Page 1935 - Saunders Comprehensive Review For NCLEX-RN

d. Instruct the client that when maximal
medical therapy has failed to halt the
progression of visual field loss and
optic nerve damage, surgery will be
recommended.
e. Prepare the client for trabeculectomy as
prescribed, which allows drainage of
aqueous humor into the conjunctival
spaces by the creation of an opening.
F. Retinal detachment
1. Description
a. Detachment or separation of the retina
from the epithelium
b. Occurs when the layers of the retina
separate because of the accumulation
of fluid between them, or when both
retinal layers elevate away from the
choroid as a result of a tumor
c. Partial detachment becomes complete if
untreated.
d. When detachment becomes complete,
blindness occurs.

2. Assessment

a. Flashes of light
b. Floaters or black spots (signs of
bleeding)
c. Increase in blurred vision
d. Sense of a curtain being drawn over the
eye
e. Loss of a portion of the visual field;
painless loss of central or peripheral
vision
3. Immediate interventions

a. Provide bed rest.
b. Cover both eyes with patches as
prescribed to prevent further
detachment.
c. Speak to the client before approaching.
d. Position the client’s head as prescribed.
e. Protect the client from injury.
f. Avoid jerky head movements.
g. Minimize eye stress.
h. Prepare the client for a surgical
procedure as prescribed.
4. Surgical procedures

1935