The nurse is caring for a client with a diagnosis of a detached retina. Which assessment sign would indicate that bleeding has occurred as a result of the retinal detachment?
A. Complaints of a burst of black spots or floaters.
B. A sudden sharp pain in the eye.
C. Total loss of vision.
D. A reddened conjunctiva.
Correct Answer: A. Complaints of a burst of black spots or floaters.
Complaints of a sudden burst of black spots or floaters indicate that bleeding has occurred as a result of the detachment. When the retina becomes detached, bleeding from nearby blood vessels can cloud the inside of the eye so that you may not see clearly or at all. Central vision becomes severely affected if the macula becomes detached. The macula is the part of the retina responsible for sharp, detailed vision.
Option B: Sharp or sudden pain in the eye is usually due to debris in or around the eye. It’s commonly described as an aching, stabbing, or burning feeling within the eye itself. Sharp pain can also be caused by more serious conditions such as uveitis or glaucoma.
Option C: Light must travel through several transparent structures before it can be sensed by the retina. First, light passes through the cornea (the clear layer in front of the iris and pupil), then the lens, and then the vitreous humor (the jellylike substance that fills the eyeball). Anything that blocks light from passing through these structures, for example, a corneal ulcer or bleeding into vitreous humor, or disrupts the transmission of nerve impulses from the back of the eye to the brain can cause loss of vision.
Option D: An infection of the conjunctiva irritates the blood vessels causing them to swell up. It is this inflammation that makes the whites of the eyes appear reddish or even a bit pink. Viruses cause up to 80 percent of all cases of conjunctivitis. Pink eye is prevalent among school children and is very contagious.
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