When obtaining the health history from a male client with retinal detachment, the nurse expects the client to report:
A. Light flashes and floaters in front of the eye.
B. A recent driving accident while changing lanes.
C. Headaches, nausea, and redness of the eyes.
D. Frequent episodes of double vision.
Correct Answer: A. Light flashes and floaters in front of the eye.
The sudden appearance of light flashes and floaters in front of the affected eye is 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 B: Difficulty seeing cars in another driving lane suggests a gradual loss of peripheral vision, which may indicate glaucoma. Many patients with glaucoma, especially early in the disease, are not aware they have this condition until it is discovered on a routine eye exam. People generally slowly lose peripheral vision but retain central vision until the disease process is severe.
Option C: Headache, nausea, and redness of the eyes are signs of acute (angle-closure) glaucoma. 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. Patients will have an unresponsive mid-dilated pupil on examination and a firm feeling eyeball on palpation.
Option D: Double vision is common in clients with cataracts. Diplopia or polyopia, mostly uniocular but can be binocular, is due to multiple refractions through clear areas between the opacities. 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.
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