Unit 1: Glaucoma Flashcards
Week 1
Glaucoma
group of eye conditions that present with increased IOP
- increased intraocular pressure (IOP) and damage to the optic nerve leading to vision loss
- leading cause of blindness
- anyone can develop
Causes of Increased Intraocular Pressure (IOP)
(>21 mm Hg)
can be a result of:
-inadequate drainage of aqueous humor from the canal of schlemn or
-an overproduction of aqueous humor
Risk Factors for Glaucoma
- African Americans over 40
- Family Hx of glaucoma
- Over age of 50
- Hx of Diabetes or Hypothyroidism
- Hx of Ocular Hypertension
- Hx of myopia
- Prolonged corticosteroid use
Pathophysiology of Glaucoma
damages optic nerve resulting in vision loss and blindness
- drainage canal blocked; too much fluid stays in the eye; this increases pressure
- high pressure damages optic nerve
Types of Glaucoma
- Primary open-angle Glaucoma
- Angle-closure Glaucoma
Primary-Open Angle Galucoma
- most common form
- chronic
- no symptoms/ no warning signs (silent thief)
- gradual loss of peripheral vision
- usually in both eyes
- tunnel vision in advanced stage
Angle-Closure Glaucoma
“acute glaucoma”, “narrow-angle glaucoma”
- rare; medical emergency
- eye pressure rises quickly
- severe eye pain
- nausea and vomiting
- headache
- sudden onset of blurred vision/ halo vision
- reddening of the eye
- no way for fluid to drain; angle closure
- eye drops instilled immediately to try to reduce the rising IOP
Best Prevention
regularly scheduled eye exams
Treatments: Medications
- eye drops or oral medications
- medications that cause the eye to make less aqueous humor or
- help to drain fluid from the eye
- Oral medications: carbonic anhydrase inhibitor to reduce IOP
Surgical Management
used if medications are not effective
- Laser Trabeculoplasty
- Trabeculotomy
- Drainage implants
Laser Trabeculoplasty
- treats primary-open angle glaucoma
- anesthetic eye drops given
- high-energy laser beam is used to open clogged drainage canals, allowing aqueous humor to drain more easily from the eye
- performed in providers office or clinic
- one eye treated at a time
Trabeculotomy
“Filtering Surgery”
- done in outpatient surgery center or hospital
- under local sedation
- surgeon uses specialized instruments and places an opening in the sclera of the patient, removing a small piece of the trabecular meshwork to allow for aqueous humor to freely exit the eye and lower IOP
Drainage Implants
- hospital or outpatient clinic
- surgeon inserts a small silicone tube in the eye to help drain the aqueous humor
Nursing Management: Assessment and Analysis
- clinical manifestations are r/t the damage and complications associated with increased IOP:
- decreased visual acuity
- nausea and vomiting
- headache
- eye pain
- multicolored halos around lights
Clinical Manifestation: Vision Loss
- can be sudden or gradual
- may not be noted until vision loss more pronounced
- associated with pressure on the optic nerve caused by increased IOP preventing transfer of nerve signals to the brain
