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What is a Cataract?
Opacity or clouding within crystalline lens
Lens are normally ____ and _______
Clear & transparent
Lens becomes _____ with _______ vision
Third leading cause of blindness is ?
What are some influencing factors of cataracts?
- Blunt trauma, toxins, systemic disease
- Diabetes, smoking
What is a Congenital factor for cataracts?
Exposure to maternal rubella
What are other contributing factors?
- Radiation/UV light exposure
- Long-term systemic or topical corticosteroid use
- Intraocular inflammation
The most common type of cataract is ?
What causes senile cataract formation?
Altered metabolic processes
List Clinical Manifestations of cataracts (5)
- Decrease in vision, blurred vision
- Photosensitivity, diplopia
- Abnormal color perception
- Glaring of vision
- Difficulty driving at night or when pupil dilates due to light scatter
Reasons why cataracts go undetected (3)
- they are Painless
- Visual decline is gradual
- Cataract development varies from pt to pt
What are some subjective data in assessing for cataracts?
- Blurred vision- often 1st symptom
- Hazy or fuzzy
What are some objective data in assessing for cataracts?
- Does pt bring newspaper close to eyes?
- Do you note pt having difficulty reading?
- C/O sensitivity to light
Diagnostic Studies used for cataracts?
- History and physical examination
- c/o of visual dysfunction
- Visual acuity measurement
- Ophthalmoscope studies
- Slit lamp microscope
- Appearance of white pupil
- Glare testing
What are the non-surgical cures for cataracts?
There is not a nonsurgical “cure”
How are cataracts treated if surgery is not an option?
- Visual aids (palliative)
- Reading glasses
- Increased lighting
What is the only definitive method of treatment?
- Surgical Therapy
- Performed at any age
- Local, topical or general anesthesia
During the preoperative phase preparations should include?
- History and physical exam
- Evaluate and control other medical problems
- Preoperative antibiotic eye drops
- Dilating drops administered
- Nonsteriodal anti-inflammatory eye drop
An alpha-adrenergic agonist that produces pulillary dilation by constriction of the iris dilator muscles?
What is the cycloplegic drug that is used in treating cataracts?
An anticholinergic agent that produces paralysis of accommodation by blocking the effect of acetylcholine on the ciliary body muscles.
What are the surgical procedures used for cataracts?
What is Extracapsular?
Most common surgical procedure for cataracts. Healing is rapid
What is the ultrasound procedure used to break up and remove lenses?
Phacoemulsification. Self healing
Intraoperative phase include these steps
- Corneoscleral incision
- Cataract extracted and sutured
- Cortex irrigated and aspirated
- Corticosteroid ointment applied with protective shield
____________ ___________ is an intraocular procedure
When is intracapsular extraction performed?
Usually only in cases of trauma
- Outpatient procedure unless complications occur
- Antibiotic and corticosteroid eye drops
- 6- to 8-week follow-up
A nurse will assess for these after surgery of cataracts
- Visual acuity
- Psychosocial impact of visual disability
- Level of knowledge of disease
- Comfort and ability to comply with postop treatment
Cataracts Nursing Diagnoses
- Risk for injury
- Self-care deficits
- Anxiety of upcoming surgery and recovery
Nursing management preoperative goals
- Make informed decisions regarding therapeutic options
- Experience minimal anxiety
Nursing management Postoperative goals
- Understand and comply with postoperative therapy
- Maintain level of comfort
- Free of infection and other complications
Nursing Management Implementation Health promotion
- Wear sunglasses
- Avoid unnecessary radiation
- Adequate antioxidant vitamins
- Good nutrition
Nursing Management Implementation for Acute intervention
- Educate about disease process and treatment options
- Administer mydriatics using punctal occlusion
- Teach signs and symptoms of infection
Nursing Management information on long-term eye care
- Activity restrictions
- Follow-up visits
- S/S of possible complications
Teaching for ambulatory and home care
- Educate on postoperative visual acuity
- Instruct family to modify activities and environment
- Remove area rugs
- Prepare frozen meals
- Provide audio books
Goals after cataract surgery
- Improved vision
- No injury
- Ability to care for self
- Minimal to no pain
- Optimistic expectations