Nursing Care Plan for Endophthalmitis

Endophthalmitis - Nursing Assessment and Diagnosis

Definition of endophthalmitis

Endophthalmitis is inflammation of the lining around the inner eye, the fluid in the eyeball (the vitreous humor) and the whites of the eyes (sclera).

Endophthalmitis is a purulent inflammation (suppurative) within the eyeball. Is a purulent inflammation of the entire intra-ocular tissues is accompanied by the formation of abscesses in the body of the glass. Cause of Sepsis, orbital cellulitis, penetrating trauma, ulcer.


Classification

Endophthalmitis can be classified according to:
1 How to enter
  • Endogenous endophthalmitis caused by bacteria spread from elsewhere in the body through the bloodstream. The main fungi. Common predisposing factor is immunocompromised status, septicemia or IV drug abuse.
  • Exogenous endophthalmitis can occur as a result of penetrating trauma or infection in the open surgery eyeball. Endogenous endophthalmitis is very rare, only 2-15% of all endophthalmitis. The main bacteria.

2. Types of agents causing
  • bacteria
  • fungi
  • virus
  • parasites


Etiology

The cause of endophthalmitis among others:
  1. Surgery.
  2. Wounds that penetrate the eye.
  3. Bacteria. The cause of most is Staphylococcus epidermidis, Staphylococcus aureus, and Streptococcus species.
  4. Fungi. The cause of most is Aspergillus, phycomycosis and Actinomyces.


Signs and Symptoms

Inflammation caused by bacteria will provide clinical manifestations of severe pain, red and swollen eyelids, difficult petals opened, chemotic and red conjunctiva, cornea cloudy, cloudy anterior chamber. In addition, there will be a decrease in visual acuity and photophobia (fear of light). Endophthalmitis due to surgery is common after 24 hours and eyesight would worsen with the passage of time. When already deteriorating, will be formed hypopyon, the white fluid-filled sac, in front of the iris.

The symptoms are often severe, which are:
  1. eye pain
  2. redness of the sclera
  3. photophobia (sensitive to light)
  4. visual impairment.

Signs often appear:
  1. eyelids red,
  2. swelling, and difficult to open,
  3. cloudy cornea,
  4. murky chamber of the eye.


Pathophysiology

Endophthalmitis or corpus vitreous abscess is severe inflammation within the eye, usually caused by trauma or surgery, or endogenous due to sepsis. Shaped suppurative inflammation within the eye, and will lead to an abscess in the body of the glass. Exogenous endophthalmitis caused by penetrating trauma or secondary infection following surgery on the open eyeball. Endogenous endophthalmitis caused by the spread of bacteria, fungi or parasites from the focus of infection in the body.
Inflammation by bacteria provide a picture of severe pain, red and swollen eyelids, anterior chamber murky, sometimes accompanied by hypopyon. In the body of the glass can be found masses of white gray and light hippion satellite abscesses form in the body of the glass.



NURSING CONCEPTS

A. Assessment
  • Assessment sharp eyesight.
  • Assessment of pain.
  • Symmetry eyelid.
  • Eye reaction to light / eye movement.
  • Color eyes.
  • The ability to open and close the eyes.
  • Assessment of visual field.
  • Inspect the outside structure of the eye and inspection nodes for the presence of swelling / inflammation.

Data Focus
  • Pain (mild to severe).
  • Photophobia (sensitivity to light) or blepharospasme (eyelid spasms).
  • Sharpness of vision.


Nursing Diagnosis
  1.  Acute Pain: eye related to inflammation and inflammatory processes.
  2.  Disturbed Sensory Perception (specify: visual) related to the inflammatory process.
  3.  Disturbed Body Image related to loss of vision.
  4.  Disturbed Sleep Pattern related to pain.
  5.  Anxiety related to lack of knowledge about the disease.
  6. Knowledge Deficit related to lack of information.

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