Glaucoma is a group of eye conditions that damage the optic nerve, the health of which is vital for good vision. This damage is often caused by an abnormally high pressure in your eye. Glaucoma is one of the leading causes of blindness for people over the age of 60

1. glaucoma
Presented by:
Mr. Abhay Rajpoot

2. DEFINITION
• Glaucoma is a group of eye diseases characterized by damage to the o
ptic nerve usually due to excessively high intraocular pressure (IOP).

4. INCIDENCE
India it is the third most common cause of blindness and in the world
(after cataract and refractive errors); causing12.8% of total blindness in
the country. Nearly 12% persons are affected by the disease.

5. RISK FACTOR
• Family history of glaucoma
• History of elevated intraocular pressure
• Age over 45 years
• Black racial ancestry
• Diabetes.
• Decrease in corneal thickness and rigidity.

6. Nearsightedness (high degree of myopia), which is the inability to see
distant objects clearly
• History of eye injury.
• Use of cortisone (steroids), either in the eye or systemically (orally or
injected).
Farsightedness (hyperopia), which is seeing distant objects better than
close ones (Farsighted people may have narrow drainage angles, which
predispose them to acute [sudden] attacks of angle-closure glaucoma.)

7. • Dilating eye drops.
• Blocked or restricted drainage in your eye.
• Medications, such as corticosteroids.

8. • Poor or reduced blood flow to your optic nerve.
• High or elevated blood pressure.

9. SIGNS AND SYMPTOMS
• Blurry vision
• Pain in the eye
• Redness of the eye
• Seeing halos around lights
• Headaches
• Unusual trouble adjusting to dark rooms.
• Difficulty focusing on near or distant objects.
• Squinting or blinking due to unusual sensitivity to light or glair.
• Change in colour of iris.
• Ocular pain.

10. CONTI….
• Diplopia (Double Vision)
• Excess tearing or watery eyes
• Dry eyes with itching or burning
• Sudden loss of vision in one eye
• Flashes of light or black spots
• Nausea or vomiting

11. TYPES
There are a variety of different types of glaucoma. The most common
forms are:
• Primary Open-Angle Glaucoma
• Angle-Closure Glaucoma
• Pigmentary Glaucoma
• Normal Tension Glaucoma

12. Open & Close angle Glaucoma

13. • Pigmentary Glaucoma
• Normal Tension Glaucoma

14. PRIMARY OPEN-ANGLE GLAUCOMA
This is the most common type of glaucoma. It happens gradually,
where the eye does not drain fluid as well as it is (like a clogged drain).
As a result, eye pressure builds and starts to damage the optic nerve.
This type of glaucoma is painless and causes no vision changes at first.
Some people can have optic nerves that are sensitive to normal eye
pressure. This means their risk of getting glaucoma is higher than
normal.

15. SYMPTOMS
• Peripheral vision is gradually lost.
• In advance stages, the patient has tunnel vision

16. ANGLE-CLOSURE GLAUCOMA (ALSO CALLED “CLOSED-ANGLE GLAUCOMA”
OR “NARROW-ANGLE GLAUCOMA”)
• This type happens when someone’s iris is very close to the drainage
angle in their eye. The iris can end up blocking the drainage angle.
You can think of it like a piece of paper sliding over a sink drain. When
the drainage angle gets completely blocked, eye pressure rises very
quickly. This is called an acute attack. It is a true eye emergency, and
should call ophthalmologist right away or patient might go blind.

17. SYMPTOMS
• Vision Is Suddenly Blurry
• Severe Eye Pain
• Headache
• Nausea
• Vomit
• Rainbow-colored rings or halos around lights are seen.

18. PIGMENTARY GLAUCOMA
• Abnormal amount of pigments are liberated from posterior surface of
iris, which are deposited throughout the anterior and posterior
chamber of the eye.

19. CLINICAL FEATURES
• Early – Asymptomatic.
• Episodes of pain/blurred vision with haloes following strenuous
exercise.
• Advanced – Loss of central vision.
• Later - Loss of peripheral vision.

20. Diagnostic evaluation
• History taking
• Physical examination
• Visual Field Test
• Visual acuity test.
• Visual field test.

21. CONTI….
• Ophthalmoscopy
• Dilated eye exam

22. • Tonometry
• Pachymetry :

23. MANAGEMENT

24. SURGERY
• Trabeculoplasty
• Filtering surgery (viscocanalostomy)

25. Drainage implant (aqueous shunt implant) -

26. NURSING MANAGEMENT
Preoperative care
 Psychological support
 Legal
 Physiological
 Therapeutic

27. Postoperative care
 Monitor status of the eye dressing following surgery.
 Assess dressings for the presence of bleeding or drainage from the
eye.
 Maintain the eye patch or eye shield in place.
 Place the client in a semi-Fowler’s or Fowler’s position, having the
client lie on the unaffected side.

28. CONTI…
 Assess the client and medicate or assist to avoid vomiting, coughing,
sneezing, or straining as needed.
 Assess comfort and Immediately report any complaint of sudden,
sharp eye pain to the physician.
 Place all personal articles and the call bell within easy reach.

29. NUTRSING DIAGNOSIS
 Disturbed sensory perception related to visual impairment.
 Risk for injury related to impaired vision.
 Ineffective health maintenance related to knowledge deficit.
 Self- care deficit related to impaired vision.
 Anxiety related to possible vision loss.