GLAUCOMA
caused by Increase
Intraocular Pressure (IOP) that
can lead to blindness.
TWO TYPES OF GLAUCOMA
ACUTE (closed-angle)
Impaired passage of aqueous humor into the circular
canal of Schlemm due to closure of the angle
between the cornea and iris.
SURGICAL EMERGENCY
Pain: severe (in & around eyes)
Halos (rainbow around light)
Burning of vision
Nausea & vomiting
CHRONIC (OPEN-ANGLE)
Degenerative changes CAUSES:
in trabecular 1. Acute closed-angle
meshwork due to Trauma
local of aqueous Associated with
humor between the ocular disease.
anterior chamber and
canal.
2. Chronic open-angle
Associated with aging,
hereditary.
STAGES OF GLAUCOMA
1. Initiating events
-precipitating factors include illness, emotional stress,
congenital narrow angles, long-term use of
corticosteroids, and use of mydriatics.
2. Structural alterations in the aqueous outflow
system
-tissue and cellular changes caused by factors that
affect aqueous humor dynamics lead to structural
alterations and to the third stage.
3.Functional alterations
-conditions such as increased IOP or impaired blood
flow create functional changes that lead to the
fourth stage.
4. Optic nerve damage
-atrophy of the optic nerve is characterized
by loss of nerve fibers and blood supply.
This fourth stage inevitably progress to the
fifth stage.
5. Visual loss
-progressive loss of vision is characterized by
visual field defects.
CLINICAL MANIFESTATION
1. Blurred vision or halos around
lights
2. Difficulty focusing and adjusting
eyes in low lighting
3. Eye pain
4. Headache
5. Increase IOP
6. Loss of peripheral vision
LABORATORY FINDINGS
Tonometry
Perimetry
Ophthalmoscopy
Snellen’sChart
Gonioscopy
TREATMENT
MIOTICS ANTI
Constricts pupils and CHOLINESTERASE
increases outflow of To facilitate outflow
aqueous humor. of the aqueous.
CARBONIC BETA BLOCKERS
ANHYDRASE
INHIBITORS Suppress secretion of
Reduces the
aqueous humor.
production of aqueous
humor.
SURGICAL MANGEMENT
LASER TRABECULOTOMY
TRABECULOPLASTY (filtering
procedure)
Useof laser to Loosely suturing of
create opening in sclera flap through
the trabecular which fluid escapes
meshwork allowing resulting to
increase outflow of absorption of
aqueous humor. aqueous.
POST-OP CARE
•Eye patching
•Lie on the unoperative side
•Report of Signs and symptoms of
IOP
•Infection
•Eye drop techniques
HEALTH TEACHING
Prevent Increased
IOP by avoiding:
a. Valsalva Maneuver f. Constrictive
b. Excessive fluids clothing
c. Anger g. Bending
d. Heavy lifting over h. Coughing
5 lbs.
i. vomiting
e. Eye strain
NURSING INTERVENTION
Maintain bed rest, darken room
Monitor V/S
Avoid fatigue and stress activity
Provide DAT
Provide emotional support
Administer meds.
Prepare for surgery if order
GROUP TWO
GOMEZ, BERNADETH
MENDOZA, FEBELYN
MIGUEL, RENATO
ORODIO, CAREL
PASCUA, JANE