A home health nurse is performing an eye assessment for an older adult client. Which of the following findings is the priority for the nurse to report to the provider?
A.
Conjunctivitis
B.
Increased sensitivity to glare
C.
Decreased near vision
D.
Hemianopsia
The Correct Answer and Explanation is:
The correct answer is D. Hemianopsia.
Explanation:
Hemianopsia refers to the loss of vision in half of the visual field, typically on the same side in both eyes. This condition is often a result of damage to the optic pathways in the brain, such as from a stroke, brain tumor, or traumatic brain injury. Hemianopsia is a significant finding because it can severely impact a person’s ability to function safely and independently. The loss of peripheral vision can lead to challenges with mobility, an increased risk of falls, difficulty in recognizing objects or people, and potential issues with reading or driving.
In contrast, the other options, while concerning, are not typically as urgent or life-threatening:
- A. Conjunctivitis: This is an inflammation or infection of the conjunctiva, the membrane that lines the eyelid and covers the white part of the eyeball. Although uncomfortable and potentially contagious (especially in cases of bacterial or viral conjunctivitis), it is generally not an emergency. Conjunctivitis can be treated with antibiotics (if bacterial), antivirals (if viral), or just supportive care.
- B. Increased sensitivity to glare: This is a common issue in older adults, often associated with cataracts or changes in the eye’s lens. While it can impact daily activities, it is typically a gradual change and does not pose an immediate risk to the client’s health.
- C. Decreased near vision: Also known as presbyopia, this is a normal age-related change where the eye’s lens becomes less flexible, making it harder to focus on close objects. It is usually corrected with reading glasses and does not require urgent medical intervention.
Hemianopsia, however, requires prompt evaluation because it could indicate a new or worsening neurological issue that might need immediate intervention, such as imaging studies (like an MRI or CT scan) to determine the cause, and potentially treatments to prevent further damage or complications. Early reporting and intervention can make a significant difference in the management and outcomes for the client. Therefore, among the listed options, hemianopsia is the priority finding for the nurse to report to the provider.