PRESENTATION ON GLAUCOMA (glaucoma.pptx)

INTRODUCTION ,DEFINITION,CAUSES,SIGN AND SYMPTOMS ,TYPES AND ITS MANAGEMENT , MEDICAL AND SURGINAL MANAGEMENT OF GLAUCOMA.

1. CLASSROOM PRESENTATION ON
GLAUCOMA PRESENTED BY: Salma Sultana

2. INTRODUCTION

3. DEFINITION Glaucoma is a group of disorders characterized by an abnormally high intraocular pressure , optic nerve dystrophy and peripheral visual field loss. Glaucoma is a symptomatic condition of the eye where the intraocular pressure is more than normal (IOP above 25mmHg). Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss , which can progress to blindness.

4. INCIDENCE Estimates suggest 67 million people worldwide and 569,000 in the UK affected by open angle glaucoma with 380,000(67%) yet to be detected. It is estimated that more than 3 million people are blind due to glaucoma.

5. In INDIA , the estimated number of cases of glaucoma is 12 million, around one fifth of the global burden of glaucoma. Based on prevalence studies, it is estimated that 79.6 million individuals will have glaucoma in 2020.

6. CAUSES AND RISK FACTORS

7. Genetic Factors

8. Aging

9. Hypertension

10. Severe myopia

11. Eye trauma

12. Diabetes Mellitus

13. Migraine Headache

14. Prolonged use of local or systemic corticosteroids

15. Eye abnormalities

16. Physical Injuries

17. PATHOPHYSIOLOGY

18. Classification

19. 1.Congenital Glaucoma 2.Acquired Glaucoma

20. Congenital glaucoma True congenital glaucoma Infantile Glaucoma Juvenile Glaucoma

21. Acquired Glaucoma Primary Glaucoma Secondary Glaucoma

22. Primary Glaucoma Primary open angle glaucoma Primary angle closure glaucoma

23. Congenital glaucoma Congenital glaucoma ,a rare disease ,occurs when a congenital defect in the angle of the anterior chamber obstructs the outflow of aqueous humor .If untreated ,causes damage to the optic nerve and blindness .In most cases, surgery is required .

24. True congenital glaucoma True congenital glaucoma – Also known as newborn glaucoma. In this type, the child is either born with ocular enlargement or enlargement of eyes and it is noticed within one month of life.

25. Infantile glaucoma It is labeled when the disease manifests prior to the child’s third birthday . It occurs in about 50% of cases.

26. Juvenile Glaucoma It is labeled in the rest 10% of cases who develop pressure rise between 3-16 years of life.

27. Acquired Glaucoma Acquired Glaucoma , often classified as secondary glaucoma, is caused by other processes not present at birth ,such as trauma , surgery, inflammation , or medications.

28. Primary Glaucoma Primary glaucoma is defined as isolated, idiopathic disease of the anterior chamber of the eye and the optic nerve, whereas secondary glaucoma is associated with known predisposing events including developmental abnormalities, systemic diseases, drug therapy, or trauma.

29. Primary Open Angle Glaucoma Primary open angle Glaucoma is a syndrome of optic nerve damage associated with an open anterior chamber angle and an elevated or sometimes average intraocular pressure. Clinical Manifestations: Mild headache Increased IOP greater than 25mmHg Reduce visual acuity, especially at night Visual field deficits.

30. Primary Angel Closure Glaucoma It is also known as primary closed angle glaucoma , narrow angle glaucoma , pupil block glaucoma , acute congestive glaucoma . Primary angle closure glaucoma typically has a rapid onset , constituting an ophthalmic emergency . Unless treated promptly , this acute form of glaucoma causes blindness in 3or 5days.

31. Clinical Manifestations Pain and redness in eyes
Increased IOP between 40-70mmHg Vision may become blurred
Headache Nausea and vomiting Decreased visual acuity

32. Secondary Glaucoma Secondary glaucoma occurs as a result of another disease or problem within the eye such as: inflammation, trauma, intraocular hemorrhage, previous surgery, diabetes , and certain medications such as steroids.

33. Diagnostic Evaluations History Collection Physical Examination Visual acuity Examination Tonometry
Ophthalmoscopy Gonioscopy Visual field perimetry

34. Medical Management: Beta adrenergic blockers. EG: timolol. Cholinergic agents . Eg : pilocarpine. Carbonic anhydrase . Eg : Methazolamide. Prostaglandins , such as latanoprost ,to reduce intraocular pressure. Mitotic eye drops ,such as pilocarpine ,to reduce intraocular pressure by facilitating the outflow of aqueous humor.

35. Surgical Therapy Argon laser Trabeculoplasty: It may be used to treat open angle glaucoma. Laser Iridotomy : It relieves pressure and preserves vision by promoting outflow of the aqueous humor. Cyclocryotherapy : Application of freezing probe to the sclera over the ciliary body .

36. Complications Of Glaucoma

37. Nursing Assessment History and presence of risk factors Positive family history
Hemorrhage Tumors of the eye The patient should be assessed for loss of both central and peripheral vision, discomfort and understanding of disease and compliance with treatment and abi6 to conduct activity of daily living. Diagnostic examination: Tonometry used to measure intraocular pressure.

38. Nursing Diagnosis Acute pain related to increased intraocular pressure and surgical complications.
Self care deficit related to decreased vision. Anxiety related to partial or total visual loss.
Risk for injury related to decreased vision
Deficient knowledge related to medical regimen, disease process due to no prior experience.

39. Nursing Interventions: Orient patient and explain procedures to decrease anxiety. Monitor for any pain or visual changes. Monitor the patients compliance with medications and follow up care. Administer prescribed drug therapy to prevent an increase in IOP. Administer medications IV , orally or topically. Encourage the patient to wear eye shield at night to protect operated eye from injury while sleeping.

40. Summary

41. Conclusion