Ophthalmology Nursing: More Than Meets the Eye

Ophthalmology nursing is often perceived as a routine nursing specialty. But to those who practice it, the work is challenging, cutting-edge and abundant with opportunity.

“I don’t think many healthcare professionals realize how technically and emotionally demanding ophthalmology nursing can be,” says Amy Lucci, DNP, RNFA, CNOR, a nurse manager in Cleveland Clinic’s Cole Eye Institute. “For example, ophthalmic eye surgery is performed under a microscope with margins thinner than a human hair.”

Lucci says extraordinary attention to detail, precision in practice, and an intuitive understanding of surgeons’ preferences are a few of the skills needed in the field.

“Ophthalmology is an incredible specialty to work in as a nurse because it blends high-precision procedures with deeply meaningful patient outcomes,” Lucci explains. “It’s a specialty where science meets compassion. You get to be part of cutting-edge surgical technology while also witnessing some of the most emotional patient moments, like the joy of someone seeing clearly for the first time in years.”

Variety and versatility

Approximately 45 ophthalmology nurses work alongside ophthalmologists in Cleveland Clinic’s Cole Eye Institute. They assist with a wide scope of therapies and treatments in pre-operative, post-operative, operating room (OR) and clinic settings.

“What makes ophthalmology nursing so unique is that it encompasses many different subspecialties,” says Sarah Lansky, MSN, RN, an RN program coordinator in the institute’s perioperative area. “Most of our nurses work in all areas, covering pre-op, post-op, and the OR.”

Cleveland Clinic’s newest eye care building includes three procedure rooms, eight operating rooms and 60 outpatient exam rooms — all equipped with imaging technology. Each year, the Cole Eye Institute sees an average of 21,000 surgical cases and 400,000 outpatient visits.

“We’re seeing more patients than ever, including thousands of international patients,” Lansky says. “The new building supports our growth so we can continue to enhance the care we provide, as well as the number of patients we see in a day.”

Cleveland Clinic ophthalmology nurses care for patients of all ages and with diverse backgrounds, varying comorbidities and ophthalmic conditions that require everything from basic eye care to advanced eye surgery. Eight nurses work as care coordinators. Partnering with Cleveland Clinic’s retina surgeons, they conduct post-procedure follow up and assist with continuity of care. They may also scrub in on surgeries. Other nursing caregivers serve as circulating nurses in the OR, and some work in the clinic’s photography department, performing image-related injections used for diagnosing patients, assisting with non-OR procedures, and more.

“In every capacity, our team is integral,” explains Lansky. “We get patients and families ready for surgery, we ensure safety in the OR, and we provide discharge instructions after surgery to encourage optimal results.”

Other aspects of the job include:

• Collecting medical histories and recording visual activity and ocular functions
• Assessing patients before and after eye surgery
• Assisting with medication, instrumentation and supply needs during surgery
• Ensuring universal protocols are followed during surgery
• Educating patients on caring for eye injuries or diseases at home

Powerful and personal

“Everything an ophthalmology nurse does actively helps patients improve their quality of life,” says Lansky.

Many ophthalmology nurses hold professional certifications such as CNOR (certified perioperative nurse), CAPA (certified ambulatory perianesthesia nurse), CPAN (certified post anesthesia nurse) and CRNO (certified registered nurse in ophthalmology). They enhance their practice through continuing education and involvement with professional organizations such as the Association of periOperative Registered Nurses and the American Society of Ophthalmic Registered Nurses.

Educating nursing staff is an important part of Lansky’s role. She trains new and current nursing caregivers, ensuring they are apprised of relevant policies, procedures, evidence-based practices and industry updates. She also educates patients and families, informing them of procedural details and answering their pre-procedure questions.

“Patients are generally nervous when they come in for surgery,” she says. “But often, they come out seeing better than when they walked in. It’s meaningful work — you know you are making a difference in people’s lives.”

Lucci agrees, “Many patients fear they will lose their vision, which is one of the most dreaded forms of impairment.”

She adds, “Restoring or preserving someone's sight is life-changing — not just for the patient, but for everyone involved in their care.”

Like other nursing fields, ophthalmology nursing is rooted in compassionate, empathetic patient care.

“In every interaction, our nursing team provides compassion and empathy,” shares Lansky. “We assess and treat each of our patients as our own family, educating them and advocating for them.”

In many cases, ophthalmology nurses form lasting patient relationships.

“You do get to build a rapport with the patients that you see because many come back a second time, such as for cataract surgeries, or after their visual disturbances are resolved,” Lansky notes.

Lucci adds, “Seeing people come in withdrawn and anxious and leave with a new lease on life is a daily reminder of how powerful and personal nursing can be.”