Clinical Manifestations and Diagnostic Examination of Cataract

Cataract is the name given to a clouding of the lens resulting in a reduction in visual acuity by a screen which is lowered in the eyes, like seeing the falls.

Type of cataract is the most common senile cataract and senile cataract is a degenerative process (deterioration). The changes coincided with presbyopia, but besides that it also becomes yellow and cloudy color, which would interfere with the refraction of light.

Although the so-called senile cataract but earlier changes can occur in middle age, at the age of 70 years most people have experienced changes in the lens even though it may only cause slight vision impairment.

Etiology of Cataract

• Aging (senile cataract).
• Trauma.
• Other eye diseases (uveitis).
• Systemic disease (diabetes).
• Congenital defect (a hereditary disorder as a result of prenatal viral infection, such as German Measles).

Clinical Manifestations of Cataract

Cataract is diagnosed primarily by subjective symptoms. Usually clients reported a decrease in visual acuity and glare as well as some degree of functional impairment caused by loss of vision earlier. Objective findings usually include condensation pearly gray on the pupil so that the retina would not appear with the ophthalmoscope. When the lens has become opaque, light will be open, be transmitted with a sharp focused image on the retina. The result is blurred vision or dim, glare is annoying eye shadow with distortion and hard look at night. Pupils are normally black will look gray or white.

Diagnostic Examination of Cataract

• Snellen eye chart / tele binocular eye machine: may be impaired by damage to the cornea, lens, aqueous / vitreous humor, refractive error, nervous system disease, vision to the retina.
• Field of vision: the decline may be due to the tumor mass, carotid, glaucoma.
• Tonograph: IOP (12-25 mmHg)
• Gonioscopy measurements from the point distinguishes open-angle glaucoma closed.
• Provocative test: determining the presence / type of glaucoma.
• Ophthalmoscopy: examines the internal structure of the ocular, optic disc atrophy, papilledema, bleeding.
• Complete blood, LED: indicates anemia systemic / infection.
• ECG, serum cholesterol, lipids.
• Glucose tolerance test: controls of DM.

Read More..

4 Cataract Nursing Diagnosis and Interventions

4 Nursing Diagnosis and Interventions for Cataracts

1. Nursing Diagnosis for Cataract: Anxiety related to lack of knowledge.
   
   Goal:
   
   1. Lowering the emotional stress, fear and depression.
   2. Acceptance and understanding instructions surgery.
   
   Nursing Interventions for Cataract:
   
   1. Assess the degree and duration of visual impairment. Encourage conversation to find out the patient's concerns, feelings, and the level of understanding.
   Rational: Information can eliminate the fear of the unknown. Coping mechanisms can help patients with kegusara compromise, fear, depression, tension, despair, anger, and rejection.
   
   2. Orient the patient to the new environment.
   Rationale: The introduction to the environment helps reduce anxiety and increase security.
   
   3. Explain the perioperative routines.
   Rationale: Patients who have a lot of information easier to receive treatment and follow instructions.
   
   4. Describes intervention much detail as possible.
   Rationale: Patients who experience visual disturbances rely on other senses salts input information.
   
   5. Push to perform daily living habits when able.
   Rationale: Self-care and will increase the sense of healthy independence.
   
   6. Encourage participation of family or the people who matter in patient care.
   Rationale: Patients may not be able to perform all duties in connection with the handling of personal care.
   
   7. Encourage participation in social activities and diversion whenever possible (visitors, radio, audio recording, TV, crafts, games).
   Rationale: Social isolation and leisure time is too long can cause negative feelings.
2. Nursing Diagnosis for Cataract: Risk for injury related to blurred vision
   
   Goal: Prevention of injury.
   
   Nursing Intervenion for Cataract:
   
   1. Help the patient when able to do until postoperative ambulation and achieve stable vision and adequate coping skills, using techniques of vision guidance.
   Rational: Reduce the risk of falling or injury when the step stagger or have no coping skills for vision impairment.
   
   2. Help the patient set the environment.
   Rationale: Providing facilities of independence and lower the risk of injury.
   
   3. Orient the patient in the room.
   Rationale: Improving safety and mobility in the environment.
   
   4. Discuss the need for the use of metal shields or goggles when instructed
   Rational: shield l; ogam or goggles protect the eyes against injury.
   
   5. Do not put pressure on the affected eye trauma.
   Rational: The pressure in the eye may cause further serious damage.
   
   6. Use proper procedures when providing eye drugs.
   Rational: Injury can occur if the container touch the eye medication.
3. Nursing Diagnosis for Cataract: Acute pain related to trauma to the incision and increased IOP
   
   Goal: Reduction of pain and the IOP.
   
   Nursing Interventions for Cataract:
   
   1. Give medications to control pain and the IOP as prescribed.
   Rational: Use the recipe will reduce pain and the IOP and increase comfort.
   
   2. Give cold compress on demand for blunt trauma.
   Rational: reduce the edema will reduce the pain.
   
   3. Reduce the level of pencayahaan
   Rationale: The level of lighting is more nyakan lower after surgery.
   
   4. Encourage use of sunglasses in strong light.
   Rasioanal: Strong light causes discomfort after use of eye drops dilator.
4. Nursing Diagnosis for Cataract: Risk for infection related to trauma to the incision
   
   Goal: Complications can be avoided or promptly reported to the doctor.
   
   Nursing Interventions for Cataract:
   
   1. Maintain strict aseptic technique, do wash your hands frequently.
   Rationale: It would minimize infection.
   
   2. Supervise and report immediately any signs and symptoms of complications, such as: bleeding, increased IOP or infection.
   Rational: The discovery of early complications can reduce the risk of permanent vision loss.
   
   3. Explain the recommended position.
   Rational: Elevation of the head and avoid lying on the side of the operation may reduce the edema.
   
   4. Instruct the patient to know bedrest activity restrictions, with flexibility to the bathroom, according to a gradual increase in activity tolerance.
   Rational: Limitation of activity prescribed to speed healing and avoid further damage to the injured eye.
   
   5. Describe the actions that should be avoided, as prescribed by coughing, sneezing, vomiting (ask for medication for it).
   Rational: It can lead to complications such as vitreous prolapse or dehisensi injury due to increased tension on the suture wounds that are very subtle.
   
   6. Give medications as prescribed, according to prescribed techniques.
   Rational: Drugs are administered in a way that is inconsistent with prescriptions can interfere with healing or cause complications.

Read More..