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SUDESHNA BANERJEE DUTTA
SENIOR LECTURER
S.R.S.V.M B.SC NURSING COLLEGE
 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.
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 trabecular meshwork & 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.
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 angle between the iris and cornea
➢ Develops very quickly
➢ Has symptoms and damage that are usually very noticeable
➢ Demands immediate medical attention
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.
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.
Ocular factors
➢ Increased IOP
➢ Increased corneal thickness
➢ Optic nerve structure damaged
➢ Disc haemorrhage
Non-ocular factors
➢ Age
➢ Race
➢ Family history
➢ Vascular diseases
SMOKING
ALCOHOL
GENETIC ENVIRONMENT
STRESS
DIET
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
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
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
Tonography/Ocular tonometry is the procedure to
determine the intraocular pressure (IOP), the
fluid pressure inside the eye.
Fundoscopy- Ophthalmoscopy, also
called fundoscopy, is a test that allows a health
professional to see inside the fundus of the eye and
other structures using
an ophthalmoscope (or fundoscope).
Gonioscopy- Gonioscopy is an eye examination to
look at the front part of your eye (anterior chamber)
between the cornea and the iris
Prostaglandin analogs, such
as LATANOPROST, BIMATOPROST
and TRAVOPROST: Increase uveo-scleral outflow
of aqueous humor.
Topical beta-adrenergic receptor antagonists, such
as TIMOLOL, LEVOBUNOLOL, and BETAXOLOL:
Decrease aqueous humor production.
Alpha2-adrenergic agonists, such
as BRIMONIDINE and APRACLONIDINE: Work by a
dual mechanism, decreasing aqueous humor
production and increasing uveo-scleral outflow.
 Miotic agents (cholinergics), such
as PILOCARPINE: Allowing increased outflow
of the aqueous humour.
 Carbonic anhydrase inhibitors, such
as DORZOLAMIDE, BRINZOLAMIDE,
AND ACETAZOLAMIDE: Lower secretion of
aqueous humor.
❑ CANALOPLASTY
Canaloplasty is a new
nonperforating surgical technique for open-angle
glaucoma, in which a microcatheter is inserted
within Schlemm's canal for the entire 360 degrees.
❑ TRABECULECTOMY
Trabeculectomy is a type of glaucoma surgery
performed on the eye that creates a new pathway
for fluid inside the eye to be drained.
 A flexible glaucoma drainage device that
is implanted in the eye to divert aqueous
humor (the fluid inside the eye) from the
inside of the eye to an external reservoir.
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.
Glaucoma

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Glaucoma

  • 1. SUDESHNA BANERJEE DUTTA SENIOR LECTURER S.R.S.V.M B.SC NURSING COLLEGE
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  • 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 trabecular meshwork & 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.
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  • 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 angle between the iris and cornea ➢ Develops very quickly ➢ Has symptoms and damage that are usually very noticeable ➢ Demands immediate medical attention
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  • 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
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  • 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
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  • 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
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  • 22. Tonography/Ocular tonometry is the procedure to determine the intraocular pressure (IOP), the fluid pressure inside the eye. Fundoscopy- Ophthalmoscopy, also called fundoscopy, is a test that allows a health professional to see inside the fundus of the eye and other structures using an ophthalmoscope (or fundoscope). Gonioscopy- Gonioscopy is an eye examination to look at the front part of your eye (anterior chamber) between the cornea and the iris
  • 23. Prostaglandin analogs, such as LATANOPROST, BIMATOPROST and TRAVOPROST: Increase uveo-scleral outflow of aqueous humor. Topical beta-adrenergic receptor antagonists, such as TIMOLOL, LEVOBUNOLOL, and BETAXOLOL: Decrease aqueous humor production. Alpha2-adrenergic agonists, such as BRIMONIDINE and APRACLONIDINE: Work by a dual mechanism, decreasing aqueous humor production and increasing uveo-scleral outflow.
  • 24.  Miotic agents (cholinergics), such as PILOCARPINE: Allowing increased outflow of the aqueous humour.  Carbonic anhydrase inhibitors, such as DORZOLAMIDE, BRINZOLAMIDE, AND ACETAZOLAMIDE: Lower secretion of aqueous humor.
  • 25. ❑ CANALOPLASTY Canaloplasty is a new nonperforating surgical technique for open-angle glaucoma, in which a microcatheter is inserted within Schlemm's canal for the entire 360 degrees. ❑ TRABECULECTOMY Trabeculectomy is a type of glaucoma surgery performed on the eye that creates a new pathway for fluid inside the eye to be drained.
  • 26.  A flexible glaucoma drainage device that is implanted in 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.