[Comprehensive Assessment and Treatment of Cataracts].

Cataract is a global disease that may cause blindness. Due to the slow pace of disease progression, patients often presume incorrectly that their blurred vision is caused by excessive fatigue or lack of sleep. In addition to their role in causing blindness, cataracts that are diagnosed late into their progression are more difficult to treat with corrective surgery. Furthermore, many older individuals believe incorrectly that declines in vision are part of the natural course of aging and accept these declines as inevitable. Reduced vision has a significant and negative effect on quality of life. Although aging is one of the main causes of cataracts, other major factors include common chronic diseases and the side effects of drugs. In addition, lifestyle factors such as diet, activity, and environmental exposure to ultraviolet rays and radiation are factors in cataract development. Surgery is the only treatment for cataracts currently available. Healthcare professionals not only consider a patient's background but also whether surgery may promote quality of life. While preoperative evaluation requires a holistic and comprehensive approach, postoperative care is also important to the overall success of cataract surgery. For example, instructions in topical-drop application, wound assessment, and symptoms of comorbidities are crucial for patients. Therefore, a critical literature review was used in this article to establish a strategy for the holistic evaluation of and perioperative nursing care and prevention strategies for cataracts. In addition, recommendations for the comprehensive assessment of and nursing care for patients with cataracts are provided to healthcare professionals article in hopes of improving the quality of care provided to patients with cataracts.

Effects of Discharge Education and Telephone Follow-up on Cataract Patients' Activities According to the Model of Living.

PURPOSE: Assess the impact of planned discharge education and telephone follow-up of patients who underwent cataract surgery on daily living activities. DESIGN: A controlled comparative study. METHODS: This study was carried out on patients who underwent cataract surgery (intervention group = 72, control group = 72). Discharge education designed according to the Model of Living was used in the intervention group. Phone follow up was performed for both groups after surgery and activities were assessed. FINDINGS: Significant differences were found between the two groups in applying eye drops, knowledge on using old eye glasses and protecting the operated eye, conditions requiring a physician call, conditions that may deteriorate the operated eye, personal hygiene, mobilization, and sleeping (P < .05). CONCLUSIONS: Using a Model of Living in discharge education of cataract patients and following up using a structured checklist was an effective intervention. This model can be efficiently used in postoperative education of day surgery patients.

The effect of nursing intervention on preoperative cataract.

This retrospective study investigated the effect of nursing intervention (NIV) in Chinese patients under preoperative cataract (PC). A total of 70 eligible patients with PC were included. Thirty-five patients in an intervention group received regular clinical treatment and NIV before the surgery, while the other 35 patients received regular clinical treatment only. The NIV was applied 4 sessions, 1 week before the surgery. The primary outcome of satisfaction was measured by 11-points visual analog scale. The secondary outcomes were measured by the functional impairment caused by cataract (the VF-14), cooperativeness during the surgery period, and sleep quality. All the outcome measurements were assessed before and after the surgery. After NIV, patients in the intervention group exerted better outcomes in decreasing anxiety (P < .01), increasing current experience with satisfaction (P < .01), and enhancing the cooperativeness during the surgery period (P < .01), compared to those outcomes in the control group. The results of this study showed that NIV may help increase satisfaction in experience and cooperation, and decrease anxiety in Chinese patients with PC.

Résultats fonctionnels de la chirurgie de la cataracte à l'hôpital central de Yaoundé par la technique de la petite incision manuelle

But. Décrire les résultats fonctionnels sans correction de la chirurgie de la cataracte par la technique de la petite incision manuelle ou phacoalternative à l'Hôpital Central de Yaoundé (HCY). Méthodologie. Il s'agit d'une étude transversale descriptive et rétrospective. Les dossiers de patients opérés de cataracte par phacoalternative entre mars 2013 et décembre 2017 comportant les données recherchées ont été retenus. L'âge, le sexe, l'acuité visuelle pré opératoire et l'acuité visuelle de loin au 30e jour post-opératoire étaient les variables analysées. Nous avons utilisé la classification de l'Organisation Mondiale de la Santé (OMS) pour l'évaluation du résultat fonctionnel post-opératoire. Le résultat était bon si l'acuité visuelle de loin était ≥ 3/10, limite si entre 1/10 et < 3/10 et mauvais si < 1/10. Résultats. Durant la période d'étude, 264 yeux ont été opérés, mais 94 patients (116 yeux) suivis jusqu'à un mois ont été inclus. Le sex-ratio homme / femme était de 1,25. L'âge moyen des patients était 66,87 ± 15,10 ans avec les extrêmes de 12 et 92 ans. A un mois post-opératoire, 53,45% des yeux opérés (n= 62/116) avaient un bon résultat sans correction. Conclusion. Le résultat fonctionnel de la chirurgie de la cataracte à l'HCY est bon dans 53,45% des cas. Ce chiffre est inférieur aux recommandations de l'OMS. L'amélioration de la disponibilité des implants selon la biométrie ainsi que le respect des protocoles de chirurgie et de suivi post opératoire par les chirurgiens devraient permettre d'améliorer le résultat visuel sans correction

Nurses' role in early detection of cataracts.

Cataracts are a common problem but can have a significant negative impact on an person's functional abilities and emotional wellbeing. This article shows how age-related cataracts develop and clarifies which symptoms to look out for when conducting holistic patient assessments. Many symptoms go unnoticed for years but early detection could help patients learn to manage gradual loss of vision, thereby maintaining a good quality of life for as long as possible.

[Continuing Nursing Care of Patients with Senile and Diabetic Cataract].

PURPOSE: To explore the treatment and continuing nursing of patients diagnosed with senile and diabetic cataract. METHODS: In total, 142 patients diagnosed with senile and diabetic cataract admitted to Zhongshan Ophthalmic Center from January to December 2014 were randomly assigned into groups A and B. In group A, patients received conventional instruction after discharge, and those in group B additionally received continuing nursing care after discharge including ocular nursing, use of anti-diabetic drugs, psychological nursing, diet nursing, self-monitoring guidance, re-examination and regular follow-up according to the patients' conditions. RESULTS: After one year of continuing nursing care, visual acuity of patients in group B was increased without complications. Body mass index, the fasting and 2h postprandial plasma glucose, and the systolic and diastolic blood pressure were decreased significantly compared with those in group A (all P < 0.05). CONCLUSION: Continuing nursing care, including knowledge education related to ocular use and diabetes mellitus, targeted psychological nursing, medication nursing and daily life guidance, play a pivotal role in enhancing the compliance rate of the patients, reducing the influence upon work and life and enhancing the quality of life to varying extent.

Diabetes and cataract surgery: preoperative risk factors and positive nursing interventions.

PURPOSE: In the United States, approximately three million cataract surgeries are performed annually. Although cataract surgery has been demonstrated to improve vision in up to 95% of patients, those with diabetes may be at increased risk of complications and poor visual outcomes. Preoperative risk factors such as age, retinal diseases, hypoglycemic medications, and hemoglobin A1C (Hgb A1C) levels may play a role in patient outcomes following cataract surgery. Furthermore, intraoperative risk factors such as the use of pupillary expanders, trypan blue staining, and additional procedures such as anterior vitrectomy may also be considered as a challenge for diabetic patients. This article will describe preoperative risk factors associated with visual outcomes for diabetic patients undergoing cataract surgery and appropriate nursing interventions for these patients. METHODS: Literature review of risk factors and cataract surgery outcomes in terms of complications, visual acuity, and visual functioning of diabetic patients was undertaken. Preoperative risk factors (i.e., age, retinal diseases, advanced macular disease [AMD], hypoglycemic medications, and Hgb A1C levels) and postoperative complications, including inflammation and cystoid macular edema (CME), were also examined. To emphasize evidence of best practices, the role of the nurse as educator and advocate was further explored in terms of their impact on diabetes management of the patient to improve visual results. RESULTS: Diabetic patients of advanced age, with a history of diabetic retinopathy who are taking insulin and have elevated Hgb A1C levels, may have an increased risk of intraoperative and postoperative complications and decreased postoperative visual acuity and visual functions that may affect their quality of life. CONCLUSIONS: High-risk factors should be identified in diabetic patients when developing a perioperative patient education plan to help reduce their risk of cataract complications and improve their visual outcomes.

Ações da enfermagem no controle e tratamento da catarata: revisão integrativa / Nursing actions in the control and treatment of cataracts: integrative review

Objetivo: analisar na literatura sobre as ações da enfermagem no controle e tratamento da catarata.Método: revisão integrativa, com busca nas bases de dados Lilacs e Medline e na biblioteca virtual Scielo,entre 2004 a 2011, com vistas a responder as questões de pesquisa > Utilizou-se formulário estruturado para coleta de dados, queabrangeu título do artigo, ano de publicação, objetivo do estudo, tipo do estudo e nível de evidência. Paraanálise crítica, realizou-se a sistemática caracterização das publicações bem como a interpretação e aanálise. Resultados: foram selecionados 12 artigos, dos quais dez abordaram cirurgia de catarata e dois asações da enfermagem para distintas cirurgias oftalmológicas, não especificando a de catarata. Conclusão:ações da enfermagem para paciente com catarata envolveram a promoção da saúde, prevenção da doença ecuidado perioperatório.

Improved pupil dilation with medication-soaked pledget sponges.

Use of multiple preoperative drops for pupil dilation has been shown to be inexact, to delay surgery, and to cause dissatisfaction among perioperative personnel. This article reports on an evidence-based, quality improvement project to locate and appraise research on improved effectiveness and efficiency of mydriasis (ie, pupillary dilation), and the subsequent implementation of a pledget-sponge procedure for pupil dilation at one ambulatory surgery center. Project leaders used an evidence-based practice model to assess the problem, research options for improvement, define goals, and implement a pilot project to test the new dilation technique. Outcomes from the pilot project showed a reduced number of delays caused by poor pupil dilation and a decrease in procedure turnover time. The project team solicited informal feedback from preoperative nurses, which reflected increased satisfaction in preparing patients for cataract procedures. After facility administrators and surgeons accepted the procedure change, it was adopted for preoperative use for all patients undergoing cataract surgery at the ambulatory surgery center.

Managing depression in older people with visual impairment.

The author describes the management of depression in older people with visual impairment. The concept of depression is defined, and the main classifications are outlined. The signs and symptoms of depression are presented and approaches to treatment are discussed. The role of the nurse in managing depression in older people with sight loss is discussed.

Supporting patients undergoing cataract extraction surgery.

A cataract is an opacification, or clouding, of the lens of the eye, causing a deterioration in the clarity and brightness of vision, which may reduce quality of life. Surgical removal and artificial replacement of the opacified lens is the only treatment option available. This article discusses the patient's experience of treatment and highlights the role of the nurse in pre and post-operative care. A review of the anatomy of the eye is included and, as nurses have a vital role in supporting patients undergoing surgery, the cataract extraction operation and its potential risks and complications are described briefly.