{
  "name": "Cataract",
  "slug": "cataract",
  "url": "https://nursingplex.com/care-plans/cataract",
  "category": "Ophthalmic & Sensory",
  "summary": "Lens opacity; pre/post-op eye care, activity limits and safety adaptation.",
  "nursing_diagnoses": [
    "Disturbed visual sensory perception",
    "Risk for injury",
    "Deficient knowledge"
  ],
  "overview": [
    "A cataract is a progressive clouding of the eye's normally clear lens, most often related to aging, that gradually scatters and blocks light from reaching the retina. Vision loss develops slowly over months to years, so patients frequently normalize the change until it significantly interferes with reading, driving, or recognizing faces.",
    "While aging is the most common cause, cataracts can also result from diabetes, prolonged corticosteroid use, ultraviolet light exposure, trauma, or be congenital. Surgical removal with intraocular lens implantation is highly effective and is one of the most commonly performed and successful surgeries, typically done as same-day outpatient surgery under local anesthesia.",
    "Nursing care centers on preoperative assessment and education, ensuring safety given reduced vision, and thorough postoperative teaching, since patients go home the same day and are responsible for their own eye protection, medication administration, and symptom monitoring during recovery."
  ],
  "key_facts": [
    {
      "label": "Most common cause",
      "text": "Age-related lens protein changes; also linked to diabetes, steroid use, UV exposure, and trauma."
    },
    {
      "label": "Classic symptoms",
      "text": "Painless, progressive blurring, glare or halos around lights, and faded color perception."
    },
    {
      "label": "Surgery",
      "text": "Phacoemulsification with intraocular lens implant, typically outpatient under local/topical anesthesia and mild sedation."
    },
    {
      "label": "Recovery",
      "text": "Vision often improves within days, but full stabilization can take several weeks."
    },
    {
      "label": "Emergency sign",
      "text": "Sudden eye pain, significant vision loss, or flashes/floaters after surgery may indicate infection or retinal detachment and needs urgent evaluation."
    }
  ],
  "nursing_priorities": [
    "Assess visual function and its impact on safety and daily activities.",
    "Provide thorough preoperative teaching, since the surgery is typically same-day outpatient.",
    "Prevent falls and injury related to impaired vision before and immediately after surgery.",
    "Monitor for and teach recognition of postoperative complications (infection, increased intraocular pressure, retinal detachment).",
    "Support correct instillation of postoperative eye drops.",
    "Educate on activity restrictions that protect the surgical eye during healing.",
    "Address anxiety related to eye surgery and fear of vision loss."
  ],
  "assessment": {
    "subjective": [
      "Report of gradually worsening, painless blurry vision",
      "Complaints of glare or halos around lights, especially at night",
      "Difficulty reading, driving, or recognizing faces",
      "Report that colors seem faded or yellowed",
      "Anxiety about upcoming eye surgery or fear of blindness"
    ],
    "objective": [
      "Visual acuity testing showing decreased vision uncorrected by glasses",
      "Cloudy or opaque appearance of the lens on examination",
      "Absence of the normal red reflex on ophthalmoscopic exam",
      "Signs of poor mobility or difficulty navigating the environment safely",
      "Post-op: eye redness, discharge, or excessive tearing beyond expected",
      "Post-op: increasing eye pain or sudden vision change",
      "Patient's ability to correctly demonstrate eye drop instillation technique"
    ],
    "related_factors": [
      "Age-related lens protein denaturation and clouding",
      "Diabetes mellitus accelerating cataract formation",
      "Long-term corticosteroid use",
      "Cumulative ultraviolet light exposure",
      "Ocular trauma or prior intraocular surgery",
      "Family history and congenital factors in some cases"
    ]
  },
  "goals": [
    "The client will verbalize understanding of the surgical procedure and postoperative care.",
    "The client will remain free of falls or injury related to visual impairment.",
    "The client will demonstrate correct technique for eye drop administration.",
    "The client will report improved visual acuity following surgery.",
    "The client will identify signs of postoperative complications requiring immediate care.",
    "The client will verbalize reduced anxiety about the surgical procedure."
  ],
  "interventions": [
    {
      "title": "1. Preoperative assessment and teaching",
      "points": [
        "Assess baseline visual acuity in both eyes and how vision loss affects daily function and safety.",
        "Review the planned procedure, expected same-day discharge, and need for a driver, since sedation and eye patching prevent safe self-transport.",
        "Confirm understanding of preoperative eye drop regimens (often started days before surgery) and reinforce the schedule.",
        "Address anxiety by explaining what to expect during the brief procedure, typically performed under local/topical anesthesia with mild sedation.",
        "Review current medications, particularly anticoagulants and alpha-blockers (which can affect pupil response during surgery), per surgeon instruction."
      ]
    },
    {
      "title": "2. Promoting safety with impaired vision",
      "points": [
        "Orient the patient to the environment and keep pathways clear of clutter, especially before surgery when vision is most impaired.",
        "Encourage the use of assistive devices (magnifiers, adequate lighting) to maintain independence safely.",
        "Assist with mobility and implement fall precautions, particularly immediately after surgery when one eye may be patched.",
        "Advise against driving until cleared by the surgeon, since depth perception may be altered with one eye patched or recovering."
      ]
    },
    {
      "title": "3. Postoperative eye care",
      "points": [
        "Teach correct eye drop instillation technique, including hand hygiene, avoiding contact between the dropper tip and the eye, and correct sequencing when multiple drops are prescribed.",
        "Instruct the patient to wear the protective eye shield as directed, especially during sleep, to prevent inadvertent rubbing or pressure on the eye.",
        "Advise avoiding bending, heavy lifting, straining, and rubbing the eye, all of which can raise intraocular pressure and disrupt healing.",
        "Review the use of sunglasses outdoors to reduce light sensitivity and protect the healing eye.",
        "Reinforce hand hygiene before any eye care to reduce infection risk."
      ]
    },
    {
      "title": "4. Monitoring for complications",
      "points": [
        "Teach the patient to recognize and immediately report increasing pain, redness, purulent discharge, or sudden vision loss, which suggest infection or hemorrhage.",
        "Explain that new floaters, flashes of light, or a curtain-like vision loss requires urgent evaluation for retinal detachment.",
        "Review signs of elevated intraocular pressure — severe eye pain, nausea, halos — and the importance of prompt reporting.",
        "Confirm the patient has scheduled and understands the importance of the follow-up appointment, typically within 24-48 hours after surgery."
      ]
    },
    {
      "title": "5. Supporting recovery and independence",
      "points": [
        "Reassure the patient that mild scratchiness, tearing, and blurriness are expected initially and typically improve within days.",
        "Encourage gradual resumption of normal activities as cleared by the surgeon, typically avoiding swimming and strenuous exercise for a specified period.",
        "Discuss timing for updating eyeglass prescriptions, since vision may continue to change during the initial weeks of healing.",
        "Provide written instructions given that patients may be sedated and less able to retain verbal information immediately after surgery."
      ]
    }
  ],
  "patient_teaching": [
    "Arrange for a ride home; you will not be able to drive yourself the day of surgery.",
    "Use eye drops exactly as scheduled, including drops started before surgery and the tapering course afterward.",
    "Wear the protective shield at night as instructed to avoid accidentally rubbing or bumping the healing eye.",
    "Avoid bending over, heavy lifting, straining, and swimming for the period specified by your surgeon.",
    "Wear sunglasses outdoors, as the eye will be more sensitive to light during healing.",
    "Report immediately: increasing pain, redness, discharge, sudden vision loss, or new floaters/flashes.",
    "Keep your follow-up appointment, usually within a day or two after surgery.",
    "Expect vision to keep improving over several weeks; a new glasses prescription is usually delayed until the eye fully stabilizes."
  ]
}