Primary open angle glaucoma (POAG) is the most common type of glaucoma. It is characterized by a raised intraocular pressure, optic nerve damage, and visual field loss. Early signs include increased cupping of the optic nerve head and visual field defects like paracentral scotomas. Treatment aims to lower intraocular pressure through medications, laser therapy, or surgery to prevent further optic nerve damage and vision loss.
-IOL formula
1st generation formula : SRK, Binkhost
2nd generation formula : SRK II
3rd generation formula: Hoffer Q, Holladay 1, SRK/T
4th generation formula: Haigis, Holladay 2, Olsen
-The Hoffer Q, Holladay I, and SRK/T formula are all commonly used.
Congenital Glaucoma is one of the most common causes of irreversible childhood blindness. This presentation covers this topic in detail that can aid physicians in effective patient care.
PS: The slides in the preview look skewed, download the presentation to view the font used in Office 2012 and upwards.
-IOL formula
1st generation formula : SRK, Binkhost
2nd generation formula : SRK II
3rd generation formula: Hoffer Q, Holladay 1, SRK/T
4th generation formula: Haigis, Holladay 2, Olsen
-The Hoffer Q, Holladay I, and SRK/T formula are all commonly used.
Congenital Glaucoma is one of the most common causes of irreversible childhood blindness. This presentation covers this topic in detail that can aid physicians in effective patient care.
PS: The slides in the preview look skewed, download the presentation to view the font used in Office 2012 and upwards.
Glaucoma: the “silent thief of sight”
Glaucoma is a leading cause of preventable sight loss. Vision can often be preserved with early identification, good adherence to treatment and long-term monitoring.
A common eye condition in which the fluid pressure inside the eye rises to a level higher than healthy for that eye.
If untreated, it may damage the optic nerve, causing the loss of vision or even blindness
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
R3 Stem Cells and Kidney Repair A New Horizon in Nephrology.pptxR3 Stem Cell
R3 Stem Cells and Kidney Repair: A New Horizon in Nephrology" explores groundbreaking advancements in the use of R3 stem cells for kidney disease treatment. This insightful piece delves into the potential of these cells to regenerate damaged kidney tissue, offering new hope for patients and reshaping the future of nephrology.
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
Empowering ACOs: Leveraging Quality Management Tools for MIPS and BeyondHealth Catalyst
Join us as we delve into the crucial realm of quality reporting for MSSP (Medicare Shared Savings Program) Accountable Care Organizations (ACOs).
In this session, we will explore how a robust quality management solution can empower your organization to meet regulatory requirements and improve processes for MIPS reporting and internal quality programs. Learn how our MeasureAble application enables compliance and fosters continuous improvement.
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
India Clinical Trials Market: Industry Size and Growth Trends [2030] Analyzed...Kumar Satyam
According to TechSci Research report, "India Clinical Trials Market- By Region, Competition, Forecast & Opportunities, 2030F," the India Clinical Trials Market was valued at USD 2.05 billion in 2024 and is projected to grow at a compound annual growth rate (CAGR) of 8.64% through 2030. The market is driven by a variety of factors, making India an attractive destination for pharmaceutical companies and researchers. India's vast and diverse patient population, cost-effective operational environment, and a large pool of skilled medical professionals contribute significantly to the market's growth. Additionally, increasing government support in streamlining regulations and the growing prevalence of lifestyle diseases further propel the clinical trials market.
Growing Prevalence of Lifestyle Diseases
The rising incidence of lifestyle diseases such as diabetes, cardiovascular diseases, and cancer is a major trend driving the clinical trials market in India. These conditions necessitate the development and testing of new treatment methods, creating a robust demand for clinical trials. The increasing burden of these diseases highlights the need for innovative therapies and underscores the importance of India as a key player in global clinical research.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
3. DEFINITION
• Glaucoma is a chronic, progressive optic
neuropathy caused by a group of ocular
conditions which lead to damage of the optic
nerve with loss of visual function.
• The most common risk factor known is a
raised intraocular pressure.
6. MECHANICAL
mechanical pressure
on the lamina
cribrosa
mechanical pressure
on the lamina
cribrosa
altering capillary
blood flow
backward displacement
and compaction of the
laminar plates narrows
the openings through
which the axons pass
GANGLION CELL
DEATH
9. Diagnosis
combination of clinical signs—characteristic
changes in
• the optic nerve head
• abnormalities in the visual field
• rise in intraocular pressure
• The type of glaucoma is determined by the
status of the anterior chamber angle as
determined by gonioscopy
15. VISUAL FIELD
• Portion of space in which objects are simultaneously
visible to the steadily fixating eye.
16. Visual field examination
Screening tests …
• Confrontational visual field testing
• Amsler grid (assesses the central 10° the
visual field ) .
Quantitative measurements using manual or
automated perimetry
17. DISTRIBUTION OF RETINAL NERVE FIBRES
BJERRUM’S AREA : an arcuate area extending
above and below the blind spot , 10 to 25 ̊
from fixation
18. Visual field defects
• Relative paracentral scotoma
• Roenne’s nasal step
• Seidel scotoma
• Arcuate scotoma
• Double arcuate / ring scotoma
• End stage / near total field defect
19. • RELATIVE PARACENTRAL
SCOTOMA – areas where
smaller / dimmer objects
are not visualised by patient
but larger & brighter objects
are seen
• SEIDEL SCOTOMA
• starts at the poles of the
blind spot , arches over the
macular area without
reaching the horizontal
meridian nasally
20. ARCUATE SCOTOMA
• Starts at superior or inferior
poles of blind spot
• Arches over macular area
• Ends as a horizontal line
nasally
• Does not cross the
horizontal divide of visual
field
DOUBLE ARCUATE / RING
SCOTOMA
• Two arcuate scotomas
expand to involve the
peripheral visual field
• Central(tubular vision ) and
temporal islands of vision
are left
21. ROENNE’S NASAL STEP
• Appearance of a horizontal
shelf in the nasal visual
field.
• Caused by asymmetrical
nerve fibre loss at the poles
END STAGE / NEAR TOTAL
FIELD DEFECT
• Small island of temporal
vision
22. Intraocular pressure
• IOP > 21mmHg on more
than one occasion
• Circadian Variation >
8mmHg
• Asymmetry in IOP
between 2 eyes of more
than 5 mmHg
27. Schaffer’s grading
Grade 0
Grade 1
Grade 2
Grade 3
Grade 4
Grade 4 (35–45°) is the widest angle, the ciliary body can be visualized.
Grade 3 (25–35°) is an open angle, scleral spur is visible.
Grade 2 (20°) is an angle in which the trabeculum but not the scleral spur can be seen.
Grade 1 (10°) is a very narrow angle in which only the Schwalbe line and perhaps the top
of the trabeculum can be identified.
Slit angle is one in which there is no obvious iridocorneal contact but no angle structures
can be identified.
Grade 0 (0°) is closed due to iridocorneal contact.
29. Open-angle glaucomas
Primary open-
angle glaucoma
(POAG)
Not associated with known ocular or systemic
disorders that cause increased resistance to
aqueous outflow or damage to optic nerve;
usually associated with elevated I O P
Normal-tension
glaucoma ( NTG)
Considered in continuum of POAG;
terminology often used when I O P is not
elevated
Juvenile open-
angle
glaucoma (JOAG)
Terminology often used when open-angle
glaucoma diagnosed at young age (typically 4-
35 years of age)
30. Ocular
hypertension
Normal optic disc and visual field associated
with elevated I O P
Glaucoma suspect Suspicious optic disc or visual field regardless
of I O P
Secondary open
angle
glaucoma
Increased resistance to trabecular meshwork
outflow associated with other conditions (eg,
pigmentary glaucoma, phaco-lytic glaucoma,
steroid-induced glaucoma, exfoliation
syndrome, angle-recession
glaucoma)
Increased post-trabecular resistance to
outflow secondary to elevated
episcleral venous pressure (eg, carotid
cavernous sinus fistula)
35. SYMPTOMS
• Insidious Onset/Nonspecific
• ‘Asymptomatic’ most of the time
• Painless Progressive Loss of Vision
• Dull Headache / eye pain
• Difficulty in Near Work
• Constant pressure on ciliary muscle
• Frequent change in presbyopic correction
• Difficulty in vision more at night (dark adaptation
delay )
• Dark areas (scotomas) in field of vision
36. Diagnosis
CLASSICAL TRIAD
• RAISED IOP
• OPTIC NERVE HEAD CUPPING
• VISUAL FIELD DEFECTS
• On Gonioscopy - the angle should be ‘normal’
and ‘open’
37. Management
Principle:
• Determine TARGET PRESSURE - the range of
IOP at which there is no further progression of
glaucomatous damage.
• Parameters to document:
• Baseline IOP at which damage occurred
• Extent/severity of damage
• Associated risk factors
42. NORMAL TENSION GLAUCOMA
• Definition:
– Typical glaucomatous optic disc cupping
– Visual field loss
– A mean IOP ≤ 21mm of Hg on diurnal testing
– Open angles
– Absence of any contributing ocular / specific
systemic disorders
43. EPIDEMIOLOGY
• NTG accounts for 30% of the Glaucomas
• Age – significantly older than POAG
• Gender – females ≥ males – 2:1
• Race – Japan
• Family history – POAG is greater in families
of patients of NTG
45. CLINICAL FEATURES
• IOP
• In high teens
• Wide diurnal and postural IOP fluctuations
• Night and early morning spikes
• Visual field changes
• Closer to fixation
• Deeper
• Steeper
• Localised
47. CLINICAL FEATURES
• OTHERS
• Peripheral vasospasm on cooling
• Migraine
• Nocturnal hypotension
• Reduced blood flow in ophthalmic & posterior ciliary
arteries
• Paraprotienaemias and presence of serum auto
antibodies
48. TREATMENT OF NTG
• Lower IOP by 30%
• Betaxolol- Increases the pulsatile ocular blood flow to the
optic nerve
• Brimonidine 0.2%:Neuroprotective
• Prostaglandin analogues –
• Latanoprost: 0.005% once daily
• Bimatoprost: 0.03%
• Travoprost: 0.004%
• Dorzolamide
• Improves blood flow and velocity in the vicinity of optic nerve
• Calcium channel Blockers
49. OCULAR HYPERTENSION
• Definition:
– IOP 22mm of Hg or greater
– Normal optic disc
– Normal Visual Fields
– Open angle
– Absence of any ocular or systemic disorder
contributing to elevated IOP
50. RISK FACTORS
• Increasing age
• Retinal nerve fibre layer defects
• Optic nerve head morphology
– Higher vertical C/D ratio
• Elevated IOP
• Peripapillary changes
• Central corneal thickness
• Positive family history -first degree relative
• High Myopia
51. MANAGEMENT
• 20% IOP reduction
• Medical
Other modalities less frequently
• LASER
• Surgery
52. • POAG clinical features
• ONH changes in POAG
• Visual field defects in POAG
• Management