Glaucoma &

Conjungtivitis
Arianti, M.Kep., Ns., Sp.Kep.MB
Dosen PSIK FKIK UMY
Bagian Keperawatan Medikal Bedah
Remember Part of The Eyes
GLAUCOMA
• Glaucoma refers to a group of optic neuropathies that cause
progressive damage to retinal ganglion cells. This damage leads to
cupping of the optic nerve and ultimate visual loss.

• Glaucoma is a leading cause of irreversible blindness worldwide;

however, the pathophysiology of glaucoma is poorly understood and
the exact factors leading to its progression are unclear. An estimated
79.6 million persons are expected to have glaucoma worldwide by
2020.
Prevalens
• Leading cause of blindness
• Glaucoma tends to run in families
• It is five time more common in African-American than in Caucasians
Types of Glaucoma
Acute or angle closure glaucoma (close-angle)
• It develops suddenly, pressure rise quickly because normal fluid flow
within the eye becomes blocked.
• A structure called the angle (where iris and cornea meet) closes

• Open-angle glaucoma
The fluid passes too slowly through the meshwork drain
Types of Glaucoma
 Symptoms
Open Angle Glaucoma Angle Closure Claucoma

Eyes pain and redness Vision is lost painlessly and gradually

Blurred vision Peripheral vision lost first

Halos around lights at night Tunnel vision (see only in front of us)

A Hazziness in the cornea

Nausea an vomiting

Extreme weakness
Risk Factors
• Anyone can develop glaucoma
• Higher risk: African-Americans >40y.o, Everyone >60 y.o, people with
family history of glaucoma
• People with diabetes or hypertension
Another etiology for Open Angle
Glaucoma
• Eye defects that develop before birth
• Eye injuries
• Eye tumors
• Medical problems: diabetes
• Medication: corticosteroids
Diagnosis

Pachymetry

Visual
Tonometry
acuitytest

Visual field
test

Dilated eye
exam
Treatments
• Medicines
Eyedrops lower eye pressure
These need to be taken regularly
Side effects: headaches, stinging, burning, and redness in the eyes
• Laser trabeculoplasty
It helps fluid drain out of the eye.
Side effects: inflammation.
• Conventional surgery
It makes the new opening for the fluid to leave the eye.
Side effects: cataract, cornea inflammation, infection inside the eye.
Nursing Roles In Glaucoma Patient
Psychological impact of the diagnosis
• Appropriate counseling
• Psychological support for hope in the future
Damage to the visual field, side-effect of treatment, cost of treatment
• Education programme
• Anxiety related gradual visual disturbances
• Assess how glaucoma affect quality of life
• Prepare the patient how to cope out door activities
• Collaboration with other proffessional: doctor, social worker…
 Conjunctivitis
• Pinkeye
• Inflammation of the conjunctiva
• Conjunctiva is the thin clear tissue that lies over the white part of the
eye and lines the inside of the eyelid
• Highly contagious, rarely serious – Not damage the vision
Classic Symptoms
• Pink or red color in the white of the eye(s)
• Watery eyes
• Itchy or scratchy eyes
• Discharge from the eye(s)
• Crusting of eyelids or lashes
Causes
• Viruses
• Bacteria
• Irritans (shampoos, dirt, smoke, pool chlorine)
• A reaction to eyedrops
• An allergic reaction
• Fungi, amoebas, parasite
Notes
• Steroid drops or combination drops containing steroids should not be
used routinely.
• Steroids can increase the latency of the adeno-viruses, prolonging the
course of viral conjunctivitis
• Steroid worsen condition in : herpes, bacteria, or fungus  leading to
corneal melt and blindness
• National Eye Institutue. Facts about Glaucoma. Retrieved from
https://nei.nih.gov/health/glaucoma/glaucoma_facts
• Azari, A.A., Neal, P.B. (2013). Conjunctivitis. A systematic review of
Diagnosis and Treatment. JAMA: Vol 310(16)
• International council of Ophhalmology. (2015). ICO Guidelines for
Glaucoma Eye Care
• Gray, E.(2005). Understanding the role of the glaucoma specialist
nurse. Nursing Times, Vol 101 (38):32