The original concept of this book arose out of a recognition by ophthalmic nurses that, in general, existing textbooks for nurses working in the specialty did not have the depth of content required to inform and evidence their practice. This book was therefore designed to meet the needs of ophthalmic professionals and, most especially, ophthalmic nurses, whose practice has expanded exponentially over the past few years, into areas we would never previously have dreamed possible. This expansion, though, has often been accompanied by a lack of accessible evidence to underpin it and this book aims to bridge that gap.
It was written by an international team of ophthalmic practitioners, all experts in their fields, who gave up a large amount of time, immensely willingly, to make this dream a reality because of their passion for, and dedication to, their area of practice. In the ten years since the first edition, practice has moved on, as has the evidence for practice.
This second edition draws on the passion and goodwill of the original team, complemented by other colleagues, to fully revise and update the text in line with new findings, new practice and new and exciting treatments. It is hoped that the book combines depth and breadth of content, but does this in an accessible manner which enables it to be used as a comprehensive resource not just by ophthalmic professionals, but by any healthcare professional who ever cares for a patient with an eye problem, thus enabling them to develop the knowledge and skills to incorporate consideration of their patients’ eye problems into their practice. The book is divided into three parts. The first section considers some general aspects relating to the understanding of the function and structure of the eye. The first two chapters cover the physiology of vision including embryology (in order to give an overview of how we see), and basic optics as applied to the eye. This section goes on to consider how drugs affect the eye and the main categories of ophthalmic drugs and delivery systems as well as some of the adverse effects of systemic and ophthalmic drugs. The eye examination chapter considers the requirements for effective assessment of the patient, including physical surroundings, taking a history and obtaining accurate visual acuity. It stresses the need for systematic eye examination and considers both the structures that may be examined and what the examiner should be looking for. The second section of the book considers issues surrounding patient care. It begins by considering visual impairment, its effects on the patient and strategies that may be used both by the patient, and by carers and health professionals in order to maximise autonomy and independence. Patient education is considered, both in general terms and for this particular client group and the chapter entitled ‘Work and the eye’ considers some work-related issues and some of the legislation pertaining to eye care and visual standards. The next five chapters deal with care of the patient in ophthalmic settings, considering, in turn, care of the adult in inpatient settings, care of the child with ophthalmic problems, care of the patient undergoing day surgery, care of the ophthalmic patient in the ophthalmic theatre and, finally, care of the patient in the acute setting. This section concludes with two entirely new chapters on eye banking and global eye health.
The third section takes a systematic approach to the care of patients with ophthalmic problems. The work of all ophthalmic health professionals is very closely intertwined and this is reflected in the structure of these chapters. Following the theme developed in the discussion of systematic eye examination and working from the front to the back of the eye, each chapter considers the anatomy and physiology of a structure (such as the lens or cornea) or group of structures (such as the eyelids and lacrimal drainage system). Each chapter discusses some of the common disorders affecting these structures, including their causes, presentation, special tests, diagnosis and treatment, as well as care of the patient. The final chapter considers the ocular manifestations of some of the more common systemic diseases that may be encountered by healthcare professionals.
Ophthalmology has a language of its own, which can be confusing for people new to the specialty, those outside it and even, occasionally, some very experienced practitioners. The book therefore concludes with a glossary of terms. Some aspects of practice discussed in the text are, of necessity, UK based, but these are clearly indicated and, wherever possible, principles (rather than specifics) are addressed and readers are directed to local policies and interpretations. The first edition became a core text for ophthalmic nursing, in particular, and for the education of ophthalmic nurses across the world. I hope this second, revised and updated edition will add to the body of evidence-based, informed and thinking practice for all those with eye problems, via those who care for them.
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