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