Health history, including accidents, allergies, exposure to pollutants, falls, hyperthermia, hypothermia, poisoning, sensory or perceptual changes (auditory, gustatory, kinesthetic, olfactory, tactile, and visual), and trauma
Use of glasses or contact lenses
Complaints and concerns about eyes
Expected Outcomes⬆⬇
Patient will not experience dry eyes.
Patient will not experience eye irritation.
Patient will state personal risk factors for dry eye.
Patient will take steps to minimize risk factors.
Patient will understand need for collaboration with health care team if signs/symptoms occur/persist.
Identify use of systemic medications that may decrease tear production and lifestyle behaviors that may potentiate dry eye conditions. Assessment data may influence interventions.
Assess for history of medical conditions to determine underlying risks for dry eye syndrome.
Modify physical environment to increase humidity, minimize excessive air movement, and control dust, which can decrease tear production.
Administer artificial tears as indicated to relieve symptoms.
Perform protective measures such as preservative-free artificial tears or polyethylene eye cover for critically ill patients to prevent eye damage due to dry eye syndrome.
Teach about simple environmental modifications to reduce evaporation of tears. Encourage patient to take frequent breaks from visually demanding activities to help minimize risk factors. Suggest diet rich in omega-3 fatty acid or dietary supplement. Diet low in omega-3 fatty acids can increase risk of dry eye syndrome.
Instruct patient on the use of sunglasses to limit exposure to light.
Instruct patient to try over-the-counter artificial tears for temporary relief of dry eye.
Encourage adherence to lifestyle modifications, which will improve quality of life and decrease the risk of eye damage.
Refer to an eye specialist if symptoms persist for further evaluation and continued care.
Collaborate with primary care provider regarding possible changes in medications that may be contributing to dry eye condition.
Encourage annual eye examination to monitor for any changes.
Offer written treatment guidelines as needed to reinforce learning.
Patient recognizes possibility of adverse reaction to dry eye.
Patient collaborates with health care team members.
Documentation⬆⬇
Patient's expressions of concern about adverse reaction and symptoms of previous episodes of dry eye
Observations of physiological and behavioral manifestations of dry eye
Interventions performed to allay adverse reaction
Patient's response to interventions
Evaluations for expected outcomes
Reference(s)⬆
Bağbaba, A., Şen, B., Delen, D., & Uysal, B. S. (2018). An automated grading and diagnosis system for evaluation of dry eye syndrome. Journal of Medical Systems, 42(11), 227.
Clayton, J. A. (2018). Dry eye. New England Journal of Medicine, 378(23), 2212-2223.
de Lima Fernandes, A. P. N., de Medeiros Araújo, J. N., Botarelli, F. R., Pitombeira, D. O., Ferreira Júnior, M. A., & Vitor, A. F. (2018). Dry eye syndrome in intensive care units: A concept analysis. Revista Brasileira de Enfermagem, 71(3), 1162-1169.
Marshall, L. L., & Roach, J. M. (2016). Treatment of dry eye disease. Consultant Pharmacist, 31(2), 96-106.