Glaucoma (Exam 2) Flashcards
Glaucoma: What it’s like
Peripheral vision is loss but central vision stays intact
Can go unnoticed because it is not central vision
Glaucoma
Eye disorder that INCREASES intraocular pressure
Major cause of blindness (second behind cataracts)
What is the most common cause of blindness
Cataracts
Two causes of glaucoma
Open angle
&
Closed angle
Open Angle Glaucoma
Clogged Kitchen Sink
Problem of reabsorption of aqueous humor (dealing with trabecular meshwork)
Asymptomatic
Close Angle Glaucoma
A “structural” problem
Narrow angle between cornea and iris that prevents aqueous humor from being reabsorbed (AH can not even get to trabecular meshwork)
OA glaucoma presents as
Asymptomatic
CA glaucoma presents as
Painful red eye and must be treated within 24 hrs or blindness may be permanent
Chronic Open Angle: First line therapy
Medications:
-Decrease aqueous humor production
-Miosis / opening of trabecular meshwork
Problems with Chronic Open Angle Glaucoma Medicaiton
COMPLIANCE
Issues because they have to be given several times per day and the disease can be asymptomatic. So patient forgets or feels like it is not important
Chronic Open Angle Glaucoma: Treatment when drug therapy is not sufficient
Argon Laser Trabeculoplasty (ALT)
Argon Laser Trabeculoplasty (ALT)
Outpatient procedure
Topical anesthetic
Laser hits damaged trabecular meshwork and opens outflow channels
Plumber opening clogged sink
What is used to diagnose Acute Angle Closure
Gonioscopy
Patients comes into ED, what is initial therapy?
4
Immediate relief:
Beta-blocker topical agent
+
Carbonic anhydrase inhibitor (acetazolamide)
Miotic eye drops to constrict pupils
Treat pain and nausea because it increases IOP
Why do we want to constrict pupil in closed angle glaucoma
Take pressure off of the angle (lower IOP)
What kind of eye drops will we give for CAG
Miotic Eye Drops
(we want to pupil to constrict to relieve pressure)
Once IOP is stabilized in closed angle glaucoma, what is next?
Prepare for iridotomy
Surgical Interventions for closed angle glaucoma
Iridotomy:
-Punch holes in the iris to allow for aqueous humor to get on the other side of the eyeball
Iridectomy:
-Removal of the iris
Health Promotion: How often should you have exam?
Every 3-5 years (40-60)
Every 1-2 years (>60)
AA’s periodic (20-40)
Acute Interventions for Acute angle closure glaucoma
Quick appropriate drug interventions
Acute pain
-if light sensitive = darken room
-Cool compress to head
-Private and calming environment
-Keep patient and family informed
Patient / family support and teaching
What is done first? Darken the room or give miotic eye drop
We want to give miotic eye drop before darkening room
If we darken the room before then the eye can dilate and we do not want that
