GLAUCOMA - GLAUCOMA Increased intraocular pressure(IOP is...

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GLAUCOMA Increased intraocular pressure ( IOP ) is the result of inadequate drainage of aqueous humor from the anterior chamber of the eye. The increased pressure causes atrophy of the optic nerve and, if untreated, blindness. There are two primary categories of glaucoma: (1) open-angle and (2) closed-angle (or narrow angle). Chronic open-angle glaucoma is the most common type, accounting for 90% of all glaucoma cases. It develops slowly, may be associated with diabetes and myopia, and may develop in both eyes simultaneously. Chronic glaucoma has no early warning signs, and the loss of peripheral vision occurs so gradually that substantial optic nerve damage can occur before glaucoma is detected. Narrow-angle, or angle-closure, glaucoma is the less common form and may be associated with eye trauma, various inflammatory processes, and pupillary dilation after the instillation of mydriatic drops. Acute angle-closure glaucoma is manifested by sudden excruciating pain in or around the eye, blurred vision, and ocular redness. This condition constitutes a medical emergency because blindness may suddenly ensue. CARE SETTING Community, unless sudden increase in IOP requires emergency intervention and close monitoring. RELATED CONCERNS Psychosocial aspects of care Patient Assessment Database ACTIVITY/REST May report: Change in usual activities/hobbies due to altered vision FOOD/FLUID May report: Nausea/vomiting (acute glaucoma) NEUROSENSORY May report: Gradual loss of peripheral vision, frequent change of glasses, difficulty adjusting to darkened room, halos around lights, mild headache (chronic glaucoma) Cloudy/blurred vision, appearance of halos/rainbows around lights, sudden loss of peripheral vision, photophobia (acute glaucoma) Glasses/treatment change does not improve vision May exhibit: Dilated, fixed, cloudy pupils (acute glaucoma) Fixed pupil and red/hard eye with cloudy cornea (glaucoma emergency) Increased tearing Intumescent cataracts, intraocular hemorrhage (glaucoma secondary to trauma) PAIN/DISCOMFORT May report: Mild discomfort or aching/tired eyes (chronic glaucoma) Sudden/persistent severe pain or pressure in and around eye(s), headache (acute glaucoma) SAFETY May report: History of hemorrhage, trauma, ocular disease, tumor (secondary to trauma) Difficulty seeing, managing activities May exhibit: Inflammatory disease of eye (glaucoma secondary to trauma) TEACHING/LEARNING May report: Family history of glaucoma, diabetes, systemic vascular disorders History of stress, allergies, vasomotor disturbances (e.g., increased venous pressure), endocrine imbalance, diabetes History of ocular surgery/cataract removal; steroid use Discharge plan May require assistance with transportation, meal preparation, self-care, homemaker/ maintenance tasks
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considerations: Refer to section at end of plan for postdischarge considerations.
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This note was uploaded on 02/01/2011 for the course PNR 182 taught by Professor Toole during the Spring '10 term at Orangeburg-Calhoun Technical College.

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GLAUCOMA - GLAUCOMA Increased intraocular pressure(IOP is...

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