GLAUCOMA

        GLAUCOMA

It is characterized by optic nerve atrophy and loss  of vision . Elevated  intraocular pressure is the most important risk factor for developing glaucoma

TYPES

1.      Primary open angle glaucoma or chronic

                                        This is the most common 90% type of glaucoma caused by obstruction in trabecular mesh work .

2.      Secondary open angle glaucoma

                                        It occurs from abnormalities in trabecular mash work or increasing venous pressure

3.      Primary angle closure (acute )

                        Result  from the narrowing or crossing of angle between iris and cornea. Presented with severe ocular pain ,diminished vision, pupil enlarged and fixed ,redden eye and may have nausea and vomiting due to increased intra ocular pressure.

4.      Secondary angle closure :

It can result from ocular inflammation blood vessels changes and trauma.

5.      Congenital :

    Abnormal development of filtration angle which is very rare.

CLINICAL MANIFESTATION :

·         Increased intraocular pressure

·         Cupping or identification of the optic nerve head

·         Visual field defects .

DIAGNOSTIC EVALUATION :

Presented with enlargement of eye, photophobia, lacrimination  and blepharospasm.

1.      Tonometry

2.      Tono graphy

3.      Ophthalmoscopy

4.      Gonioscopy 

TREATMENT :

Drug therapy eye drops

SURGERY

v  Argon laser trabeculoplasty

v  Trabeculectomy

NURSING MANAGEMENT :

1.      Advise self administration of eye drops

2.      Instruct the patient to maintain proper hygiene

3.      Observe for hemorrhage after surgery  

4.      Arrange articles in the side of un-operated side to avoid staining of operated eye