Glaucoma

GLAUCOMA EYE DISORDER

1. SUDESHNA BANERJEE DUTTA
SENIOR LECTURER
S.R.S.V.M B.SC NURSING COLLEGE

3. Glaucoma is a group of eye conditions that
damage the optic nerve, which is vital to good
vision.
This damage is often caused by an abnormally
high pressure in the eye. Glaucoma is one of the
leading causes of blindness.

4. OPEN-ANGLE GLAUCOMA Open-angle glaucoma, the
most common form of glaucoma, accounting for at least 90%
of all glaucoma cases:
➢“Open-angle” means that the angle where the iris meets the
cornea is as wide and open as it should be. Open-angle
glaucoma is also called primary or chronic glaucoma.
➢Is caused by the obstruction of trabecularmeshwork & slow
clogging of the drainage canals, resulting in increased eye
pressure
➢Has a wide and open angle between the iris and cornea
➢Develops slowly and is a lifelong condition
➢Has symptoms and damage that are not noticed.

8. ANGLE-CLOSURE GLAUCOMA
Angle-closure glaucoma, a less common form of glaucoma:
➢It is also called acute glaucoma or narrow-angle glaucoma.
Unlike open-angle glaucoma, angle-closure glaucoma is a
result of the angle between the iris and cornea closing.
➢Is caused by blocked drainage canals, resulting in a sudden
rise in intraocular pressure
➢Has a closed or narrow anglebetween the iris and cornea
➢Develops very quickly
➢Has symptoms and damage that are usually very noticeable
➢Demands immediate medical attention

11. NORMAL-TENSION GLAUCOMA (NTG)
➢Also called low-tension or normal-pressure
glaucoma. In normal-tension glaucoma the
optic nerve is damaged even though the eye
pressure is not very high. We still don't know
why some people’s optic nerves are damaged
even though they have almost normal pressure
levels.

12. CONGENITAL GLAUCOMA
➢This type of glaucoma occurs in babies when
there is incorrect or incomplete development of
the eye's drainage canals during the prenatal
period. This is a rare condition that may be
inherited. When uncomplicated, microsurgery
can often correct the structural defects. Other
cases are treated with medication and surgery.

13. Ocular factors
➢Increased IOP
➢Increased corneal thickness
➢Optic nerve structure damaged
➢Disc haemorrhage
Non-ocular factors
➢Age
➢Race
➢Family history
➢Vascular diseases

15. SMOKINGALCOHOL
GENETIC ENVIRONMENT
STRESS
DIET

16. Etiological factors
Disturbance in circulation of aqueous humor
Leads to increased IOP
Which damages the retinal layer as it passes through
the optic nerve head
Compression on the optic nerve head
Resulting in cell injury & death

17. The signs and symptoms of glaucoma vary
depending on the type and stage of the condition.
OPEN-ANGLE GLAUCOMA:
➢No initial manifestations
➢Frequent changes of glasses
➢Impaired dark adaptation
➢Patchy blind spots in peripheral or central vision, frequently in
both eyes
➢Tunnel vision in the advanced stages (preservation in the central
vision)
➢Painless

20. ACUTE ANGLE-CLOSURE GLAUCOMA:
➢Severe headache and pain in face
➢Eye pain
➢Nausea and vomiting
➢Blurred vision
➢Colored Halos around lights
➢Eye redness
➢Abrupt decrease in visual acuity
➢Corneal edema
➢Fixed pupils at midpoint
➢Rapid, significant increase in IOP

22. Tonography/Ocular tonometryis the procedureto
determine theintraocular pressure(IOP), the
fluidpressureinside theeye.
Fundoscopy-Ophthalmoscopy, also
calledfundoscopy, is a test that allows a health
professional to see inside thefundusof the eyeand
other structures using
anophthalmoscope(orfundoscope).
Gonioscopy-Gonioscopyis aneye examination to
look at the front part of youreye(anterior chamber)
between thecornea and the iris

23. Prostaglandin analogs, such
asLATANOPROST,BIMATOPROST
andTRAVOPROST: Increase uveo-scleral outflow
of aqueous humor.
Topicalbeta-adrenergic receptor antagonists, such
asTIMOLOL,LEVOBUNOLOL, and BETAXOLOL:
Decrease aqueous humor production.
Alpha2-adrenergic agonists, such
asBRIMONIDINEandAPRACLONIDINE: Work by a
dual mechanism, decreasing aqueous humor
production and increasing uveo-scleral outflow.

24. Mioticagents(cholinergics), such
asPILOCARPINE: Allowing increased outflow
of the aqueous humour.
Carbonic anhydraseinhibitors, such
asDORZOLAMIDE, BRINZOLAMIDE,
ANDACETAZOLAMIDE: Lower secretion of
aqueous humor.

25. ❑CANALOPLASTY
Canaloplastyis a new
nonperforatingsurgicaltechnique for open-angle
glaucoma, in which a microcatheteris inserted
within Schlemm'scanal for the entire 360 degrees.
❑TRABECULECTOMY
Trabeculectomyis a type of glaucoma surgery
performed on the eye that creates a new pathway
for fluid inside the eye to be drained.

26. A flexibleglaucoma drainagedevice that
isimplantedin the eye to divert aqueous
humor (the fluid inside the eye) from the
inside of the eye to an external reservoir.

27. Chronic Pain related to an increase in intra-
ocular pressure (IOP) as evidenced by pain
scoring.
Anxiety related to physiological factors, changes
in health status, presence of pain, the possibility /
reality of vision loss as evidenced by fear, doubt,
expressed concerns about changes in life events.
Knowledge Deficit regarding condition,
prognosis, and treatment as evidenced by
frequent questioning.
Risk for infection related to invasive procedure.