The nurse is reviewing discharge teaching for a client who had surgical repair of a retinal detachment. Which of the following instructions are appropriate for the nurse to include in the teaching? Select all that apply.
1. Avoid rubbing or scratching the affected eye
2. Avoid straining when having a bowel movement
3. Expect occasional flashes of light during recovery
4. Report any sudden pain to the health care provider
5. Rest the eyes by refraining from reading and writing
Retinal detachment is separation of the sensory retina from the underlying pigment epithelium. Clients experiencing retinal detachment may report a gradual, curtain-like loss of the visual field. Traumatic retinal detachment may also result in abrupt vision loss. Retinal detachment requires emergency surgery to attempt to restore vision. Surgical repair involves rebinding the choroid and retina. After repair, interventions focus on promoting retinal reattachment. Postoperative teaching should include: Avoiding activities that increase intraocular pressure (eg, rubbing the eye, straining) (Options 1 and 2) Reporting sudden pain, flashes of light, vision loss, or bleeding, which may indicate detachment or infection, to the health care provider (Option 4) Avoiding focused activities (eg, reading, writing, sewing), which can cause rapid eye movements and increase the risk for detachment (Option 5). Wearing an eye patch or shield as directed to prevent rubbing/scratching of the eye and minimize eye movement Ensuring appropriate positioning as instructed by the surgeon because clients may receive intravitreal oil or gas, which holds the retina in a specific position to allow healing (Option 3) Signs of retinal detachment include floaters, sudden flashes of light, and loss of vision. If signs of detachment occur, the surgeon should be notified immediately. Educational objective: After retinal detachment repair, clients should avoid activities that increase intraocular pressure (eg, rubbing the eye, straining); report pain, flashes of light, or floaters; wear an eye patch; avoid focused activities that may cause eye strain; and minimize eye movement.
