Is a patient’s eyesight failing? Look for clues
Listen to patients’ vision complaints
Eye care might be a home care provider’s last priority when there are wounds to heal and diseases to cure, but poor eyesight could result in serious injuries from falls. And eye disease, particularly when caused by diabetes, could lead to blindness, according to an optometrist from Charleston, SC, who believes home care patients should receive regular eye care at their homes.
"Diabetes is the number one cause of new blindness in the country," warns John Keriotis, OD. "A lot of changes in the retina can develop without any warning to the patient; retinopathy can be pretty insidious, and if the patient doesn’t get a yearly check-up to catch the problem before the vision becomes damaged, then it’s too late."
Another major problem is that patients who have poor vision are more likely to fall and injure themselves, Keriotis says.
Keriotis, who is beginning to set up an eye care practice for home care patients, says that nurses and aides can help patients prevent blindness and injuries by looking for clues that their eyesight is failing.
It’s not enough to simply ask patients if they can see all right, Keriotis insists. "In most cases, by the time a patient with retinopathy notices a vision problem, it’s too late," he says. "Significant retinopathy is often evident in patients with 20/20 vision."
So Keriotis recommends that home care professionals check with diabetic patients’ primary care physicians to make sure that the patient is receiving adequate eye care. For most diabetics, this means an eye check-up at least once a year. For patients who have extensive retinopathy, this check-up should occur every three months, he adds.
Are there unexplained bruises?
Other types of common eye problems in older patients are advanced cataracts and pterygium, which is a yellowish growth that causes vascular problems in patients who have dry eyes. Nurses and aides can watch for clues that patients have some kind of vision problem by following these tips:
• Look for unexplained bruises, the small types on legs or arms where a patient might have run into something.
• Watch the patient to make sure he or she can read well enough to take the right dosage of medicine or to turn on the correct dial on the stove.
• Notice how a patient eats his or her food. "If they’re eating and missing the food they’re trying to scoop up, of if they’re not putting their forks back where they belong, then they might have a vision problem," Keriotis says.
• Listen to the patients’ vision complaints; these might not be the normal result of aging.
• See if the patient is wearing his or her eyeglasses inappropriately, such as if the patient is wearing the reading glasses all the time.
• Watch the patient read, and see if he or she is covering one eye because this could mean the patient is seeing double.
• Look for any mucus discharge from the eyes.
• See if the patient has changed any visual habits, such as using a different reading distance, pushing things back far away or moving them closer; or look at the patient’s lighting while reading does he or she need extra lighting?
• Notice whether the patient avoids activities that require sight.
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