The nurse is performing an assessment on a client with a suspected diagnosis of cataract. The chief clinical manifestation that the nurse would expect to note in the early stages of cataract formation is:
A. Eye pain
B. Floating spots
C. Blurred vision
D. Diplopia
Correct Answer: C. Blurred vision
A gradual, painless blurring of central vision is the chief clinical manifestation of a cataract. Early symptoms include slightly blurred vision and a decrease in color perception. A cataract is a clouding or opacification of the normally clear lens of the eye or its capsule (surrounding transparent membrane) that obscures the passage of light through the lens to the retina of the eye. This blinding disease can affect infants, adults, and older people, but it predominates the latter group.
Option A: There is no eye pain in the cataract. In the acute angle-closure type, patients typically present with severe sudden ocular pain, redness, blurry vision/decreased visual acuity, headache, nausea or vomiting, and may complain of seeing halos of light.
Option B: 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. The patient often presents with slowly progressive or fixed visual field loss, typically starting in the periphery and then moving centrally.
Option D: Diplopia or polyopia, mostly uniocular but can be binocular, and this is due to multiple refractions through clear areas between the opacities. The disease process progresses gradually without affecting daily activities early on, but with time, especially after the fourth or fifth decade, the cataract will eventually mature, making the lens completely opaque to light interfering with routine activities.
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