of the eyeball.
Refractive errors are mainly of four types:
1) Myopia
2) Hypermetropia
3) Astigmatism
4) Strabismus
Myopia is also known as ‘shortsightedness’ and ‘nearsightedness’. Myopia is a type of refractive error in which near objects appear clear while distant objects appear blurry.
In myopia, the size of the eyeball is long and the cornea is seen as steep. Due to which the light rays are concentrated in the front part of the screen.
Explain the Etiology/causes of myopia
Genetic factor
Environmental Factors (Reading, Writing)
Visual stress
Structural abnormality of eye,
Due to congenital anomalies.
Explain the clinical manifestations/ Sign and symptoms of myopia
Blur vision for distance objects
I strain
Skiving
Black support floating in front of the eye,
headache,
Difficulty seeing distant objects.
Explain the diagnostic evaluation of myopia
History Collection
Physical Examination
Visual acuity testing
Refraction test
Auto refractor
Keratometry
Explain the medical management of myopia
Prescription glasses or contact lenses
Concave spedical glasses are used to correct myopia. which helps to focus the light on the retina.
Orthokeratology
In orthokeratology, specifically designed gas permeable contact lenses are worn at night. Which reshapes the cornea and provides clearer vision during the day. Hence there is no need to wear contact lenses or glasses.
Environmental and Life Style Modification
Anchoring the child for outdoor activities and not asking the child to do close-up work for a long time like reading, screen time. Educate the patient about the 20-20-20 rule. According to this rule, take a break for 20 seconds every 20 minutes to look at an object 20 feet away to reduce eye strain.
Refractive surgery Surgery such as LASIK (Laser Assisted In Situ Keratomileusis) or PRK (Photo Refractive Kerectomy) is performed to correct myopia.
Explain the Nursing management of myopia
To the child and his family members about the child’s condition, its causes, its symptoms and
Provide complete education about symptoms and its treatment.
Giving proper advice to the child’s parents to take proper care of the child’s eyes.
Proper monitoring of the child’s condition.
Providing proper emotional support to the child.
Advising parents of child to provide adequate nutritious diet to child.
To provide proper work and comfortable environment to the child.
Providing proper psychological support to the child.
Advising the parents of the child to take good care of the child.
Hypermetropia is also known as ‘farsightedness’ and ‘longsightedness’.
Hypermetropia is a type of refractive error in which distant objects appear clear while near objects appear blurry.
In hypermetropia, the size of the eyeball is short and the cornea appears flat. Due to which the light rays are concentrated at the back of the screen.
Explain the Etiology/causes of hypermetropia.
Shape of Eyeball,
genetic factor,
Certain medical conditions,
Environmental Factors.
Explain clinical manifestations/ Sign and symptoms of hypermetropia.
Blurred near vision
Clear distance vision
I strain
Difficulty in close up tasks
Head one
Fatigue and tightness of the eye
Explain the diagnostic evaluation of hypermetropia
History Collection
Physical Examination
Visual acuity testing
Refraction test
Retinoscopy
Slit lamp examination
Corneal topography
Explain the management of hypermetropia
Eye glasses
Convex glasses are used to correct hypermetropia. Convex glasses focus the light on the retina so that the image is clearly visible.
Contact lenses
Soft or rigid gas permeable contact lenses are used to correct hypermetropia.
Refractive surgery LASIK (laser assisted in situ keratomileusis) or PRK (photorefractive keratectomy) surgery is performed to correct hypermetropia.
Orthokeratology In orthokeratology, specifically designed rigid contact lenses are worn at night to temporarily reshape the cornea. Which provides clear vision during the day so there is no need to wear lenses or glasses during the day.
Explain the Nursing management of hypermetropia
To provide proper education to the child’s parents about the child’s condition.
Providing education to the child’s parents about regular eye examination of the child.
Advise the child to wear properly protective eye glasses.
Monitoring the child’s vision regularly.
Advising the child’s parents to take regular eye care of the child.
To provide proper work and comfortable environment to the child.
Astigmatism is a common imperfection in eye curvature.
Astigmatism is a type of refractive error in which the cornea or lens has an irregular shape that causes light rays to not focus properly on the retina. Because of which, even if viewed from any distance, the object appears blurry.
Explain the Etiology/ Cause of astigmatism.
Due to the irregularity in the septum of the cornea and lens of the eye,
Due to genetic factors,
Due to eye injury,
Due to certain eye conditions such as keratoconus,
Explain the clinical manifestations/ Sign and symptoms of astigmatism
Blurred or distorted vision
I strain
Head one
skinting,
fatigue,
Difficulty focusing on objects,
to see double vision,
Discomfort and irritation,
Impairment in the academic performance of the child,
Explain the management of astigmatism (right management of astigmatism)
Eye Glasses (Contact Lenses)
Contact lenses are used to correct astigmatism.
Refractive surgery Refractive surgery such as LASIK or PRK is performed to correct astigmatism to reshape the cornea. Apart from this, surgeries like RLE (refractive lens exchange) and IOL (intra ocular lens) implantation can also be done.
Explain the Nursing management of astigmatism
To properly collaborate with other health care personnel for proper care of the child.
To provide education to the child’s parents about the child’s condition and regular eye examination.
Giving advice to the child for proper eye care and hygiene.
Regular eye examination of the child.
Advising the child to maintain a properly healthy habit.
Advise the child to take a break against close work.
Advise the child to keep proper light during reading time.
To provide complete education to the parent about the child’s condition, its causes, symptoms and signs and child’s treatment.
To provide proper work and comfortable environment to the child.
Strabismus is also known as ‘crossed eye’ and ‘squint’.
Strabismus is a vision condition in which the eyes are misaligned, causing one or both eyes to turn inward, outward, upward, or downward. which affects depth perception and binocular vision.
Strabismus is a type of vision condition in which both eyes do not look in the same direction when looking in the same direction at the same time.
Explain the etiology/causes of strabismus (strabismus)
Family History (Genetic Factors)
Dysfunction of muscles controlling eye movement
Nerve injury that controls eye movement
Eye Injury and Trauma
Eye tumor
Refractive error
Congenital abnormality
Explain the clinical manifestations / signs and symptoms of strabismus
Misalignment of the eye,
double vision (diplopia),
Amblyopia (lazy eye)
Pure depth perception
Eye fatigue or strain
Abnormal head posture
Reduce visual acuity
Explain the diagnostic evaluation of strabismus.
History Collection
Physical Examination
Ocular Alignment Assessment
Visual acuity testing
Cover test
Ocular Magnitude Testing
Stereopsis test
Explain the management of strabismus.
Corrective lenses
If there is a refractive error due to strabismus, use prescription lenses or glasses to correct it.
Vision Therapy
Vision therapy involves exercises and activities to improve eye coordination, ability to focus, and depth perception. Vision therapy is primarily used in children to help retrain the eye and maintain proper alignment.
Pharmacological treatment
Pharmacological treatment involves eye drops and oral medications that help strengthen and relax the eye muscles.
Patching
If strabismus is due to amblyopia (lazy eye), eye patching is done to stabilize the weak eye. which encourages the brain to use the weak eye to improve vision and alignment.
Botulinum toxin injection
Botulinum toxin injection is given in some cases. Which temporarily weakens specific eye muscles and improves alignment.
Surgery
In surgery, the length and position of the eye muscles are adjusted and alignment is improved.
Explain the nursing management of strabismus.
Observation and monitoring
Continuous monitoring and observation of the child to assess the condition of the child.
Eye exercise
Ice exercise strengthens the child’s ice muscles and improves coordination on the ice.
Vision Therapy
Providing proper vision therapy to the child to improve the vision condition of the child.
Education and support
To provide complete education to the child and his family members about the child’s condition, its causes, symptoms and signs and treatment of the child.
Color blindness is also known as ‘Colour Vision Deficiency’. In color blindness, there is difficulty in distinguishing certain colors. A child with color blindness has difficulty distinguishing between certain colors, especially red and green or blue and yellow. Like reading traffic lights, identifying ripe fruits etc.
Explain the Etiology/causes of color blindness.
Color blindness is mainly found to be inherited.
Color blindness is also acquired in some cases.
Due to autosomal recessive inheritance,
No genetic mutation
due to,
Due to certain types of medicine,
Eye Disorders (Glaucoma, Macular Degeneration)
Eye injury
Certain medications
Explain the clinical manifestations / Sign and symptoms color blindness (tell the symptoms and signs of color blindness).
Difficulty in differentiating color
Reduce color perception
Confusion with color code information
Difficulty in Color Dependent Task,
get frustrated,
Explain the diagnostic evaluation of color blindness
History Collection
Physical Examination
Ishihar Color Test
Farnsworth Munsell 100 Hue test
Anomaloscope
Color Arrangement Test
Computerized Color Vision Test,
vision screening,
genetic testing,
Evaluation of the Other Disease Condition.
Explain the management of color blindness (right management of color blindness)
Education and Awareness
To provide complete education to the child and his family members about the child’s condition, its causes, its symptoms and signs, and its treatment.
If color blindness is inherited then it cannot be treated but if it is due to an underlying cause then the underlying cause is treated.
Color blindness cannot be corrected so we use adaptive technology and lifestyle modifications.
Adaptive Technology Adaptive technology uses specialized software or apps that adjust the colors on the screen and enhance readability.
Regular eye examination
Advising the parents of the child for regular eye screening and eye examination of the child.
Explain the nursing management of color blindness (write the nursing management of color blindness)
To provide properly supportive care and comprehensive care to children with color blindness.
To provide complete education to the child and his parents and caregivers about the child’s condition, its causes, symptoms and signs and its treatment.
Regular assessment of the child and its proper screening.
To provide a properly supportive environment to the child.
Advising the child on properly adaptive strategies.
Collaborate with other health care personnel for proper care of the child.
To provide proper work and comfortable environment to the child and provide properly supporting care.
Night blindness is also known as ‘nyctalopia’.
Night blindness is difficulty seeing in dark, dim or low light.
Explain the Etiology/causes of night blindness.
Vitamin A deficiency,
A genetic disorder, (retinitis pigmentosa),
Cataract,
glaucoma,
diabetes,
Age related macular degeneration,
birth defect,
Disorders Associated with Vitamin A Absorption.
Explain the clinical manifestations/ Sign and symptoms of night blindness.
Difficulty seeing in low light or dim light.
Difficulty seeing at night.
Straining to see in low light.
Impaired peripheral vision.
Darkness adaptive adaptation delay.
Poor peripheral vision loss.
Glare sensitivity.
Explain the diagnostic evaluation of night blindness.
History Collection
Physical Examination
Visual acuity test
Visual field test
Refraction test
Measurement of Vitamin A Levels
Electroretinography
Explain the management of night blindness.
Treat Underline Causes Treating the causes responsible for night blindness.
Vitamin A supplementation
Provide vitamin A supplement to correct vitamin A deficiency.
Protective measure
Use sunglasses and protective wear during the day and in bright light at night.
Vision Ed
In some cases use low vision aids like magnifying glass, night vision goggles. Which improves vision in low light.
Explain the Total blindness.
Total blindness means complete loss of vision in both eyes.
Blindness means visual acuity less than 3/60 (20/400).
Blindness means complete lack of light perception
Explain the Etiology/Causes of total blindness.
eye disease,
Retinal disease, (diabetic retinopathy, retinitis pigmentosa),
glaucoma,
Cataract
Corneal disease,
optic neuritis,
Neurological disorders (that affect the visual pathway),
Infection of the eye,
Congenital disease, (congenital glaucoma, cataract)
Exposure to certain toxins that affect the routine,
Explain the clinical manifestations/ Sign and symptoms of total blindness.
Lake of Response to the Light,
Inability to See,
Complete darkness and absence of visual stimuli,
Lake of visuals, response to steam.
Explain the diagnostic evaluation of total blindness
History Collection,
Physical Examination,
Ophthalmologic Examination,
Visual acuity test,
Visual field testing,
Electroretinography.
Explain the management of total blindness.
Management of total blindness includes practical adaptations, support systems and technology aids.
Orientation and Mobility Training
Providing training for safe and independent tool use like white cane, guide dog, mobility aids
Daily Living Skills Training
Providing training for daily living activities like cooking, cleaning, personal grooming
Emotional support and counselling
Vision loss is a challenge, hence counseling the patient and providing emotional support, guidance.
Braille Literacy
Braille enables individuals to read and write tactilely. So readable by touchtile.
Adaptive Technology Utilizing assistive technology. Like Screen Reader, Magnifiers, Braille Display.