The nurse is performing an admission assessment on a client with a diagnosis of a detached retina. Which of the following is associated with this eye disorder?
A. Pain in the affected eye.
B. Total loss of vision.
C. A sense of a curtain falling across the field of vision.
D. A yellow discoloration of the sclera.
Correct Answer: C. A sense of a curtain falling across the field of vision
A characteristic manifestation of retinal detachment described by the client is the feeling that a shadow or curtain is falling across the field of vision. They may also have significant photopsia (flashes of light) in their vision. The patient often presents with slowly progressive or fixed visual field loss, typically starting in the periphery and then moving centrally.
Option A: No pain is associated with detachment of the retina. Other essential aspects of the history include the timing of the onset of the symptoms, if the patient has the same visual loss symptoms in the fellow eye, whether central visual acuity is affected, prior surgery, or previous trauma.
Option B: Total loss of vision is not a characteristic of this disorder. A retinal detachment is an ophthalmic emergency and even more so if visual acuity is still normal. Essential aspects of the physical exam include getting the patient’s best-corrected visual acuity of each eye, checking the pupillary reaction of each eye, and ensuring that there is no relative afferent pupillary defect and confrontational visual field testing.
Option D: If the entire sclera turns yellow, it is often a sign of jaundice. Jaundice is caused by a buildup of old red blood cells, called bilirubin. These cells are normally filtered out by the liver and turned into bile. That bile is stored in the gallbladder and eventually excreted by the body. But when the liver, gallbladder, or pancreas are not working properly, jaundice can develop.
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