Nursing Care Plan

Nursing Care Plan for Cataracts

Cataract is the medical term for each state turbidity occurs in the eye lens that can occur as a result of hydration (adding liquid lens), the lens protein denaturation, or can also be a result of both. Usually on both eyes and walked progressive. Cataracts cause the patient can not see clearly because of the cloudy lens is difficult light reaches the retina and will produce a blurred shadow on the retina. The number and shape of the eye lens opacities in each may vary.

Causes of Cataracts

• Aging (Senile Cataracts): Most cataracts occur due to degenerative process or the age of a person. The average age of a cataract is at age 60 years and older.
• Trauma: Eye injury can be informed of all ages such as a hard blow, puncture objects, clipped, high heat, and chemicals can damage the eye and the lens is called cataract traumatic circumstances.
• Other eye diseases (uveitis)
• Systemic disease (Diabetes Mellitus).
• Congenital defects.

Cataract is diagnosed mainly by subjective symptoms. Clients reported a decrease in visual acuity and glare as well as some degree of functional impairment caused by loss of vision. Objective findings usually include condensation so that the retina would not be visible with the ophthalmoscope.

Cataracts usually develop gradually over the years and when the cataract has greatly deteriorated more powerful lens would not be able to improve vision. Common symptoms of cataracts include:

• Vision is not clear, as there is a fog blocking objects.
• Sensitive to light.
• Can see the double in one eye (diplopia).
• Require bright lighting to be able to read.
• Eyepiece turned into opaque like milk glass.

Impaired vision can be:

• Difficulty seeing at night.
• See the circle around the light or feel dazzle.
• Decreased visual acuity (even in daylight).
• Frequent sight in one eye.
• Sometimes cataract lens causing swelling and increased pressure in the eye (glaucoma), which can cause pain.

Nursing Diagnosis : Disturbed Sensory Perception : Visual related to disorders of sensory reception / status sensory organs.

Goal:

• Improving visual acuity within the limits of individual situations, recognize sensory disturbances and compensate for changes.

Expected outcomes:

• Know the sensory disturbances and compensate for changes.
• Identify / fix potential hazards in the environment.

Nursing Interventions :

1. Determine the visual acuity, and note whether one or two eyes are involved. Observe signs of disorientation.
Rational: The discovery and early treatment of complications can reduce the risk of further damage.

2. Orient the client to the environment.
Rationale: Improving safety and mobility in the environment.

3. Notice of blurred vision and eye irritation, which can occur when using eye drops.
Rational: strong light causes discomfort after use eye drops dilator.

4. Place the items needed / call bell within reach position / positions that are not operated.
Rational: Communications addressed can be more readily accepted by the obvious.

Cataract


A cataract is a clouding of the lens in your eye. It affects your vision. Cataracts are very common in older people. By age 80, more than half of all people in the United States either have a cataract or have had cataract surgery.

Common symptoms are

• Blurry vision
• Colors that seem faded
• Glare
• Not being able to see well at night
• Double vision
• Frequent prescription changes in your eye wear

Cataracts usually develop slowly. New glasses, brighter lighting, anti-glare sunglasses or magnifying lenses can help at first. Surgery is also an option. It involves removing the cloudy lens and replacing it with an artificial lens. Wearing sunglasses and a hat with a brim to block ultraviolet sunlight may help to delay cataracts.

NIH: National Eye Institute


Having cataracts is often compared to looking through a foggy windshield of a car or through the dirty lens of a camera. Cataracts may cause a variety of complaints and visual changes, including blurred vision, difficulty with glare (often with bright sun or automobile headlights while driving at night), dulled color vision, increased nearsightedness accompanied by frequent changes in eyeglass prescription, and occasionally double vision in one eye. Some people notice a phenomenon called "second sight" in which one's reading vision improves as a result of their increased nearsightedness from swelling of the cataract. A change in glasses may help initially once vision begins to change from cataracts; however, as cataracts continue to progress and opacify, vision becomes cloudy and stronger glasses or contact lenses will no longer improve sight.

Cataracts are usually gradual and usually not painful or associated with any eye redness or other symptoms unless they become extremely advanced. Rapid and/or painful changes in vision are suspicious for other eye diseases and should be evaluated by an eye-care professional.

To detect a cataract, the eye-care provider examines your lens. A comprehensive eye examination usually includes the following:

• Visual acuity test: An eye chart test is used to measure your reading and distance vision.
• Refraction: Your eye doctor should determine if glasses would improve your vision.
• Glare testing: Vision may be significantly altered in certain lighting conditions and normal in others; in these circumstances, your doctor may check your glare symptoms with a variety of different potential lighting sources.
• Potential acuity testing: This helps the ophthalmologist get an idea of what your vision would be like after removal of the cataract. Think of this as the eye's vision potential if the cataract was not present.
• Contrast sensitivity testing: This checks for your ability to differentiate different shades of gray, which is often this limited by cataracts.
• Tonometry: a standard test to measure fluid pressure inside the eye (Increased pressure may be a sign of glaucoma.)
• Pupil dilation: The pupil is enlarged with eye drops so that the ophthalmologist can further examine the lens and retina. This is important to determine if there are other conditions which may ultimately limit your vision besides cataracts.

Source : http://www.emedicinehealth.com/cataracts/page6_em.htm#Exams and Tests

1. Objective data: patient's eye's lens appears cloudy. Both pupils appear to look gray.

Subjective data: patients complaining blurred vision / dim and decreased visual acuity and glare, the patient is difficult to see at night.