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    Glaucoma: Zarka Wahid Bux Nursing Instructor Siut School of Nursing

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    Zarka Inqlabi
    Glaucoma is a disease where increased fluid pressure within the eye (intraocular pressure) damages the optic nerve. There are two main types - open-angle and angle-closure glaucoma. Open-angle is more common and occurs when fluid drainage is decreased due to blockages, while angle-closure occurs when the angle between the iris and sclera suddenly closes. Risk factors include age, diabetes, high blood pressure, and family history. Treatment involves eye drops or surgery to lower pressure and prevent further vision loss. Nursing care focuses on monitoring pressure post-surgery and educating patients on medication adherence and lifestyle modifications.

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    Glaucoma: Zarka Wahid Bux Nursing Instructor Siut School of Nursing

    Uploaded by

    Zarka Inqlabi
    41 views14 pages
    Glaucoma is a disease where increased fluid pressure within the eye (intraocular pressure) damages the optic nerve. There are two main types - open-angle and angle-closure glaucoma. Open-angle is more common and occurs when fluid drainage is decreased due to blockages, while angle-closure occurs when the angle between the iris and sclera suddenly closes. Risk factors include age, diabetes, high blood pressure, and family history. Treatment involves eye drops or surgery to lower pressure and prevent further vision loss. Nursing care focuses on monitoring pressure post-surgery and educating patients on medication adherence and lifestyle modifications.

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    glaucoma

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    Glaucoma is a disease where increased fluid pressure within the eye (intraocular pressure) damages the optic nerve. There are two main types - open-angle and angle-closure glaucoma. Open-angle is more common and occurs when fluid drainage is decreased due to blockages, while angle-closure occurs when the angle between the iris and sclera suddenly closes. Risk factors include age, diabetes, high blood pressure, and family history. Treatment involves eye drops or surgery to lower pressure and prevent further vision loss. Nursing care focuses on monitoring pressure post-surgery and educating patients on medication adherence and lifestyle modifications.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    41 views14 pages

    Glaucoma: Zarka Wahid Bux Nursing Instructor Siut School of Nursing

    Uploaded by

    Zarka Inqlabi
    Glaucoma is a disease where increased fluid pressure within the eye (intraocular pressure) damages the optic nerve. There are two main types - open-angle and angle-closure glaucoma. Open-angle is more common and occurs when fluid drainage is decreased due to blockages, while angle-closure occurs when the angle between the iris and sclera suddenly closes. Risk factors include age, diabetes, high blood pressure, and family history. Treatment involves eye drops or surgery to lower pressure and prevent further vision loss. Nursing care focuses on monitoring pressure post-surgery and educating patients on medication adherence and lifestyle modifications.

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    glaucoma

    zarka Wahid Bux


    nursing instructor
    siut school of nursing
    How aqueous humor normally flows

    • How aqueous humor normally flows


    • Aqueous humor, a plasma like fluid produced by the ciliary epithelium of the ciliary
    body, flows from the posterior chamber to the anterior chamber through the pupil. Here
    it flows peripherally and filters through the trabecular meshwork(tissue located in the
    anterior chamber angle of the eye) to Schlemm’s canal( circular lymphatic like vessel in
    the eye that collect aqueous humor from anterior chamber) and ultimately into venous
    circulation.
    What is intraocular pressure
    • intra means within and ocular means eye…so intraocular pressure is the fluid pressure
    within the eye, and the fluid we’re talking about is called aqueous humour. IOP is
    calculated by the production and drainage rate of aqueous humour in the eye. The
    production and drainage rate should be equal or increased intraocular pressure will
    occur. A normal intraocular pressure is about 10-21 mmHg.
    Glaucoma
    • Glaucoma is a disturbance of the functional or structural integrity of the optic nerve.
    Decreased fluid drainage or increased fluid secretion increases intraocular pressure
    (IOP) and can cause atrophic
    • changes of the optic nerve and visual defects. An expected reference range for IOP is
    between 10 and 21 mm/Hg.
    Types of glaucoma
    • There are two primary types of glaucoma:
    • Open-angle glaucoma – most common form of glaucoma. Open-angle refers to the angle
    between the iris and sclera. The aqueous humor outflow is decreased due to blockages in
    the eye’s drainage system (Canal of Schlemm( a channel in the eye that collect aqueous
    humour and transfer it into blood vessels) and trabecular meshwork), causing a rise in IOP.
    • Angle-closure glaucoma – less common form of glaucoma. IOP rises suddenly. With
    angle-closure glaucoma, the angle between the iris and the sclera suddenly closes, causing a
    corresponding increase in IOP.
    • Glaucoma is a leading cause of blindness. Early diagnosis and treatment is essential in
    preventing vision loss from glaucoma.
    pathophysiology
    • Chronic open-angle glaucoma results from overproduction of aqueous humor or
    obstruction of its outflow through the trabe-cular meshwork or Schlemm’s canal,
    causing increased IOP and damage to the optic nerve. In secondary glaucoma, such
    conditions as trauma and surgery increase the risk of intraocular fluid obstruction
    caused by edema or other abnormal processes.
    Risk factors
    • Age
    • Infection
    • Tumors
    • Diabetes mellitus
    • Genetic predisposition
    • Hypertension
    Sign and symptoms
    • Open-angle glaucoma • Angle-closure glaucoma
    • Headache • Rapid onset of elevated IOP
    • Mild eye pain • Decreased or blurred vision
    • Loss of peripheral vision • Seeing halos around lights
    • Decreased accommodation • Pupils are nonreactive to light
    • Elevated IOP (greater than 21 mm Hg) • Severe pain and nausea
    • Photophobia
    Diagnostic evaluation
    • Visual assessments
    • Decrease in visual acuity and peripheral vision
    • Tonometry
    • Tonometry is used to measure IOP. IOP (expected reference range is 10 to 21 mm Hg)
    is elevated with glaucoma, especially angle-closure.
    • Gonioscopy
    • Gonioscopy is used to determine the drainage angle of the anterior chamber of the
    eyes.
    groups of glaucoma meds, let’s remember the ABCC’s:
    • Alpha agonists “idine”: Brimonidine: works with • Carbonic anhydrase Inhibitors (CAIs): “zolamide” (oral or
    alpha receptors by activating them….decreases drops): “Acetazolamide”
    aqueous humour production (constriction to the • Decrease aqueous humour production…diuretic that inhibits
    ciliary body) and helps increase the drainage of carbonic acid production
    aqueous out of the eye and this lowers IOP. • Assess for a sulfonamide allergy
    • Cholinergic (miotics): “Pilocarpine” eye drops: helps lower
    • Systemic effects: punctal occlusion very important
    intraocular pressure especially in angle-closure glaucoma
    • Risk of feeling very drowsy • How? They constrict the pupil which will help increase drainage
    • Beta blockers “olol”: Timolol: decrease aqueous of aqueous humour out through the trabecular meshwork.
    humour production • Antidote is atropine.
    • Systemic effects, cardioselective & non • Cholinergic effects: sweating, increase salivation,
    bronchospasm, decreased heart rate etc. increase eye sensitivity
    cardioselective types not for patients with bradycardia, to light (problems with vision in dim light especially) Punctal
    asthma, or COPD assess breathing and heart rate occlusion during administration
    before administration
    Surgical Interventions

    • laser iridotomy: small hole created in the iris with a laser to drain the increased
    aqueous humour
    • Iridectomy: removes part of the iris) may be performed in both eyes because of the risk
    of the other eye developing angle-closure as well.
    Nursing management
    • IOP is checked 1 to 2 hr. postoperatively by the surgeon.
    • Educate clients about the disease and importance of adhering to the medication schedule to treat IOP. Wear sunglasses while outside or in
    brightly lit areas.
    • Report signs of infection, such as yellow or green drainage.
    • Avoid activities that increase IOP.
    • Bending over at the waist
    • Sneezing
    • Coughing
    • Straining
    • Head hyperflexion
    • Restrictive clothing, such as tight shirt collarsClients should not lie on the operative side and should report severe pain or nausea (possible
    hemorrhage).
    • Clients should report if any changes occur, such as lid swelling, decreased vision, bleeding or discharge, a sharp, sudden pain in the eye
    and/or flashes of light or floating shapes.
    complication
    • Blindness
    • Blindness is a potential consequence of undiagnosed and untreated glaucoma.
    • Client Education
    • Encourage adults 40 or older to have an annual examination, including a measurement
    of IOP.

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