Wednesday, August 8, 2012

Pathophysiology - Eye Tumors: Retinoblastoma and Melanoma

TUMORS OF THE EYE
  • may be benign or malignant, can form in or metastasize to the eye
  1. Retinoblastoma – a congenital malignant neoplasm found in children
    • Spreads easily by extension to the brain or bone marrow
  2. Melanoma – common in the iris and choroid
    • Grows slowly but metastasizes to the liver and lungs
Signs and Symptoms
  • Subjective
    • Headache
    • Visual complaints
  • Objective
    • Decreased vision
    • Increased intra ocular pressure
    • White pupils
    • Strabismus – in retinoblastoma
Treatment
  • Chemotherapy – such as cyclophosphamide, vincristine, carbotin
  • Radiation therapy – has significant consequences such as cataracts, chronic dry eye
  • Enucleation – surgical removal of the eye
Nursing Management
  • Support the client and significant others as they attempt to cope up with the disease
  • Observe for side effects of medical therapy and attempt to limit their effects
  • Provide care for the client who had undergone enucleation
  • Maintain pressure dressings on the eye for 1 or 2 days to minimize hemorrhage
  • Explain that artificial eye may be inserted when healing is complete, usually 1 to 2 months
  • Instruct the client about the care of the eye socket and prosthesis with warm water and saline
  • Support natural defense mechanism, encourage intake of nutrient dense foods and vitamin A, C, E, as well as protein.

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