In the second major blow to handicapped persons in a week, the Supreme Court yesterday refused to review the case of a Richmond nurse who was fired because she was losing her eyesight.

In a 7-to-2 vote, the court left standing a ruling by the 4th U.S. Circuit Court of Appeals dismissing a lawsuit brought by the nurse. Justics Potter Stewart and Thurgood Marshall voted in favor of review.

The case involved a section of the Rehabilitation Act of 1973, which prohibits employment discrimination against the handicapped in any federally aided program or activity.

Last week, in a case involving the same section, the court held unanimously that educational institutions are not required to lower or substantially modify their standards to admit the handicapped.

In yesterday's case, the American Civil Liberties Union, representing nurse Novella H. Trgeser, argued that Trageser's employer, having accepted federal funds, fired her illegally.

Trageser's vision is impaired by a hereditary disease known as retinitis pigmentosa.

In 1976, a Virginia state health inspector told the Libbie Convalescent Home, that Trageser's eyesight had worsened since his last inspection. Reportedly he inquired what the employer was going to do about it.

Soon afterward, the board of the home's parent corporation - a recipient of Social Security payments and Veterans Administration Benefits - voted to dismiss Trageser.

On hearing that she was to be dismissed, Trageser resigned and filed a lawsuit alleging that her termination violated Section 504 of the Rehabilitation Act. The suit was later dismissed by U.S. District Judge D. Dortch Warriner.

Last December, the 4th Circuit Court of Appeals upheld Warriner. It ruled that under a 1978 amendment to that act, Section 504 implied that a private citizen is entitled to bring suit only when "a primary objective of the federal financial assistance is to provide employment."

Yesterday the supreme Court in effect agreed.

In a friend of the court brief asking the court to overturn the 4th Circuit decision, the Justice Department argued that the appeals court ruling placed a "severe limitation" on Section 504 and was contrary on the intent of Congress in enacting the law.