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- Glaucoma is characterized by high IOP associated with optic disk cupping and visual
field loss.
Acute Glaucoma
• Results when the angle between the iris and the cornea becomes narrowed, restricting or
blocking the drainage of aqueous humor through the trabecular network and the canal of
Schlemn. This causes IOP to increase suddenly.
• It may result from trauma, stress, or any process that pushes the iris forward against the
inside of the cornea when there is already an anatomically shallow anterior or chamber.
• It is an acute, painful condition that can cause permanent eye damage within several
hours.
Chronic (open-angle)
• Results from the gradual deterioration of the trabecular network that, as in the acute form,
blocks drainage of aqueous humor and causes IOP to increase.
• If untreated, may result in degeneration of the optic nerve and visual field loss.
• It is the most common form of glaucoma, and its incidence increases with age.
• Genetics and conditions, such as diabetes and hypertension, also play a role.
Risk Factors:
• Elevated IOP
• Age
• Ethnic Background
• Family History
• Medical Conditions
• Other Eye conditions
• Nearsightedness
• Prolonged corticosteroid use
Assessment:
1. Acute Glaucoma:
• Severe pain, occurring in and around the eyes due to increased IOP; may have transitory
attacks.
• Cloudy, blurred vision; rainbow color around lights.
• Hazy cornea due to edema; may be profuse lacrimation and ciliary injection.
• Nausea and vomiting may occur.
• Pupil is mild-dilated and fixed.
2. Chronic Glaucoma
Diagnostic Evaluation:
Pharmacologic Interventions:
Surgical Interventions:
1. Surgery is indicated for acute glaucoma if IOP is not maintained within normal limits by
pharmacotherapy and if there is progressive visual field loss with optic nerve damage.
a. Peripheral iridectomy – Small portion of the iris excised so aqueous humor can bypass pupil.
c. Laser iridectomy - creates multiple incisions in the iris to create openings for aqueous to flow.
d. Corneoscleral trephine (rarely done) – a permanent drainage opening is made at the junction
of the cornea and sclera through the anterior chamber.
Nursing Interventions: