Preventing eye injuries--the nurse's role.

Federal estimates report that approximately 2 1/2-3 million people each year are affected by eye injuries and approximately 40,000 of those individuals are permanently blinded as a result of that trauma. The National Society for the Prevention of Blindness believes that 90% of those injuries could be prevented through proper education and recognition of the potential hazards. This presentation will focus on the specific preventive actions that can be taken to decrease the incidence of ocular trauma. Also discussed will be the significant role the ophthalmic registered nurse can play in the prevention of ocular trauma through education of colleagues and community members.

Patient responses to topical anesthesia for cataract surgery.

This presentation will summarize subjective comments and clinical findings obtained from 27 cataract patients who underwent extracapsular cataract extraction by phacoemulsification and intraocular lens implantation under topical anesthesia 0.5% tetracaine hydrochloride (HCl) without retrobulbar block. All data presented in this study was obtained by one ophthalmic registered nurse who questioned the patient in the immediate preoperative period, observed all operative procedures, questioned each patient immediately postoperatively and performed a slit lamp examination and interview with each patient on the first post-operative day. As a result of this study, specific nursing interventions have been altered and unique circumstances identified that reinforce the valuable contributions of the ophthalmic registered nurse in the completion of successful cataract surgery.

Perioperative nursing in the Third World: improvise without compromise.

1. The reality of nursing in the Third World is a severe limitation of human, fiscal, and environmental resources. Our plan was to overcome these obstacles and establish a plan and perform outpatient eye surgeries. 2. The biggest obstacle was a lack of acceptance of the outpatient concept and many cultural differences. Native team members became excited about the concept when they saw positive results and the effectiveness of care. 3. Today, well-trained ophthalmic nurses are performing perioperative nursing in their native setting; they have become self-sufficient, independent workers; they are teaching other native nurses; and outpatient surgery is being performed daily.

Clinical evaluation of intraocular lens calculations.

The DBR-300 A-Scan ultrasonic unit was used to evaluate 100 patients preoperatively. Intraocular lens power was calculated using the formula supplied with the instrument and the accuracy of the instrument was then evaluated. It was determined that 54% of our patients were within +/- 1.00 diopter of the calculated refractive error and that 85% of the patients were within +/- 2.00 diopters and that 97% were within +/- 3.00 diopters. Only 3% of our patients had greater than a 3.00-diopter difference between predicted and actual postoperative refractive error. A standard 3.2-mm anterior chamber depth was utilized for Choyce lenses and 3.4 mm ACD was utilized for Medallion lenses. No single factor could be found to account for the slight tendency toward myopia, although several were found to contribute. No single factor was found to contribute to large errors, though the 3% of patients with greater than three diopters variation from the predicted refractive error demonstrated high degrees of cylinder or corneal astigmatism postoperatively as compared to preoperatively. Though we are presently in the process of reviewing ACD postoperatively, one would not suggest any drastic changes in the values at this time due to the overall accuracy obtained. Certainly though small adjustments may be made in the Binkhorst formula in the future, this is yet to be proven clinically.