OPHTHAL CASE SCENARIO 1 : ACUTE ANGLE CLOSURE GLAUCOMA IN RIGHT EYE

Mrs. R is a 51 year old mother who came to EMD, PSG Hospitals with severe Right eyebrow, Right cheek and Right eye
pain started 2-3 hrs before. She also noticed blurry vision from right eye and rainbow-colored halos around lights around
the same time. She had acute nausea. She had vomited twice since feeling the eye pain. There is mild redness in the Right
eye. She had no previous history of eye surgeries, trauma, amblyopia or strabismus. She was on medication Tab. Vicodin
prn for back pain for past 3 years. Her father had history of chronic angle closure glaucoma.

Eye Examination

Visual Acuity (cc):

Right eye: 20/70
Left eye: 20/20

Pupils:

Right eye pupil mid dilated, sluggish to respond to light. Left eye pupil round and reactive to light

Slit Lamp findings:

1. Lids and Lashes Normal both eyes

2. Conjunctiva/Sclera Mild diffused injected conjunctiva right eye, normal left eye

3. Cornea Hazy cornea in right eye, normal left eye

Shallow anterior chamber 360 right eye – hazy view, deep and quiet left
4. Anterior Chamber
eye
5. Iris Mild dilated iris right eye, normal left eye

6. Lens Trace nuclear sclerosis

7. Anterior Vitreous Clear both eyes

She was then diagnosed as acute angle closure glaucoma in Right eye. Laser peripheral iridectomy (placing a hole in the
peripheral iris) was performed. This procedure restores aqueous flow from the posterior to anterior chamber by creating
an extra opening in the iris, relieving the pathologic pressure gradient. This ultimately allows the iris to regress and pull
away from the trabecular meshwork and then normal aqueous humor drainage is restored.

 Based on the history write care note for Mrs.R?

 Perform physical examination specific to the diagnosis.
 Prepare nursing care plan based on priority nursing diagnosis.
 Provide need based health education.