AMALTAS INSTITUTE OF NURSING SCIENCES
BANGAR DEWAS [M.P.]
SESSION - 2022-2023
SEMINAR
ON
cataract
SUBMITTED TO
DR MOHHAMAD MOHASIN KHAN
HEAD OF DEPARTMENT
NURSING EDUCATION
SUBMITTED BY
Miss AKANKSHA CHAVHAN
[Link] 1ST YEAR
AIMS DEWAS
Introduction :-
• A cataract is a dense, cloudy area that forms in the lens of the eye. A cataract begins when
proteins in the eye form clumps that prevent the lens from sending clear images to the
retina. The retina works by converting the light that comes through the lens into signals.
It sends the signals to the optic nerve, which carries them to the brain. It develops slowly
and eventually interferes with your vision. You might end up with cataracts in both eyes,
but they usually don’t form at the same time. Cataracts are common in older people.
Over half of people in the United
States have cataracts or have undergone cataract surgery by the time they’re 80 years
old, according to the National Eye Institute.
Definition :-
Cataract: A clouding or loss of transparency of the lens in the eye as a result of tissue
breakdown and protein clumping. There are many causes of cataracts, including aging,
cortisone medication, trauma, diabetes, and other diseases. Cataracts affect most people
who live into an old age. Symptoms include double or blurred vision and sensitivity to light
and glare. A physician can diagnose cataracts by examining the eyes with a viewing
instrument. Sunglasses can help to prevent cataracts.
Symptoms of Cataracts
Common symptoms of cataracts include:
• blurry vision
• trouble seeing at night
• seeing colors as faded
• increased sensitivity to glare
• halos surrounding lights
• double vision in the affected eye
• a need for frequent changes in prescription glasses
Causes Cataracts :-
There are several underlying causes of cataracts. These include:
• an overproduction of oxidants, which are oxygen molecules that have been chemically
altered due to normal daily life
• smoking
• ultraviolet radiation
• the long-term use of steroids and other medications
• certain diseases, such as diabetes
• trauma
• radiation therapy
Types of Cataracts:-
There are different types of cataracts. They’re classified based on where and how they develop
in your eye.
• Nuclear cataracts form in the middle of the lens and cause the nucleus, or the center, to
become yellow or brown.
• Cortical cataracts are wedge-shaped and form around the edges of the nucleus.
• Posterior capsular cataracts form faster than the other two types and affect the back of
the lens.
• Congenital cataracts, which are present at birth or form during a baby’s first year, are
less common than age-related cataracts.
• Secondary cataracts are caused by disease or medications. Diseases that are linked with
the development of cataracts include glaucoma and diabetes. The use of the steroid
prednisone and other medications can sometimes lead to cataracts.
• Traumatic cataracts develop after an injury to the eye, but it can take several years for
this to happen.
• Radiation cataracts can form after a person undergoes radiation treatment for cancer.
Risk Factors of Cataracts :-
Risk factors associated with cataracts include:
• older age
• heavy alcohol use
• smoking
• obesity
• high blood pressure
• previous eye injuries
• a family history of cataracts
• too much sun exposure
• diabetes
• exposure to radiation from X-rays and cancer treatments
Diagnosing Cataracts :-
perform a comprehensive eye exam to check for cataracts and to assess your vision. This will
include an eye chart test to check your vision at different distances and tonometry to measure
your eye pressure.
The most common tonometry test uses a painless puff of air to flatten your cornea and test
your eye pressure. Your doctor will also put drops in your eyes to make your pupils bigger. This
makes it easier to check the optic nerve and retina at the back of your eye for damage.
Other tests your doctor might perform include checking your sensitivity to glare and your
perception of colors.
Prevention of Cataracts :-
To reduce your risk of developing cataracts:
• protect your eyes from UVB rays by wearing sunglasses outside
• have regular eye exams
• stop smoking
• eat fruits and vegetables that contain antioxidants
• maintain a healthy weight
• keep diabetes and other medical conditions in check
Medical Management :-
Pharmacologic Therapy
Medications administered pre and postoperatively are:
• Dilating drops. Dilating drops are administered every 10 minutes for four doses at
least 1 hour before surgery.
• Antibiotic drugs. Antibiotic drugs may be administered prophylactically to prevent
postoperative infection and inflammation.
• Intravenous sedation. Sedation may be used to minimize anxiety and discomfort
before surgery.
Surgical Management
Common surgical procedures done to correct cataracts:
Phacoemulsification
• Lens replacement. There are three lens replacement options:
• Phacoemulsification. A portion of the anterior capsule is removed, allowing
extraction of the lens nucleus and cortex while the posterior capsule and zonular
support are left intact.
o Aphakic glasses. In aphakic glasses, objects are magnified by 25%, making
them appear closer than they actually are.
o Contact lenses. Contact lenses provide patients with almost normal vision,
but because contact lenses need to be removed occasionally, the patient
also needs a pair pf aphakic glasses.
o IOL implants. The most common IOL is the single focus lens or monofocal
IOL that cannot alter the visual shape; multifocal IOLs reduce the need for
eyeglasses; accommodative IOLS mimic the accommodative response of
the youthful, phakic eye.
• Extracapsular cataract extraction (ECCE).ECCE removes the anterior lens and cortex,
leaving the posterior capsule intact.
• Intracapsular cataract extraction. This procedure removes the entire lens within the
intact capsule.
Nursing Management :-
The patient with cataract should receive the usual preoperative care for ambulatory surgical
patients undergoing eye surgery.
Nursing Assessment
The nurse should assess:
• Recent medication intake. It is a common practice to withhold any anticoagulant
therapy to reduce the risk of retrobulbar hemorrhage.
• Preoperative tests. The standard battery of preoperative tests such as complete
bloodcount,
electrocardiogram, and urinalysis are prescribed only if they are indicated by the
patient’s medical history.
• Vital signs. Stable vital signs are needed before the patient is subjected to surgery.
• Visual acuity test results. Test results from Snellen’s and other visual acuity tests are
assessed.
• Patient’s medical history. The nurse assesses the patient’s medical history to
determine the preoperative tests to be required.
Nursing Diagnosis
Based on assessment data, the nursing diagnoses for the patient include:
• Disturbed visual sensory perception related to altered sensory reception or status pf
sense organs.
• Risk for trauma related to poor vision and reduces hand-eye coordination.
• Anxiety related to threat of permanent loss of vision/independence.
• Deficient knowledge regarding ways of coping with altered abilities related to lack of
exposure or recall, misinterpretation, or cognitive limitations.
Nursing Care Planning & Goals
Main Article: 2 Cataracts Nursing Care Plans
The major goals for the patient include:
• Regaining of usual level of cognition.
• Recognizing awareness of sensory needs.
• Be free of injury.
• Identifying potential risk factors in the environment.
• Appearing relaxed and reporting anxiety is reduced at manageable level.
• Verbalizing feelings of anxiety.
• Identifying healthy ways to deal with and express anxiety.
Nursing Interventions
Care for a patient with cataract includes:
• Providing preoperative care. Use of anticoagulants is withheld to reduce the risk of
retrobulbar hemorrhage.
• Providing postoperative care. Before discharge, the patient receives verbal and
written instructions about how to protect the eye, administer medications, recognize
signs of complications, and obtain emergency care.
Evaluation
Evaluation of the patient may include:
• Regained usual level of cognition.
• Recognized awareness of sensory needs.
• Free of injury.
• Identified potential risk factors in the environment.
• Appeared relaxed and reporting anxiety is reduced ti a manageable level.
• Verbalized feelings of anxiety.
• Identified healthy ways to deal with and express anxiety.
