Charting

[AlynnSN]

Just curious how you would chart someone who is blind?

We are taught in nursing school how to assess PERRLA and how to chart it but what if someone is blind?

Can you just chart "pt is blind" ?

[Asystole RN]

Chart what you are assessing. There are various levels of "blindness"

Blind as in the pt has no eyes at all, blind as in the pt can only see shadows etc etc. What do the eyes look like and what do they do?

[RaziRN]

I could be wrong but just because a pt. is blind doesn't mean that their pupils don't react to light. In any case, their pupils should be equal if their neurological status is intact. They should also be round. The only thing I could see that would be different is that they wouldn't be able to accomodate. You could chart: "Pupils equal, round and reactive to light. Pt. is blind." But then again I'm not sure if a blind person's pupils react to light....someone correct me if I'm wrong.

[Asystole RN]

I could be wrong but just because a pt. is blind doesn't mean that their pupils don't react to light. In any case, their pupils should be equal if their neurological status is intact. They should also be round. The only thing I could see that would be different is that they wouldn't be able to accomodate. You could chart: "Pupils equal, round and reactive to light. Pt. is blind." But then again I'm not sure if a blind person's pupils react to light....someone correct me if I'm wrong.

Well you are on the right track.

What is causing the blindness is the issue. The pupils may or may not work depending upon the nature of the blindness, that is why it is important to chart what the eyes look like and how they react.

[AlynnSN]

Well you are on the right track.

What is causing the blindness is the issue. The pupils may or may not work depending upon the nature of the blindness, that is why it is important to chart what the eyes look like and how they react.

Good point! I wasn't even thinking that we would still assess their PERRLA knowing they were blind.

It always comes back to "chart what you see" which would mean that you would still assess it.

[RaziRN]

Well you are on the right track.

What is causing the blindness is the issue. The pupils may or may not work depending upon the nature of the blindness, that is why it is important to chart what the eyes look like and how they react.

Thanks for the feedback!

[ittibittinurse]

Interesting post. I actually cared for a patient recently who went blind during her admission. She was told she would be going blind over time about a month before her admission, but was unable to tell the nurses and doctors on her admission about the possiblity of going blind. When she started having visual changes, she told us and then over time she remembered her pre-admission diagnosis. I did chart what her pupillary reaction, etc. as part of my head to toe assessment even though I was not aware of her diagnosis. I also let the doctor know that her pupillary reaction was not normal and he thought she was going blind. I find it is always a good idea to do a thorough head to toe assessment...that includes the eyes, ears and mouth....because you just never know what you will find out about your patients....this is just my opinion of course.

[caliotter3]

I also agree on the thorough head to toe. It is somewhat embarrassing for something to be "discovered" shifts, weeks, or months after your first introduction to a particular patient.