امرأة عمرها ٤٠ سنة عندها داء غريفز، تشتكي من ألم وحرقة في العينين، ورؤية مزدوجة، وصعوبة إغلاق العين ليلاً، والعينان بارزتان أكثر. تدخن. ما التدخل التمريضي الأهم؟

A 40-year-old woman with Graves’ disease has painful burning eyes, double vision and difficulty closing her eyes at night, with worsening proptosis. She smokes. What is the most important nursing intervention?

1. Avoid lubricating drops because they increase bulging
2. Massage the eyes firmly each morning to reduce the bulging
3. Sleep without a pillow to improve venous return
4. Lubricate, tape eyes at night, raise head, stop smoking

Answer: D) Lubricate, tape eyes at night, raise head, stop smoking. Thyroid eye disease exposes the cornea to drying and ulceration. Lubricants, taping at night, head elevation, sunglasses and stopping smoking, which worsens it, are key.