Dr. Huntley's
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Visual floaters are particles of blood or cellular debris that move about in the vitreous. As these floaters enter the visual field, they appear as spots or dots. Chronic floaters may occur normally in elderly or myopic patients; however, the sudden onset of visual floaters commonly signals retinal detachment, an ocular emergency.
Sudden onset of visual floaters may signal retinal detachment. Does the patient also see flashing lights or spots in the affected eye? Is he experiencing a curtainlike loss of vision? If so, notify an ophthalmologist immediately and restrict the patient's eye movements until the diagnosis is made.
If the patient's condition permits, obtain a drug and allergy history. Ask about nearsightedness (a predisposing factor), use of corrective lenses, eye trauma, or other eye disorders. Ask about a history of granulomatous disease, diabetes mellitus, or hypertension, which may have predisposed him to retinal detachment, vitreous hemorrhage, or uveitis. If appropriate, inspect the patient's eyes for signs of injury, such as bruising or edema, and determine his visual acuity. (See Retinal detachment.With retinal detachment, floaters and light flashes appear suddenly in the portion of the visual field where the retina is detached from the choroid. As the retina detaches further (a painless process), gradual vision loss occurs, likened to a cloud or curtain falling in front of the eyes. Ophthalmoscopic examination reveals a gray, opaque, detached retina with an indefinite margin. Retinal vessels appear almost black.
Uveitis (posterior).Uveitis may cause visual floaters accompanied by gradual eye pain, photophobia, blurred vision, and conjunctival injection.
Vitreous hemorrhage.Rupture of retinal vessels produces a shower of red or black dots or a red haze across the visual field. Vision is suddenly blurred in the affected eye and visual acuity may be greatly reduced.
▪ Place the patient on bed rest and provide a calm environment.
▪ Place a patch over one or both of the patient's eyes, as ordered.
▪ If bilateral eye patches are necessary, take measures to ensure the patient's safety.
▪ Prepare the patient for surgery, as necessary.
▪ Administer medications, as ordered.
▪ Provide sensory stimulation, such as music, if the patient desires.
▪ Place pillows or towels behind the patient's head to maintain appropriate patient position.
▪ Identify yourself when you approach the patient.
▪ Orient the patient to time frequently.
▪ Tell the patient not to touch or rub his eyes and to avoid straining or sudden movements.
Read excerpts from these other book chapters related to Vision loss:
Copyright Details: Nursing: Interpreting Signs and Symptoms, Copyright © 2008 Williams & Wilkins.
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Title: Nursing: Interpreting Signs and Symptoms
Authors: Springhouse
Publisher: Lippincott Williams & Wilkins
Copyright: 2007
ISBN: 1-58255-668-7
» Next page: Eye pain [Ophthalmalgia] (Nursing: Interpreting Signs and Symptoms)
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