Contents

Colour plate section falls after page 122

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Foreword

There are few things more frightening than losing your sight, whether suddenly, as a result of an accident or a malignant growth, or slowly, through retinopathy or a cataract. However knowledgeable the patient is, however clearly the surgeon explains your prognosis, there remains this fear that you will be visually impaired for the rest of your life.

And, at this point in time, there is nothing more reassuring than finding yourself in the hands of a competent, knowledgeable and empathic nurse who not only understands how you feel, but is skilled enough to help you adapt to the treatment and life change demands and who can help you move forward.

There is no doubt that the nurse will be familiar with Stollery and will use it as her first choice for clinical professional updating. Written by those best of teachers; lecturer practitioners who in their day-to-day work constantly practice nursing informed by the most up-to-date knowledge available. Lecturer practitioners understand the linking of theory with practice and how that blend informs the delivery of skilled and compassionate nursing care.

There is no doubt that this text is excellent, well written, patient focused and able to clearly explain the complexities of the wide range of ophthalmic conditions.

It forms a valuable resource not just for those working in ophthalmic units but also as a reference for the many staff who work with older people, the diabetic patient, the middle aged man with spondylitis, and the practice nurse. All these need to not only understand ophthalmic treatments but need to explain them to patients and carers. It is these nurses who will ensure the glaucoma patients understand the need for total compliance in the installation of their drops; it is these nurses who appreciate patient education may mean the diabetic doesn’t get retinopathy and it is the nurse in the nursing home who will recognise the signs of early cataract and ensure consultation and treatment.

In the preface Mary Shaw and Agnes Lee write of the many changes that have taken place in ophthalmology and ophthalmic nursing since the first edition was published some twenty years ago. Ophthalmic nurses have expanded their roles, providing almost the total interventions for those with chronic conditions and taking on an increasing number of tasks which were once the remit of ophthalmologists.

But for all this change, all this advancement of role, and skill, and practice, the fundamentals of all that is best in nursing still lies in the hands of ophthalmic nurses who care for patients who face, albeit hopefully temporarily, one of the greatest fears known to man.

This book will help them achieve that high level of knowledgeable practice which serves patients best.

Betty Kershaw DBE FRCN

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Preface

Since 1997, ophthalmic nursing and ophthalmic care practices have moved on in leaps and bounds.

There have been several reasons for this including the government targets to bring down hospital waiting times, new approaches to patient management with a move away from inpatient care to mainly day case management and primary care settings. Ophthalmic nursing has been transformed by the involvement of others in ophthalmic nursing care such as clinical support workers, assistant practitioners and surgical care assistants. In the UK there are now several ophthalmic nurse consultants and they are at the vanguard of change. Ophthalmic nurses have become more skilled and knowledgeable within their speciality. Many ophthalmic nurses have focussed on a particular area interest to advance their practice, in many instances taking on a clinical caseload. This has included their taking on board more duties and responsibilities previously undertaken by medical staff.

Those involved in ophthalmic care have long looked to ‘Stollery’ to help and guide their practice. In editing this edition we have merely sought to build on the framework that has stood the test of time. Newer source materials have been included and are reflected in each chapter. Within the References and Further Reading list are recommendations for reading, including accessing the Web. These texts should help the nurse new to ophthalmic care as well as the busy practicing ophthalmic nurse.

For the sake of ease and clarity, the nurse is referred to as ‘she’ and the patient as ‘he’ with no discrimination intended.

Mary Shaw and Agnes Lee

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Acknowledgements

We would like to thank our families, friends and colleagues who have helped us write this edition.

We are especially grateful to staff at the Manchester Royal Eye Hospital and The University of Manchester for their encouragement. Special thanks go to the staff in the ophthalmic imaging department at the Manchester Royal Eye Hospital, for permission to use the colour photographs. We are deeply indebted to all of the secretaries for their patience and assistance with our repeated requests for advice.

This book is dedicated to those in our families who sadly died whilst we were writing this book.

Figure acknowledgements

The illustrations have come from various sources and in addition to those acknowledged in the text, we also wish to acknowledge P.D. Trevor-Roper and P.V Curran’s The Eye and its Disorders (2nd edn), P.D. Trevor-Roper’s

Lecture Notes on Ophthalmology (7th edn) and Pocket Consultant Ophthalmology

(2nd edn), all published by Blackwell Publishing. We would also like to thank Mr Peng Khaw for the use of some of his photographs.

If we have failed to mention a specific source it is hoped that the author/publisher will accept this blanket acknowledgement and our gratitude.

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