GLAUCOMA

Definition
Glaucoma is a group of eye diseases
characterized by increased pressure
within the eye and resulting loss of
vision

Vision loss is caused by damage to
the optic nerve caused by congestion
of aqueous humor in the eye
Classification

Narrow-Angle or Angle-Closure
or Pupillary Block Glaucoma
(Acute Type)

Open-Angle Glaucoma (Chronic
Type)
Narrow-Angle or Angle-Closure or
Pupillary Block Glaucoma
(Acute)

Closed-angle glaucoma may progress
gradually without manifesting any
symptoms until long after it has set in.

iris blocks intraocular fluid from draining
properly.


Open-Angle Glaucoma (Chronic)

Asymptomatic

Most common

Loss of peripheral vision first

Leads to total loss of vision (if left
untreated)
Incidence
2/1000 Americans have Acute-Angle
Glaucoma ; 2.2 Million has Chronic type
(in the US)
Ages 40 and above

More on males

Afro-American and Asians
Risk Factors
Family History
African-American and Asians
Older age
Diabetes mellitus
Cardiovascular disease
Migraine syndromes
Myopia
Eye Trauma
Prolonged use of topical or systemic corticosteroids


Caused by.


Increase in IOP that surrounds the eye ----
imbalance of aqueous humor production
and drainage
Signs and Symptoms
Cloudy or haloed vision
Nausea or headaches
Light sensitivity (photophobia)
Excessive blinking (blepharospasm)
Crossed or out-turned eyes (strabismus)
One eye becoming larger than the other
Excessive tearing (epiphora)
Decreased vision (amblyopia)

Pathopysiology
Precipitating Factors:

- DM, CVD
- Migraine
- Myopia
- Eye trauma
- Prolonged use of
steroids


Predisposing
Factors:

- Family history
- Age
- Race
- Gender
Changes in the
aqueous humor
flow system
*Impaired blood flow
in the optic nerve

*Increase IOP
Atrophy of the Optic
Nerve
Progressive loss of vision
Atrophy of the Optic Nerve
Progressive Loss of Vision
Nursing Diagnosis
Anxiety related to reality of loss of vision as
evidenced by expressed feelings regarding
changes in life events.
Disturbed visual sensory perception related
to altered sensory perception as evidenced by
progressive loss of visual field.
Risk for physical injury related to altered
visual perception as evidenced progressive
loss of vision.

Diagnostic Tests

Tonometry
Pachymetry
Gonioscopy
Ophthalmoscopy
Visual Field Screening


Ophthalmoscopy
Gonioscopy
Tonometry
Pachymetry


Medical Management.

Prevention of optic nerve
damage
By: Pharmacotherapy and
Surgery
Pharmacologic Treatment
Parasympathomimetic agents
Sympathomimetic agents
Beta-adrenergic blocking agents
Hyperosmotic agents
Carbonic anhydrase inhibitors
Alpha2-adrenoreceptor agonists

Surgery
Laser iridotomy
Laser trabeculoplasty
Trabeculectomy
Viscocanalostomy
Glaucoma Prognosis

Irreversible blindness
Acute symptoms are manageable
to preserve vision
Early diagnosis and treatment is
the key