Case Study Eyes 11

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Case Study: The Eyes

1. A nurse is preparing an educational presentation on “Eye Health


Promotion, Disease Prevention, and Education” focusing on various age
groups. In order to maximize the effect of the presentation, the nurse
plans to provide separate presentations to address the issues regarding
children and those regarding the older adult. (Learning Objective 5)

a. What topics should the nurse include in the child-focused


presentation?

 ANSWER: The nurse should include the following topics in the child-
focused presentation:
o Vision screenings for:
 Amblyopia
 Strabismus
 Refractive errors
o Eye protection:
 Chemical burns
 Blunt object trauma
 Cuts around/directly to the eye
 Avoidance of direct sunlight
 Sunglasses to protect the eyes.

b. What topics should the nurse include in the older adult-focused


presentation?

a. ANSWER: The nurse should include the following topics in the


older adult–focused presentation:
o Vision screenings for:
 Refractive errors
 Cataracts
 Macular degeneration
 Glaucoma
o Eye protection:
 Chemical burns
 Blunt object trauma
 Cuts around/directly to the eye
 Avoidance of direct sunlight
 Sunglasses to protect the eyes
o Care of contact lenses:
 Wash hands when inserting or removing lenses.
 Wear and remove lens as prescribed by the health
care provider.
 Clean lens as directed by health care provider/lens
manufacturer.
 Do not share contacts.
 Unused solutions should be discarded at the expiration
date.

2. During a routine physician check-up, the patient is asked when was the
last time he had an eye exam. This patient has a history of diabetes and
states he has “floaters” in his eyes. The ophthalmologist diagnoses the
patient with moderate nonproliferative retinopathy. How will you describe
this finding to the patient in terms he can understand? (Learning
Objective 3)

ANSWER: Moderate nonproliferative retinopathy is essentially a


progression from a milder stage.
 The blood vessels in the eye are damaged from microaneurysms (small
saccular outpouchings). These miniature aneurysms can rupture and
leak blood into the macula, the center of the retina that is responsible
for central vision.
 Just like a damaged garden hose, the damaged blood vessels
surrounding the macula leak, and fluid accumulates around the
surrounding macular tissue, causing it to swell and create blurry vision.
 The danger is that such damage can result in reduced blood flow to the
surrounding retinal tissue, leading to vision loss.
 This is called diabetic macular edema and it can occur at any stage of
diabetic retinopathy.
 It is the most common cause of reduced vision in people with diabetes.

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