Blindness

  1. Causes
    1. Genetic disorders: Tay-Sach's disease, inborn errors of metabolism
    2. Maternal infections during pregnancy: TORCH syndrome
    3. Perinatal: prematurity, retrolental fibroplasia
    4. Postnatal: trauma, childhood infections
  2. Medical management: treatment of causative disorders
  3. Assessment findings
    1. Vacant stare; obvious failure to look at objects
    2. Rubbing eyes, tilting head, examining objects very close to the eyes
    3. Does not reach for objects (over 4 months)
    4. Does not smile when mother smiles (over 3 months), but does smile in response to mother's voice
    5. Crawls or walks into furniture (over 12 months)
    6. Does not respond to the motions of others
    7. No concept of the look of an object, no concept of color or reflection of self
    8. Other senses become more keenly developed to compensate
    9. Unable to copy the actions of others; delayed motor milestones in accomplishing tasks but are not mentally handicapped
    10. Various degrees (20/200 O.U. and worse)
  4. Nursing interventions
    1. For hospitalized child, find out parents' usual method of care.
    2. Encourage infant to be active; use multisensory stimulation (rocking, water play, musical toys, touch).
    3. From ages 2-5 arrange environment for maximum autonomy and safety (e.g., avoid foods with seeds and bones).
    4. Speak before you touch the child, announce what you plan to do.
    5. Do not rearrange furniture without first telling child.
    6. For a partially sighted child
      1. Encourage child to sit in front of classroom.
      2. Speak directly to child's face; do not look down or turn back.
      3. Use large print and provide adequate nonglare lighting.
      4. Use contrasting colors to help locate areas.
    7. Provide client teaching and discharge planning concerning
      1. General child care, with adaptations for safety and developmental/ functional level
      2. Availability of support groups/community agencies
      3. Special education programs
      4. Interaction with peers; assist child as necessary

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