MANAGEMENT OF RETINAL DETACHMENT

FROM THE PRESPECTIVE

OF OPHTHALMIC NURSE

Ns. Jurita P. S.Kep

 EYE DISORDERS
RETINAL DETACHMENT
 EYE DISORDERS
RETINAL DETACHMENT

A retinal detachment is a separation of the sensory

retina from the underlying retinal pigment epithelium
(American Optometric Association, 2018).

If the retina is detached from the choroid, the photoreceptors will

fail. The fovea has no retinal blood vessels and depends wholly on
the choroid for its oxygen, so detachment of the macula leads to
permanent damage to the cones and rods at the posterior pole,
and loss of vision (Community Eye Health, 2003)

Remove the retina from the supporting tissue (Jakarta Eye Center)
 RISK FACTOR

‰Ocular ‰Retinal
High myopia trauma breaks ‰
Aphakia or Surgical loss Lattice retinal
pseudophakia of vitreous degeneration
Personal or
family history
of retinal
detachment

American Optometric Association, 2018

 COMMON SIGNS, SYMPTOMS, AND
COMPLICATIONS

Early symptoms may include

photopsia and/or a sudden shower of
floaters
Shadow or curtain moving over
vision and significant loss of central
vision
 DIAGNOSIS

Retinal detachment can be examined by:

 Ultrasound
 Fluoroscein Angiography
 Ophthalmoscopy
 Refraction Test
 Visual Acuity
 Color vision test
 Tonometry
 Slit-lamp examination
 TREATMENT FOR RETINAL
DETACHMENT

 Complete bed rest and restriction of eye movement to prevent further

detachment.
 Laser theraphy, if there's a hole in the posterior portion of the retina
 Scleral buckling to reattach the retina
 TREATMENT FOR RETINAL
DETACHMENT

 Pneumatic Retinopexy, It is a short simple procedure, where a fixed

amount of air is injected in the posterior part of the eye

 Vitrectomy, the procedure involves cutting and removal of the vitreous

gel along with removal of all the fibrous tissue causing traction (pull) on
the retina and detaching
NURSES MANAGEMENT FOR
RETINAL DETACHMENT
 NURSING MANAGEMENT

Nursing diagnoses for Retinal Detachment :

• Disturbed sensory perception (visual).
• Anxiety.
• Risk for injury.
Planning and goals nursing care plan for Retinal
Detachment :
• The client will remain free from injury.
• The client will be free from permanent visual impairment.
• The client will understand the treatment options .
 NURSING MANAGEMENT
PRE OPERATIVES

 Assess the viusal acuity of the client’s non operative

eye prior to surgery
 Assess the client’s support system and the possible
effect of impaired vision on lifestyle and ability to
perform ADLs in the post-operative period
 Usual preoperative care for ambulatory surgery
Safety measures such as instaling hands rails,
especially is the client’s has limited vision in the
unaffected eye
 Dilating eye drops or other medication as ordered
 NURSING MANAGEMENT
POST OPERATIVES

 Patient teaching
 Monitor status of the eye dressing following surgery
 Assess dressings for the presence of bleeding or
drainage
 Place the client position (semi-fowler’s, face down)
 Assess IOP
 Assess the client and medicate or assist to avoid
vomiting coughing, sneezing or straining as needed
 Give client back massage is needed
 EVALUATION

Evaluation nursing care plan for Retinal Detachment :

• The client's vision is restored.
• The client will remains free from injury.
• The client will understands all discharge
instructions.