2 Macular Degeneration Nursing Care Plans

Use this nursing care plan and management guide to provide care for patients with macular degeneration. Enhance your understanding of nursing assessment, interventions, goals, and nursing diagnosis, all specifically tailored to address the unique needs of individuals with mecular degeneration.

What is Macular Degeneration?

Macular degeneration is a progressive eye disease wherein the central portion of the retina gradually deteriorates. There are two types of age-related macular degeneration that occur. The dry or atrophic form is characterized by atrophic pigment epithelial changes and is most often associated with slow, progressive, and mild vision loss. The wet type is characterized by subretinal neovascularization that causes leakage, hemorrhage, and fibrovascular scar formation, which produce a significant loss of central vision.

Nursing Care Plans and Management

Nursing management of macular degeneration involves educating the patient about the condition, its progression, and the importance of regular eye exams. Nurses can also provide support in managing visual impairments through strategies such as providing low-vision aids, promoting adequate lighting, and referring patients to vision rehabilitation services.

Nursing Problem Priorities

The following are the nursing priorities for patients with macular degeneration:

• Recognize and assess macular degeneration
• Monitor visual changes
• Educate patients about macular degeneration
• Provide support for optimizing visual function

Nursing Assessment

Assess for the following subjective and objective data:

• Blurred central vision
• Distorted or wavy lines
• Dark or empty areas in the central vision
• Difficulty recognizing faces or reading fine print
• Decreased color perception
• Visual hallucinations (rare)
• Straight lines appear crooked or wavy

Nursing Diagnosis

Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with macular degeneration based on the nurse’s clinical judgement and understanding of the patient’s unique health condition. While nursing diagnoses serve as a framework for organizing care, their usefulness may vary in different clinical situations. In real-life clinical settings, it is important to note that the use of specific nursing diagnostic labels may not be as prominent or commonly utilized as other components of the care plan. It is ultimately the nurse’s clinical expertise and judgment that shape the care plan to meet the unique needs of each patient, prioritizing their health concerns and priorities.

Nursing Goals

Goals and expected outcomes may include:

• The patient will regain the optimal vision possible and will adapt to permanent visual changes
• The patient will be able to verbalize understanding of visual loss and diseases of the eyes.
• The patient will be able to regain vision to the maximum possible extent with the surgical procedure.
• The patient will be able to deal with the potential for permanent visual loss.
• The patient will maintain a safe environment with no injury noted.
• The patient will be able to use adaptive devices to compensate for visual loss.
• The patient will be compliant with the instructions given and will be able to notify the physician of emergency symptoms.
• The patient will be free of injury and will be able to perform activities within the parameters of sensory limitation.
• The patient will be able to be free of injury.
• The patient and/or family will be able to modify the environment to ensure patient safety.

Nursing Interventions and Actions

Therapeutic interventions and nursing actions for patients with macular degeneration may include:

1. Assessing Visual Acuity and Optimizing Visual Perception

Macular degeneration is characterized by a progressive loss of central vision, resulting in decreased visual acuity. Patients may experience blurred or distorted vision, making it challenging to read, recognize faces, or see fine details. Visual perception may also be affected, resulting in difficulties with depth perception, color perception, and overall visual interpretation. These changes can significantly impact a person’s ability to perform daily activities and tasks that rely on clear and accurate vision.

Assess the patient’s ability to see and perform activities.
Provides a baseline for the determination of changes affecting the patient’s visual acuity.

Assist in diagnostic procedures and provide appropriate information:

• Indirect ophthalmoscope
  Fundus examination through a dilated pupil may reveal gross macular changes.
• Amsler’s grid
  Used to monitor visual field loss.
• I.V. fluorescein angiography
  Sequential photographs may show leaking vessels as fluorescein dye flows into the tissues from the subretinal neovascular net.

Encourage the patient to see an ophthalmologist at least yearly.
Can monitor progressive visual loss or complications. Decreases in visual acuity can increase confusion in elderly patients.

Provide sufficient lighting for the 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 patients’ eyes are more sensitive to glare and cataracts diffuse glare so the patient has more difficulty with vision.

Provide night light for the patient’s room and ensure lighting is adequate for the patient’s needs.
Patients’ eyes may require longer accommodation time to changes in lighting levels. The provision of adequate lighting helps to prevent injury.

Provide large print objects and visual aids for teaching.
Assists patient to see larger print and promotes a sense of independence.

Provide information about laser surgery.
Laser surgery may be helpful for the wet type of macular degeneration if done early. Approximately only 20% of patients will have any improvement in visual function if done later.

2. Preventing Injuries

Patients with Macular Degeneration are at prone to injury due to several factors. Firstly, decreased vision, particularly central vision, can impair a patient’s ability to navigate their environment safely and increase their risk of falls and accidents. Secondly, aging can further exacerbate vision changes and lead to decreased visual acuity, making it more difficult for patients to perceive potential hazards. Lastly, the disease process itself can impact the function of the macula, leading to progressive vision loss and further increasing the risk of injury.

Assess the patient for the degree of visual impairment.
Increases awareness of the problem, and identifies severity to allow for the establishment of a plan of care.

Inform about special devices that can be used.
Low-vision optical aids are available to improve the quality of life in patients with good peripheral vision.

Ensure the room environment is safe with adequate lighting and furniture moved toward the walls. Remove all rugs, and objects that could be potentially hazardous.
Provides a safe environment to reduce the potential for injury.

Keep the patient’s glasses and call bell within easy reach.
Provides assistance for the patient and for optimal visual acuity.

Instruct the patient and/or family regarding the need to maintain a safe environment.
Reduced visual acuity puts the patient at risk for injury.

Instruct patient and/or family regarding safe lighting. The patient should wear sunglasses to reduce glare. Advise family to use contrasting bright colors in household furnishings.
These techniques help enhance visual discrimination and reduce the potential for injury.

After surgery to extract a cataract: 

• Remind the patient to attend a checkup the following day after surgery.
  Because the patient will be discharged after he recovers from anesthesia post-op. Warn him to avoid activities that increase intraocular pressure.
• Instruct the patient to wear a plastic or metal shield over the eye with perforations; a shield or glasses should be worn for protection during the day.
  To protect the eye from accidental injury.

Teach the patient how to administer antibiotic ointment or drops; including steroids.
To prevent infection and inflammation.

Instruct the patient to watch out for the development of complications, such as sharp pain in the eye uncontrolled by analgesics, or clouding in the anterior chamber.
This may indicate infection and should be reported immediately.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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Ackley & Ladwig’s Nursing Problems & Care Planning Handbook
The newest edition (2026) of Ackley and Ladwig’s evidence-based guide, now organized around nursing problems, with outcomes and interventions for common client conditions.

Nursing Care Plans: Diagnoses, Interventions, and Outcomes
The 2025 edition of Gulanick and Myers’ care plan collection, covering medical-surgical conditions and nursing diagnoses with assessments, outcomes, interventions, and rationales.

Nurse’s Pocket Guide: Problems, Diagnoses, Prioritized Solutions, and Rationales
The 2025 edition of Doenges’ compact pocket reference for finding nursing problems and diagnoses fast, with prioritized interventions and rationales for clinicals.

Nursing Diagnosis Manual: Identifying Problems and Individualizing Care
The 2025 edition of Doenges’ guide to identifying client problems and individualizing care, with assessment cues, desired outcomes, and interventions for each diagnosis.

Swearingen’s All-in-One Nursing Care Planning Resource
Care plans for medical-surgical, pediatric, maternity, and psychiatric-mental health clients in one book, including interprofessional client problems.

Nursing Care Plans: Guidelines for Individualizing Client Care Across the Life Span
The 2024 edition of Doenges’ care plan guide for clients across the life span, with sample plans that show how to individualize care.

See also

Other recommended site resources for this nursing care plan:

Other ophthalmic nursing care plans:

• Cataracts
• Glaucoma
• Macular Degeneration