NCLEX RN Practice Question 462

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Cataracts

Description

• A cataract is an opacity of the lens that distorts the image projected onto the retina and that can progress to blindness.
• Causes include the aging process (senile cataracts), inherited (congenital cataracts), and injury (traumatic cataracts); cataracts also can result from another eye disease (secondary cataracts).
• Causes of secondary cataracts include diabetes mellitus, maternal rubella, severe myopia, ultraviolet light exposure, and medications such as corticosteroids.
• Intervention is indicated when visual acuity has been reduced to a level that the client finds to be unacceptable or adversely affects his or her lifestyle.

Assessment

• Blurred vision and decreased color perception are early signs
• Diplopia, reduced visual acuity, absence of the red reflex, and the presence of a white pupil are late signs. Pain or eye redness is associated with age-related cataract formation.
• Loss of vision is gradual.

Interventions

• Surgical removal of the lens, one eye at a time, is performed.
• With extracapsular extraction, the lens is lifted out without removing the lens capsule; the procedure may be performed by phacoemulsification, in which the lens is broken up by ultrasonic vibrations and extracted.
• With intracapsular extraction, the lens and capsule are removed completely.
• A partial iridectomy may be performed with the lens extraction to prevent acute secondary glaucoma.
• A lens implantation may be performed at the time of the surgical procedure.