Eye Conditions: Cataracts PDF

8/25/2024 Eye Conditions: Cataracts NU RS641 F NP1 Pre pared and Presente d by Lori -Jeanne West ©Lori-Jeanne West, 2024 Rep roduction of th is mater ia l is proh ibited w ith out the auth or’s co nse...

8/25/2024 Eye Conditions: Cataracts NU RS641 F NP1 Pre pared and Presente d by Lori -Jeanne West ©Lori-Jeanne West, 2024 Rep roduction of th is mater ia l is proh ibited w ith out the auth or’s co nsen t. Postin g or sharin g of these mate rials w itho ut the autho r’s con sen t is a copyright vio lation. Overview and Presentation Cataract is an opacity of the lens of the eye, may or may not have visual impairment, one or both eyes Leading cause of blindnes s worldwide More likely in Afric an American males and females of all ages Leading cause of visual impairment in African Americ ans, Americ an of Hispanic/Latino and European descent Risk Factors: cigarette smoking, diabetes, ex ces sive exposure to sunlight, long term corticosteroid use, prior intraocular surgery, eye trauma 1  8/25/2024 Overview and Presentation Nuclear Cataracts : centrally located, significant nearsightedness (myopia), and slow indolent course Cortical Cataracts: peripheral, asymmetric, radial, typic ally c ause wors e glare symptoms than other types Subcapsular Cataracts: anterior or posterior, associated with acute angle-closure glaucoma and cortic osteroid use, progress faster over months rather than years Physical Exam Gradual, painless, progressive loss of vision May be asymptomatic May present with visual changes and/or functional impairment Eye exam: lens opacity, vision testing, extraocular movement, pupillary size, and light reactivity Refer to ophthalmologist, sudden vision changes should be treated as an emergency Diagnostics Ophthalmologist: visual acuity testing, refraction, check intraocular pressure, dilated eye exam with slit lamp, fundus exam, glare testing, contrast sensitivity No single eye exam can establish need for cataract surgery, decision based on quality of life, perception of visual deficits, size/maturity of cataract 2  8/25/2024 Differentials Refractive Errors Glaucoma Retinopathy Age-related Macular Degeneration Diabetic Retinopathy Treatment Refe r to o phth almo logist Surg ery (safe, outp atien t procedure) – May need pre-op clearance by PCP for patients with comorbidities Minimal n onsu rgica l treatmen t options – Eyeglasses with tints to reduce glare – Handheld monoculars for distance vision – Magnifiers for near vision Patient Education Follow up with ophthalmologist within 48 hrs after cataract surgery, 4 weeks after procedure to evaluate need for corrective lenses Tight blood glucose control for patients with DM Smoking cessation Avoid excessive eye exposure to sunlight Multivitamin and mineral supplements may decrease risk of nuclear cataracts 3  8/25/2024 References Buttaro, T.M., Polgar-Bailey, P., S and berg -Cook, J., & Trybulski, J. (202 1). Primar y care: Interpro fess ion al collabor ative pr actice (6th ed.). Elsevier. Du nphy, L. M., Win land-Brow n, J. E., Porter, B. O., & Thomas, D. J. ( 2022). Primar y care: The ar t and science of advanced pr actice nurs in g and inter professional approach (6th ed.). F. A. Davis Company. 4