Glaucoma

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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