The long-term care nurse is caring for a client newly diagnosed with macular degeneration. Which client statement would support this diagnosis?
- “I have been seeing small flashes of light.”
- “I have trouble threading my sewing needle; I have to hold it at arm’s length.”
- “I notice that my peripheral vision is becoming worse.”
- “I see a blurry spot in the middle of the page when I read.”
Answer
Correct answer
4-“I see a blurry spot in the middle of the page when I read.”
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Explanation
Macular degeneration is a progressive, incurable disease of the eye in which the central portion of the retina, the macula, begins to deteriorate with age. This causes distortion (blurred or wavy disturbances) or loss of the central field of vision, whereas the peripheral vision remains intact.
Macular degeneration has 2 different etiologies. “Dry” macular degeneration occurs when the microvasculature supplying the macula is blocked, causing ischemia. In “wet” macular degeneration, abnormal blood vessels form and eventually destroy the macula. If it is diagnosed early, further progression of wet macular degeneration can be slowed or stopped using surgery or antineoplastic agents.
Age and heredity are the biggest risk factors for macular degeneration.
(Option 1) Seeing small flashes of light is associated with retinal detachment.
(Option 2) Inability to see things close up, known as presbyopia, occurs when the lens of the eye becomes less elastic with age and thus unable to adjust to near and far vision.
(Option 3) Poor peripheral vision, also called tunnel vision, can result from optic nerve damage seen in glaucoma.
Educational objective:
Macular degeneration occurs when the central portion of the retina deteriorates secondary to age, giving rise to distortion (blurred or wavy visual disturbance) or loss in the center of the visual field.
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