Glaucoma

A group of disorders characterized by
- Increased IOP and consequences of elevated pressure
- Optic nerve atrophy
- Peripheral visual field loss
Second leading cause of blindness in U.S.
Leading cause of blindness in African Americans
- Many are unaware
- Incidence increases with age
- Preventable
- Genetic traits

Etiology and pathophysiology

Primary open-angle glaucoma (POAG)
- Most common type of glaucoma
- Outflow of aqueous humor is ↓ in trabecular meshwork
- Develops slowly
- No symptoms
- Unnoticed until peripheral vision is severely compromised
Primary angle-closure glaucoma (PACG)
- Angle closure ↓ the flow of aqueous humor
- Caused by age, pupil dilation
- Possibly drug induced

Clinical manifestation

PACG
- Sudden onset
  - Excruciating pain in or around eyes
  - Nausea and vomiting
  - Seeing colored halos around lights
  - Blurred vision
  - Ocular redness
- IOP elevated in glaucoma
  - Normal IOP 10 to 21 mm Hg
  - Open-angle glaucoma 22 to 32 mm Hg
  - Acute angle-closure glaucoma >50 mm Hg

Interprofessional Care

Acute angle-closure glaucoma
- Miotics
  - Decreased visual acuity in dim light
- Oral/IV hyperosmotic
- Laser peripheral iridotomy
- Surgical iridectomy

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