Ni Ketut Alit Armini

Nursing Faculty
Airlangga University Surabaya East Java.
 Black, J.M. & Matassarin E, (1997). Medical Surgical
Nursing: Clinical Management for continuity of care. J.B.
Lippincott.co.
 Barbara C.L & Wilma J.P. (2006). Essentials of Medical
Surgical Nursing. Philadelphia: Lippincott Williams &
Wilkins.
 Smeltzer, S.C., & Bare, B. (2003). Brunner and Suddarth's
Textbook of Medical-Surgical Nursing (10th ed.).
Philadelphia: Lippincott Williams & Wilkins.
 Ignativicius & Bayne. (2001). Medical and Surgical Nursing.
Philadelphia: W.B. Saunders Company.
 Luckman & Sorensen. (2000). Medical Surgical Nursing.
Philadelphia: W.B. Saunders Company.
 Journals and article related
The Light-Processing Parts. To understand sight, one begins with light and
its passage through the eye's sensitive camera-like structures:
 Light first passes through the cornea, a clear tissue at the front of the eye.
 Behind the cornea, the iris (the colored tissues of the eye) opens and
closes like a camera shutter to regulate the passage of light.
 The lens, located behind the iris, focuses the light, which then hits the
retina.
 The retina is an electric fragile membrane of nerve cells called
photoreceptors that receive light and translate it into signals.
 The optic nerve is actually a cable of about 1.2 million nerve fibers called
axons. It carries the signals to the brain, which interprets them as images.

The Supportive Chambers. To help support and protect these sensitive

structures, the eye contains two fluid-filled chambers:
 The posterior (rear) chamber is the large area behind the iris.
 Fluid passes from the posterior into the anterior (forward) chamber located
in the bulging area between the iris and the front of the eye.
 a group of diseases that can damage the eye's
optic nerve and result in vision loss and
blindness.
 Glaucoma occurs when the normal fluid pressure
inside the eyes slowly rises
The optic nerve is a bundle of more than 1 million
nerve fibers. It connects the retina to the brain.
The retina is the light-sensitive tissue at the back
of the eye. A healthy optic nerve is necessary for
good vision.
 In the front of the eye is a space called the anterior
chamber.
 A clear fluid flows continuously in and out of the
chamber and nourishes nearby tissues.
 The fluid leaves the chamber at the open angle where
the cornea and iris meet. When the fluid reaches the
angle, it flows through a spongy meshwork, like a
drain, and leaves the eye.
 Sometimes, when the fluid reaches the angle, it
passes too slowly through the meshwork drain. As
the fluid builds up, the pressure inside the eye rises
to a level that may damage the optic nerve. When the
optic nerve is damaged from increased pressure,
open-angle glaucoma--and vision loss--may result.
PRIMARY GLAUCOMA
The most occuring form, the structure involved in
circulation and reabsorpsion of aqueus humor
undergo direct pathologic change.
1. Primary open angle glaucoma(POAG) , the most
common form. Usualy bilateral and produces no
simptoms in the early stage.
2. Angle- closure glaucoma “ less common form. It
has sudden onset and is treatedas an
emergency.
SECONDARY GLAUCOMA
 Develop as complications of other medical
conditions. These types of glaucomas are
sometimes associated with eye surgery or
advanced cataracts, eye injuries, certain eye
tumors, or uveitis (eye inflammation).
 Pigmentary glaucoma occurs when pigment from
the iris flakes off and blocks the meshwork,
slowing fluid drainage. A severe form, called
neovascular glaucoma, is linked to diabetes.
Corticosteroid drugs used to treat eye
inflammations and other diseases can trigger
glaucoma.
 CONGENITAL GLAUCOMA
 Children are born with a defect in the angle of the eye
that slows the normal drainage of fluid. These
children usually have obvious symptoms, such as
cloudy eyes, sensitivity to light, and excessive
tearing.
 Conventional surgery typically is the suggested
treatment, because medicines may have unknown
effects in infants and be difficult to administer.
 Surgery is safe and effective. If surgery is done
promptly, these children usually have an excellent
chance of having good vision.
ASSESMENT
Demografic data of age, race. Family history og
glaucoma, and other eyes problem
Nurse should ask the patient to describe any
change in vision.
Assess how the client coping with the loss vission :
greif and loss

PHISICAL ASSESMENT
 Sensory /perceptual alteration (visual) related to
ocular lens opacity
 High risk for injury (Fall) related to dificulty in
processing visual image and altered depth
perception.
 Impaired home maintenance management related
to age, limited vision, or activity restriction
imposed by surgery.