MEDICAL COLLEGES OF NORTHERN PHILIPPINES

Alimannao Hills, Penablañca, Cagayan

Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

SCENARIO 1
Ms. Y.T. is an 79-year-old female who has been diagnosed with open-angle glaucoma and
ocular hypertension. She presents to the ophthalmology clinic for a follow-up appointment. Her
medical history is positive for hypertension, depression, arthritis, and atrial fibrillation. She
states that she has been “doing pretty good, I guess.” She denies any specific complaints
except some blurred vision. She self-administers solution 2 gtt q8h.

a. What is open angle glaucoma?

Open-angle glaucoma is the most common form of the disease. The drainage angle
formed by the cornea and iris remains open, but the trabecular meshwork is partially
blocked. This causes pressure in the eye to gradually increase. This pressure damages
the optic nerve. It happens so slowly that you may lose vision before you're even aware
of a problem. Open-angle glaucoma usually happens to people over 50 and affects
approximately 95% of individuals.

So for additional information about open angle glaucoma. May I present to you the
symptoms of it;

Glaucoma in the early stages usually doesn’t produce any symptoms but Damage to your vision
can occur before you’re aware of it. When symptoms appear, they can include:

 Reduced vision and loss of peripheral vision

 Swollen or bulging cornea
 Pupil dilation to a medium size that doesn’t change with increasing or decreasing light
 Redness in the white of the eye
 Nausea

So, In the early stages, primary open-angle glaucoma doesn’t usually have any noticeable
symptoms.
but In advanced stages, it can cause blurred vision in one or both eyes, along with a narrowed field
of vision.
With primary open-angle glaucoma, vision loss starts at the outer edges of your field of vision. So as
the disease progresses, your field of vision shrinks and If left untreated, primary open-angle
glaucoma can cause blindness.

OVERVIEW
 MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills, Penablañca, Cagayan
Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

-Open-angle glaucoma is the most common type of glaucoma. Glaucoma is a disease that damages your
optic nerve and can result in reduced vision and even blindness.

Glaucoma affects more than 70 million peopleTrusted Source worldwide. It’s the leading cause of
irreversible blindness.

DRAINAGE PATHWAY DAMAGE:

-In open-angle glaucoma, the trabecular meshwork offers increased resistance to fluid outflow. This
causes the pressure to build up inside your eye.

-In closed-angle glaucoma, both the uveoscleral drain and the trabecular meshwork become blocked.
Typically, this is caused by a damaged iris (colored part of the eye) blocking the outlet.

Blockage of either of these outlets leads to an increase in pressure inside your eye. The fluid pressure
inside your eye is known as intraocular pressure (IOP).

-In open-angle glaucoma, the trabecular meshwork offers increased resistance to fluid outflow. This
causes the pressure to build up inside your eye.

DIFFERENCE BETWEEN ANGLE

-The angle in the glaucoma type refers to the angle that the iris makes with the cornea.

In open-angle glaucoma, the iris is in the right position, and the uveoscleral drainage canals are clear.
But the trabecular meshwork isn’t draining properly.

In closed-angle glaucoma, the iris is squeezed against the cornea, blocking the uveoscleral drains and
the trabecular meshwork.

What Causes It?

You have fluid inside your eyes that keeps them healthy. As new fluid comes in, the old has to
move out. That’s where the “open angle” comes in.
 MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills, Penablañca, Cagayan
Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

The angle is where the clear part of your eye, the cornea, meets the colored part of your eye,
the iris. It’s important because that’s where the system to drain your eye fluid sits. It’s like a
strainer with a web of tiny holes that lead to drainpipes below.

OPEN ANGLE GLAUCOMA:

It’s by far the most common type of glaucoma. It comes on so slowly and painlessly that you
can go years without knowing you have it. And by the time you do, it’s likely already done a lot
of damage.

Open-angle glaucoma usually happens to people over 50. You often get it in both eyes, but one
eye isn’t as bad as the other.

There’s no cure for it, and it gets worse over time. The key is to get checked and catch it early.
Once you know you have it, you can get medicine and surgery to slow it down and save
your eyesight.

What Causes It?

You have fluid inside your eyes that keeps them healthy. As new fluid comes in, the old has to
move out. That’s where the “open angle” comes in.

The angle is where the clear part of your eye, the cornea, meets the colored part of your eye,
the iris. It’s important because that’s where the system to drain your eye fluid sits. It’s like a
strainer with a web of tiny holes that lead to drainpipes below.

In some other types of glaucoma, the angle is too narrow or closed, so fluid can’t even reach the
drainage system. But in this case, the angle isn’t the problem. It’s wide open, which is normal.
Instead, you have a clog or some other problem deeper in the system. Your eye can also be
producing too much fluid that causes a backup in outflow. Both cause fluids to drain more slowly,
which raises the pressure in your eye.

In most cases, it isn’t clear what’s causing that clog or causing your eye to produce more fluid than
normal.

What Does It Do to Your Eye?

 MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills, Penablañca, Cagayan
Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

Like with other types of gl aucoma, you’ll have higher pressure than normal in your eye. Over
time, that damages the optic nerve, the cord that sends information from your eye to
your brain. As the nerve breaks down, you get blind spots. It’s like a frayed cord on an old lamp
that makes the light bulb blink on and off.

But high pressure can be a little tricky to pin down. It isn’t like blood pressure, where the
danger zone is clear. In fact, about 1 in 3 people with this type of glaucoma have normal
pressure in their eyes, but still have a damaged optic nerve.

That’s important when it comes to treatment. It means there isn’t a general pressure level
that’s good for everyone. It’s specific to you.

Who’s Most Likely to Get It?

Your chances go up based on your:

Age. It mostly affects people over age 50. Your risk rises as you get older.

Family Race. African-Americans and Hispanics get it more often than whites. It tends to affect
African-Americans earlier, and there’s a greater chance it will lead to blindness.

Some conditions also raise your odds:

 Diabetes
 A thin cornea
 High blood pressure
 Nearsightedness, where you can only see things when they’re close to you

What Are the Symptoms?

There aren’t any for quite some time. It’s called the sneak thief of sight because you may not
find out you have it until it’s pretty far along.

Early on, you start to lose peripheral vision, the stuff you see out the side of your eyes. You may
not notice it’s happening.

Later, you might miss a stair while you walk or notice letters missing from words when you
read. You might also have some close calls when you drive.

family history. You’re more likely to get it if other family members have it.
 MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills, Penablañca, Cagayan
Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

OPEN ANGLE GLAUCOMA:

It’s by far the most common type of glaucoma. It comes on so slowly and painlessly that you
can go years without knowing you have it. And by the time you do, it’s likely already done a lot
of damage.

Open-angle glaucoma usually happens to people over 50. You often get it in both eyes, but one
eye isn’t as bad as the other.

There’s no cure for it, and it gets worse over time. The key is to get checked and catch it early.
Once you know you have it, you can get medicine and surgery to slow it down and save
your eyesight.

What Causes It?

You have fluid inside your eyes that keeps them healthy. As new fluid comes in, the old has to
move out. That’s where the “open angle” comes in.

The angle is where the clear part of your eye, the cornea, meets the colored part of your eye,
the iris. It’s important because that’s where the system to drain your eye fluid sits. It’s like a
strainer with a web of tiny holes that lead to drainpipes below.

In some other types of glaucoma, the angle is too narrow or closed, so fluid can’t even reach the
drainage system. But in this case, the angle isn’t the problem. It’s wide open, which is normal.
Instead, you have a clog or some other problem deeper in the system. Your eye can also be
producing too much fluid that causes a backup in outflow. Both cause fluids to drain more slowly,
which raises the pressure in your eye.

In most cases, it isn’t clear what’s causing that clog or causing your eye to produce more fluid than
normal.

What Does It Do to Your Eye?

Like with other types of glaucoma, you’ll have higher pressure than normal in your eye. Over
time, that damages the optic nerve, the cord that sends information from your eye to
 MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills, Penablañca, Cagayan
Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

your brain. As the nerve breaks down, you get blind spots. It’s like a frayed cord on an old lamp
that makes the light bulb blink on and off.

But high pressure can be a little tricky to pin down. It isn’t like blood pressure, where the
danger zone is clear. In fact, about 1 in 3 people with this type of glaucoma have normal
pressure in their eyes, but still have a damaged optic nerve.

That’s important when it comes to treatment. It means there isn’t a general pressure level
that’s good for everyone. It’s specific to you.

Who’s Most Likely to Get It?

Your chances go up based on your:

Age. It mostly affects people over age 50. Your risk rises as you get older.

Family Race. African-Americans and Hispanics get it more often than whites. It tends to affect
African-Americans earlier, and there’s a greater chance it will lead to blindness.

Some conditions also raise your odds:

 Diabetes
 A thin cornea
 High blood pressure
 Nearsightedness, where you can only see things when they’re close to you

What Are the Symptoms?

There aren’t any for quite some time. It’s called the sneak thief of sight because you may not
find out you have it until it’s pretty far along.

Early on, you start to lose peripheral vision, the stuff you see out the side of your eyes. You may
not notice it’s happening.

Later, you might miss a stair while you walk or notice letters missing from words when you
read. You might also have some close calls when you drive.

family history. You’re more likely to get it if other family members have it.
 MEDICAL COLLEGES OF NORTHERN PHILIPPINES
Alimannao Hills, Penablañca, Cagayan
Telefax No.: (078) 304-1010
Website: www.mcnp.edu.ph Email Address: adminoffice@mcnp.edu.ph
COLLEGE OF NURSING

GLAUCOMA- IT HAPPEN BECAUSE OF INTRAOCULAR PRESSURE THAT DAMAGE THE OPTIC

NERVE

-TUNNEL VISION

CARATACTS- IT HAPPEN BECAUSE OF THE BREAKDOWN OF PROTEIN

-BLURRY VISION