Name of the disease:
❖ Cataracts
Specific organ involved:
❖ Disorder that causes the lens or its capsule to lose its transparency and/or become opaque
❖ The lens is normally clear and transparent and allows light to pass through to the retina.
❖ As clouding develops, visual impairment occurs.
❖ Cataracts usually affect both eyes; however, the degree of visual impairment is often
❖ different in each eye.
Associated disorders:
❖ Diabetes mellitus
❖ Uveitis
❖ Maternal rubella during the first trimester of pregnancy
❖ Glaucoma
Cause and patho:
❖ Aging (senile cataracts)
❖ Exposure to ionizing radiation or nfrared rays
❖ Foreign body injury
❖ Genetic abnormalities
❖ intrauterine nutritional deficiencies
❖ Senile cataracts
➢ evidence of protein aggregation, oxdative injury, and increased pigmentation in the center
of the lens.
❖ Traumatic cataracts
➢ phagocytosis of the lens or inflammation may occur when a lens ruptures
❖ 4 stages of cataract development:
➢ Immature- the lens isn’t totally opaque
➢ Mature- the lens is completely opaque and vision loss is significant
➢ Tumescent- the lens is filled with water; may lead to glaucoma
➢ Hypermature- the lens proteins deteriorate, causing peptides to leak through the lens
capsule; glaucoma may develop if intraocular fluid outflow is obstructed
Risk factors:
❖ Family history of cataracts at a young age
❖ Aging
❖ Smoking
❖ Obesity
❖ High blood pressure
❖ Past eye injury or inflammation
❖ Previous eye surgery
❖ Steroid medication use
MEDICAL-SURGICAL MANAGEMENT
Diet (special diet/ food or fluid restriction)
❖ No specific diet or fluid restriction but encouraged to eat well balanced diet
Activity
❖ Avoid driving
❖ Avoid rigorous exercise and activities that require heavy lifting for a couple of weeks after
surgery
Surgery to be done (if any)
❖ Intracapsular cataract extraction
➢ Removal the lens within its capsule
❖ Extracapsular cataract extraction
➢ Removal of the anterior portion of the capsule and then expresses, or removal of the
lens. An intraocular lens is generally implanted. Glasses or special contact lenses also are
used
Possible medications
❖ Tranquilizer such as diazepam (Valium) or midazolam (Versed)
➢ To reduce anxiety when receiving injections on the face and around the eye.
❖ Mydriatic drugs such as Atropine, Mydrilate® (Cyclopentolate), Homatropine, Mydriacyl®
(Tropicamide
➢ makes pupil dilate
❖ Cycloplegic drugs such as Atropine sulfate, Homatropine Hydrobromide, Cyclopentolate
hydrochloride, and Tropicamide
➢ paralyzes ciliary muscle
❖ Antibiotic eyedrops such as Chloramphenicol, Erythromycin and Azithromycin
➢ as a prophylaxis against infection,
❖ Intravenous infusion of Mannitol
➢ to lower intraocular pressure
NURSING MANAGEMENT
★ ASSESSMENT
❖ Subjective data
● Haziness
● Cloudiness
● Blurred vision
● Double vision
● Altered color perception, and glare when looking at lights
❖ Objective data
● Black pupil appears clouded, progressing to a milky white appearance
POSSIBLE NURSING DIAGNOSIS
❖ Disturbed Sensory Perception (Visual) related to ocular lens opacity
❖ Risk for Injury related to difficulty in processing visual images and altered depth perception
❖ Impaired Home Maintenance related to age, limited vision, or activity restrictions imposed by
surgery
INTERVENTIONS
Independent nursing actions
Assess and document baseline visual acuity.
Elicit functional description of what the client can and cannot see
Teach the client to change position slowly.
Teach the client to avoid reaching for objects to maintain stability when ambulating, because
depth perception is altered.
Discuss the client’s ability to meet self-care needs and activiies of daily living.
Evaluate how the client’s current functional abilities are affected by activity restrictions and
postoperative care needs.
Help the client decide on a realistic site for postoperative care needs.