Retinitis is inflammation of the retina that can be caused by various pathogens like toxoplasma, cytomegalovirus, and herpes zoster virus. There are different types of retinitis including retinitis pigmentosa, which is a genetic eye disease that affects night vision. Clinical manifestations include blurred vision, loss of side vision, floaters, and tunnel vision. Diagnostic tests include eye examinations, visual field testing, genetic testing, and imaging tests like OCT. Management involves pharmacological treatments like carbonic anhydrase inhibitors and lutein, as well as surgical options like bionic retinas and retinal transplantation. Nursing management focuses on pain management, maintaining visual function, and preventing injury related to impaired vision.
3. Types
Retinitis
pigmentosa
• Group of genetic
eye disease
• Affect the rods (
loss of night
vision)
Cytomegalo virus
retinitis
• Develops from
viral infection of
retina
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4. Clinical manifestations
• Blurred vision
• Loss of side vision
• Floaters
• Tunnel vision
• Eye pain
• Photophobia
• Blindness redness
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6. Diagnostic evaluation
Eye examination -
• Help of ophthalmoscopy
• Reveals - abnormal, dark
pigment deposits that
streak the retina.
Visual field testing -
• Measur peripheral ( side) vision.
Genetic testing- disease inherited or not
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7. Electrode tomography -
• Measure electrical activity in retina
• In retinitis have decreased electrical activity,
reflecting the declining of Photoreceptor.
Optical coherence tomography (OCT)-
• take special, highly detailed picture of retina.
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9. Pharmacological management
1. Carbonic anhydrase inhibitors -
• Action- decrease pressure in eye
• Example -. Topical Acetazolamide
2. Lutein-
• Action- protect the macula from oxidative
damage & oral supplementation has been
shown to increase the macular pigment.
• Dose- 20 mg/day
• 3. Vitamin A/ Carotene
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11. Nursing management
Assessment
• History collection ( previous eye infection,
family history).
• Physical examination (subjective and objective
data) like blurred vision , tunnel vision, floaters
etc .
Nursing diagnosis
1. Chronic pain r/t inflammation in retina as
evidence by expression of pain.
Goal- to reduce pain
Intervention -
• Determine the location, characteristics, onset,
duration, frequency, quality, and severity of
pain via assessment.
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• Determine the patient’s anticipation for pain relief.
• Provide measures to relieve pain before it becomes
severe.
• Provide diversion therapy.
2. Disturbed sensory perception (visual )r/t damaged
retina as evidenced by verbal complaint of vision
problems such as tunnel vision, floaters.
Goal- The patient will regain optimal vision while being
able to cope with and accept permanent vision
changes.
Intervention -
• Assess the vision ability of the patient.
• Encourage the patient to have regular checkups with
an ophthalmologist at least once a year.
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• Encourage the patient to have regular checkups with
an ophthalmologist at least once a year.
• Administer medications as prescribed.
• Advise to include fish that are high in omega-3 fatty
acid, such as salmon, sardines and tuna. Encourage
the patient to add foods containing vitamins C, E,
beta-carotene, zinc, and copper in his/her diet in
accordance to daily recommended intake.
3. Risk for Injury related to impaired sensory function
secondary to diplopia as evidence by patient reporting
he is seeing blurry.
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Goal- Pt will remain free from injury throughout his
hospital stay.
Intervention -
• The nurse will identify factors that will increase
the risk for injury to the patient.
• The nurse will assess the patients vision twice a
shift for any more deterioration.
• To provide safe environment. (Remove sharp
objects from the surrounding of the pt.
• Assist to pt for ADLs.