During the nursing history, which assessment data would the nurse expect the client scheduled for surgical correction of chronic open-angle glaucoma to report?
A. Seeing flashes of lights and floaters.
B. Recent motor vehicle crash while changing lanes.
C. Complaints of headaches, nausea, and redness of the eyes.
D. Increasingly frequent episodes of double vision.
Correct Answer: B. Recent motor vehicle crash while changing lanes.
Typically, the client with chronic open-angle glaucoma experiences a gradual loss in peripheral vision leading to tunnel vision. Being involved in a motor vehicle crash while changing lanes suggests the disorder. The client may experience insidious blurring, decreased accommodation, mild aching eyes and, eventually, halos around the lights as intraocular pressure increases.
Option A: Flashes of light and floaters are characteristic of retinal detachment. Patients with a rhegmatogenous retinal detachment may present with a history of a large number of new-onset floaters. They may also have significant photopsia (flashes of light) in their vision.
Option C: Nausea, headache, and eye redness are seen with an episode of acute (sudden) closed-angle closure. Acute angle-closure glaucoma presents as a sudden onset of severe unilateral eye pain or a headache associated with blurred vision, rainbow-colored halos around bright lights, nausea, and vomiting.
Option D: Double vision occurs when one eye has a lens and the other is aphakic. When evaluating a diplopic patient, one has to first determine whether diplopia is monocular or binocular. While this has already been mentioned above, it is of paramount importance as skipping this step will lead to unnecessary investigations and anxiety for the patient.
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