1. What is glaucoma?
    A group of eye disorders
  2. 3 characteristics of glaucoma?
    • 1. Increased IOP and consequences of elevated pressure
    • 2. Optic nerve atrophy
    • 3. Peripheral visual field loss
  3. What is the second leading cause of blindness?
  4. Leading cause of blindness in what racial group?
    African Americans
  5. Etiology of glaucoma is related to the ____________ of __________ ________
    Consequences of elevated IOP.
  6. Balance between _______ _______ and __________ needed for normal level of IOP
    Aqueous production and reabsorption
  7. Glaucoma is related to elevation of?
  8. What is Primary open-angle glaucoma (POAG)?
    Outflow of aqueous humor is ↓ in trabecular meshwork
  9. POAG represents what % of primary glaucoma cases?
  10. What is Primary angle-closure glaucoma (PACG)?
    Angle closure ↓the flow of aqueous humor
  11. PACG represents what % of primary glaucoma cases?
  12. What are the clinical manifestations of POAG (3)
    • No symptoms
    • Unnoticed until all peripheral vision is lost
    • Usually noted with increase in MVA’s
  13. What are the Clinical Manifestations of POAG?
    • Sudden pain around eyes
    • Nausea and vomiting
    • Seeing colored halos around lights
    • Blurred vision
    • Ocular redness
    • Corneal edema
  14. What is the application goniometry measurement of IOP?
    10-22 mm/Hg
  15. What are the diagnostic test for glaucoma?
    • Gonioscopy
    • Peripheral and central vision test
    • Ophthalmoscopy
  16. What is the collaborative care for chronic open-angle glaucoma?
    • Drug therapy
    • Argon laser trabeculoplasty
    • Trabeculectomy
    • Cyclocryotherapy
  17. What are the drug therapies for glaucoma?
    Beta Blockers, miotics, CAI’s
  18. What drug reduces IOP?
  19. What is the MOA of Miotics?
    • Causes pupil to constrict, draws iris away from cornea, allowing
    • drainage out of Canal of Schlemm
  20. what drug decreases aqueous humor, decreases IOP?
  21. When is Argon Laser Trabeculoplasty used for?
    • Therapeutic option to lower IOP
    • Laser stimulates scarring and contraction of trabecular meshwork,
    • increases outflow of aqueous humor
    • Option when meds ineffective
  22. What is a Trabeculectomy
    • Removal of part of iris and trabecular meshwork
    • Aqueous humor percolates out area of missing iris
  23. What is cyclocryotherapy?
    • the procedure that freezes part of a ciliary tissue causing local
    • destruction and lowers aqueous production?
  24. What are the drug treatments used for Acute angle-closure glaucoma?
    • Miotics - Pilocarpine
    • Oral/IV hyperosmotic diuretics
    • Diamox, Mannitol
  25. List 2 procedures used for acute angle-closure glaucoma
    • Laser peripheral iridotomy
    • Surgical iridectomy: restores drainage of aqueous humor
  26. List Nursing Assessments for clients with glaucoma
    • Assess patient’s ability to understand and comply with treatment
    • Assess patient’s psychologic reaction to sight-threatening disorder
    • Assess family for patient care
    • Assess visual acuity, visual fields, IOP
  27. List Nursing Diagnoses for glaucoma patients
    • Noncompliance
    • Risk for injury
    • Self-care deficits
    • Acute pain
  28. What are some of the expected goals for treating pts with glaucoma?
    • No progression of visual loss
    • No injury
    • Understand disease process and rationale
    • Comply with all aspects of therapy
    • No postoperative complications
  29. List 3 Nursing Implementations for glaucoma pts.
    • Teach patient and family risks of glaucoma
    • Stress importance of early detection
    • Ophthalmologic examination
  30. 4 acute interventions for glaucoma patients
    • Administer medication to lower IOP
    • Darken the environment
    • Apply cool compresses
    • Provide quiet space
  31. 3 Ambulatory and home care nursing interventions
    • Encourage patient to follow therapy
    • Educate on disease process and treatments
    • Discuss follow-up appointments
  32. List 4 Expected outcomes
    • No further loss of vision
    • Comply with recommended therapy
    • Safely function in environment
    • No pain from disease and surgery
  33. How long does a glaucoma patients need to have medical supervision?
    for the rest of their life
  34. Can a patient stop using his eye drops when the symptoms go away?
  35. How long will a glaucoma patient need to be treated?
    Tx is usually lifelong
  36. List pt teaching used for eye drops
    • May have blurred vision initially
    • Improves with use
    • Avoid driving for 1-2 hours after miotics
    • Press lacrimal duct for 1 minute after insertion…prevents systemic absorption
  37. Do not use these drugs if you have glaucoma.
    • Avoid use of mydriatics or cyclopegic drugs
    • Atropine, belladonna, dilates pupil
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