Specific Nursing Care

 

Cataract

 

 

 

Introduction

  
A cataract is a clouding of the lens of the eye.  The lens is a clear disc situated behind the pupil within the eyeball.  When a cataract develops, the amount of light passing through the retina reduces.  Hence, vision becomes blurred or completely lost.  The pupil, which normally appears black, may undergo noticeable color changes and appear to be yellowish or white.  Cataract does not cause pain or discomfort.
 
Surgery is the only effective way to remove a cataract.  The surgery involves the removal of the lens and implanting a replacement lens.  With technology advances, the successful rate is high with more than 90% of patients regaining good vision.  Most cataract surgeries are performed as day surgical procedures without the need for hospital admission.  Typically, the patient is given appointment to see his eye doctor the next day after surgery and one week following the procedure. Post-operative consultations are extremely important for the doctor to check the healing progress
    

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Care after Cataract Surgery 

 

Follow the instructions given by your doctor after cataract surgery.  If the person is discharged with an eye pad over his operated eye, please leave the pad in place until his appointment with the doctor the next day.
 
The following are general tips and information you can observe:

 

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Use the eye drops as prescribed.  They are usually  for preventing infection and controlling eye pressure.  Note that some eye drops need to be kept in the refrigerator.

 
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Wash hands before and after assisting the person in any procedure such as applying eye drops or cleaning the eye.

 
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If more than one type of eye drops is prescribed for the same eye, wait 5 minutes before instilling the second type of eye drop.

 
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If the person is receiving both eye drops and ointment, apply the eye drops first.

 

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If drug allergy develops, stop the eye medication immediately and consult your doctor.

 
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Do not use eye baths or irrigations unless they have been prescribed.

 
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Usual medication for pre-existing illness such as diabetes, high blood pressure or heart disease, should be continued after surgery.  Please consult your doctor if you are doubtful.

 
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Mild pain is expected.  Over-the-counter pain killers such as Paracetamol can be used to relieve the pain, provided the person has no allergy to the medicine.

 

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Reading or watching television can be resumed soon after the operation, as long as the person feels comfortable.

 
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Normal physical activities may be resumed one day after surgery unless advised otherwise.

 
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Strenuous activities such as jogging, lifting weights, swimming, gardening, aerobics, contact sports etc. should be avoided for 1-2 months.  Consult your doctor before resuming these activities.

 
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Sleeping in any position is acceptable, but the person should avoid direct pressure on the operated eye.

 
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A protective eye shield should be worn during sleep or nap for at least the first week after surgery.  This helps to prevent accidental injury to his eye during sleep.  Check with the surgeon when the use of the shield can be stopped.

 
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Usual diet may be continued after surgery.  Avoid constipation by taking high fiber diet and plenty of fluids.  Constipation causes unnecessary strain which may affect the operated eye.

 
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Remove any discharge from the operated eye with either a clean cotton-swab moistened with cool boiled water or clean piece of soft tissue paper.  Ask the person to close his eyes, clean his eye lids using a sweeping motion from inner to outer corner of the eye, using a fresh swab for each stroke to prevent contamination.

 
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To remove crusted secretions around the eye, ask the person to close his eye and place a gauze pad moistened with cool boiled water over it for 1 or 2 minutes.  Reapply if the secretions are not softened enough to be removed.  Do not attempt to use force or apply pressure to remove the dried-up secretions, you may injury the eye.

 
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As far as possible, vigorous coughing and sneezing should be avoided because this can cause an increase in eye pressure.  Notify your doctor if the person coughs frequently.

 
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Avoid crowded and/or dusty places to prevent accidental injury or contamination to the operated eye.

 
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Avoid carrying children who may accidentally hurt the operated eye.

 
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Instruct the person not to bend over or lift anything heavy.

 
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Sunglasses may be worn during the daytime, especially outdoors, to avoid any discomfort caused by the bright light and also to prevent any injury to eye.

 
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Do not rub, press or squeeze the operated eye.  If there is any discomfort, consult your doctor.

 
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Do not allow water or soap to enter the operated eye during the first 2 weeks after surgery.

 
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Instead of splashing water directly, advise the person to use a clean, soft, wet towel to wipe his face.

 
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Wash hair the salon way, that is the head tilted backwards to avoid any water splashing into the eye.

 
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Bathing can be resumed after the first day, but should be done below the neck.

 
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After surgery, the person may use his existing pair of eye glasses if he finds them useful and comfortable.  The eyes are usually tested 4 to 6 weeks after surgery and then, if necessary, a prescription for glasses will be given.

 
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Consult your doctor if there is any concerns regarding the eye.

 

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Postoperative Symptoms 

 

The followings symptoms are common after surgery and not a cause for alarm.  They may remain to some extent for 6-8 weeks:

 

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Mild discomfort, mild tearing, slight redness, scratchy sensation, glare and slight drooping of upper eyelid in the operated eye.

 
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The person may feel that there is something in his eye.  This is normal and is due to the stitches. This feeling may last up to six weeks.

 
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The vision may be blurry until eye glasses prescription is given or changed.

 

 

Contact the hospital immediately if any of the following symptoms is presented:

 

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Severe or increasing pain in the operated eye

 
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Decrease in vision, floaters or flashes of light in the operated eye

 
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Excessive discharge and redness in the operated eye

 
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Headache, nausea and/or vomiting

 

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