Eye Disorders

Question 1

What are the two types of glaucoma?

Answer 1

Primary open-angle glaucoma (POAG) - CHRONIC peripheral vision is gradually lost
90% of cases of glaucoma

Closed-angle (Angle-closure) - ACUTE emergency
sudden and intense eye pain, changes in vision

Question 2

What is happening with POAG?

Answer 2

Decrease outflow of aqueous humor slowly increase IOP and peripheral vision is gradually lost.

Question 3

What are some treatments for glaucoma?

Answer 3

beta blockers - first line

Alpha 2 adrenergic agonists - often used

Prostaglandins - often used

cholinergic agents - in form of eye drops (watch for systemic effect)

carbonic anhydrase inhbitors

nonselective adrenergic agonists - watch for systemic effects

Question 4

For beta-blockers, alpha 2 agonists, and prostaglandins, what are some effects of the drug (having to do with the eye or systemic effects)?

Answer 4

beta-blockers - decreases IOP by decreasing amount of aqueous humor… systemic: cardiac (decrease HR) and respiratory (nonselective)

Alpha 2 agonists (alphagan) - decrease production and increase outflow of aqueous humor… systemic: vasodilation = hypotension

Prostaglandin analogs (latanoprost (Xalatan)) - relax ciliary muscles… may change eye color (to brown or hazel) and make lashes grow thicker and longer

Question 5

What are some key nursing administration considerations for eye drop administration?

Answer 5

remove contact lenses

Use sterile technique when handling applicator tip

Hold gentle pressure on nasolacrimal duct for 30-60 seconds (increase local absorption and decreases systemic absorption (effects).

Monitor for systemic systemic effects (HR for beta-blockers (respiratory and HR for nonselectives) and hypotension for alpha 2 agonists.