A cataract is the gradually developing opacity of the of the lens or lens capsule of the eye. It is the most common cause of correctable vision, loss. Cataracts commonly occur bilaterally, with each progression independently. The prognosis is generally good and surgery improves vision in 95% of affected people.
Nursing Care Plans
Treatment of cataract consists of surgical extraction of the cataractous lens opacity and intraoperative correction of visual deficits. The current trend is to perform the surgery as a same-day procedure. Nursing care revolves around patient education before and after surgery and providing safety.
Here are two (2) nursing care plans (NCP) for patients with cataracts:
Disturbed Sensory Perception: Visual
Disturbed Sensory Perception: Change in the amount or patterning of incoming stimuli accompanied by a diminished, exaggerated, distorted, or impaired response to such stimuli.
- Poor visual acuity
- Changes in the eyes due to aging
Possibly evidenced by
- Visual distortions
- Loss of vision
- Diminished visual acuity
- Night blindness
- Accommodation changes
- Changes in usual response to stimuli
- Presence of cataract
- Patient will regain optimal vision possible and will adapt to permanent visual changes
- Patient will be able to verbalize understanding of visual loss and diseases of eyes.
- Patient will be able to regain vision to the maximum possible extent with surgical procedure.
- Patient will be able to deal with potential for permanent visual loss.
- Patient will maintain a safe environment with no injury noted.
- Patient will be able to use adaptive devices to compensate for visual loss.
- Patient will be compliant with instructions given, and will be able to notify physician for emergency symptoms.
|Assess patient’s ability to see and perform activities.||Provides baseline for determination of changes affecting the patient’s visual acuity.|
|Encourage patient to see ophthalmologist at least yearly.||Can monitor progressive visual loss or complications. Decreases in visual acuity can increase confusion in the elderly patient.|
|Provide sufficient lighting for patient to carry out activities.||Elderly patients need twice as much light as younger people.|
|Provide lighting that avoids glare on surfaces of walls, reading materials, and so forth.||Elderly patient’s eyes are more sensitive to glare and cataracts diffuse and glare so that patient has more difficulty with vision.|
|Provide night light for patient’s room and ensure lighting is adequate for patient’s needs.||Patient’s eyes may require longer accomodation time to changes in lighting levels. Provision of adequate lighting helps to prevent injury.|
|Prepare patient for cataract surgery as warranted.||Provides knowledge, and facilitates compliance with regimen.|
|Instruct patient regarding normal age-related visual changes, cataracts, and methods of dealing with visual acuity changes.||Helps increase the patient’s understanding of visual changes and to make informed choices about options as the patient ages, the lens becomes more dense and has less elasticity thus accommodation is decreased.|
Presbyopia is an age related change that begins in people who are in their 40s and progresses. Visual acuity changes occur as the eye becomes more hyperopic as a result of neurologic changes in the visual pathways of the brain. The ability to distinguish fine details decreases because of loss of neurons in the visual pathways in the brain.
Vitreous humor changes related to aging occur and consist of haziness, vertical flashing lights, line spots, or clusters of moving dots. The ability to differentiate colors also decreases with age because the cones that are responsible for color vision decline in sensitivity. In patients over 60, the lens may become yellowed from age, which results in blue objects appearing gray. Visual field decreases by approximately 1-3 inches per decade after 50.
|Provide large print objects and visual aids for teaching.||Assists patient to see larger print, and promotes sense of independence.|
|If surgery is planned, instruct patient and/or family regarding procedure, post-procedure care, and the need for follow-up with physician.|
Instruct about complications and emergency signs and symptoms (flashing lights with loss of vision, seeing a “veil” falling over visual field, loss of vision in a specific portion of the visual field, etc.) of which to notify physician.
|Prepares patient for what to expect, facilitate compliance, and provides instruction about potential problems to lessen anxiety.|
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Ophthalmic Care Plans
Care plans relating to eye disorders: