Coat’s Disease: Symptoms And Therapies
There are many conditions that can occur within the eye that oftentimes influence an effected person’s everyday life. In understanding these conditions as a nurse, you can provide better care for that patient even if they aren’t there being treated for their eye. This article looked specifically at Coat’s disease.
Coat’s disease has a rare occurrence and is recognized as abnormalities to the normative development of the retinal vasculature. Majority of the time Coat’s disease only affects one eye (Perrone, et al. , 2016). Pathologically speaking, the disease process of Coat’s disease breaks down the blood-retinal barrier at the endothelium. This results in the leaking of plasma into the vessel wall which then become necrotic and unmanaged. This leakage also results in swelling of the retina. There are pericytes and endothelial cells present that are abnormal in retinal blood vessels. These abnormal cells decline rapidly and lead to retinal vasculature that is abnormal and are seen closing vessels, forming aneurysms, and ischemia.
As a nurse, recognizing the signs and symptoms that Coat’s disease may present can help you identify a need for a referral to an ophthalmologist. If while examining a child for other medical purposes you notice a loss in parallax and depth perception, leukocoria, decline of peripheral or central eyesight, or strabismus it would be good nursing judgement to investigate these symptoms further and possibly further recommend to an ophthalmologist. Recognizing these signs could encourage an early diagnosis, which has a direct correlation on an increasing chance of a positive prognosis.
The timeline for Coat’s disease is often unpredictable but early and accurate diagnosis and consistent therapy are often related to positive outcomes. If left untreated total retinal detachment and neovascular glaucoma can occur. It is also imperative that a nurse is able to recognize that continued advancement of this disease can result in neovascular glaucoma where certain medications may increase intraocular pressure and cause more harm. When speaking with a patient who has Coat’s disease, it is important to identify which eye is affected and stand on or approach a person on their unaffected eye to allow the patient to see you.
There are a few therapies available for someone managing Coat’s disease. These include, laser photocoagulation, cryotherapy, scleral bulking, vitrectomy, and anti-vascular endothelial growth factor injections. According to the research performed, laser photocoagulation as well as cryotherapy seem to signify the most effective therapy towards decreasing sight-threatening progression related to posterior pole retinal detachment.
With all therapies offered, long term follow-up is a critical component of managing this progressive disease and reducing further effects on the eye. Complications of this disease can progress from retinal detachment, cataract development, iridocyclitis, rubeosis iridis, and even a blind eye that is painful resulting in enucleation.
