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
Nursing management of macular degeneration involves supportive lifestyle changes to adapt to the decrease in vision, unless the degeneration is new and caused by abnormal blood vasculature, then laser surgery can sometimes slow or halt the deterioration by sealing off the leaking vessels. Reversal of damage that has already occurred is not possible.
Risk for Injury
May be related to
- macular degeneration
- decreased vision
- decreased central vision
- Retinal hemorrhage
- Visual distortion
- Presence of drusen
- Decreased visual acuity
- Decreased visual fields
- Decreased central vision
- Patient will be free of injury and will be able to perform activities within parameters of sensory limitation.
- Patient will be able to be free of injury.
- Patient and/or family will be able to modify the environment to ensure patient safety.
|Assess patient for 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 the patient 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 patient’s glasses and call bell within easy reach.||Provides for assistance for the patient and for optimal visual acuity.|
|Instruct 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:|
||Because the patient will be discharged after he recovers from anesthesia post-op. Warn him to avoid activities that increase intraocular pressure.|
||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 patient to watch out for 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.|
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Ophthalmic Care Plans
Care plans relating to eye disorders: