N109: Foundations in Nursing Practice

N109: Foundations in Nursing Practice Study Guide o Open-angle (chronic) glaucoma: This is the most common cause of glaucoma, but the cause of open-angle glaucoma is not known. Pressure in the eye increases over time and the individual may experience no symptoms until she begins to lose peripheral vision. Most people with open-angle glaucoma can be treated successfully with eye drops. Most eye drops used today have fewer side effects than those used in the past. The patient may need more than one type of drop. Some patients may also be treated with pills to lower pressure in the eye. Newer drops and pills are being developed that may protect the optic nerve from glaucoma damage. o Angle-closure (acute) glaucoma: This occurs when the exit of the aqueous humour fluid is suddenly blocked. This causes a quick, severe, and painful rise in the pressure within the eye (intraocular pressure). This condition is an emergency and intervention must be implemented rapidly. Symptoms may be intermittent at first, but will develop into severe pain in the eye. Vision may become cloudy with halos around lights. With severe symptoms, the individual may have nausea and vomiting. An acute angle-closure attack is a medical emergency. Blindness will occur in a few days if it is not treated. Drops, pills, andmedicine given through a vein (by IV) are used to lower pressure. Some people also need an emergency operation called an iridotomy. This procedure uses a laser to open a new channel in the iris. The new channel relieves pressure and prevents another attack. o Congenital glaucoma: This is a hereditary condition present at birth resulting from abnormal development of the fluid outflow channels in the eye. Parents may notice cloudiness in the front of the eye, excessive tearing, or enlargement of one or both eyes. This form of glaucoma is almost always treated with surgery to open the outflow channels of the angle. This is done while the patient is asleep and feels no pain (with anesthesia). o Secondary glaucoma: This can be caused by some drugs, other eye diseases, and some systemic diseases. • Corneal abrasions: These are scratches or superficial damage to the cornea. These abrasions are usually caused by mechanical means (an external agent gets in the eye and causes the scratch). These abrasions are common problems and are typically very painful. • Retinal detachment: This is a separation of the light-sensitive membrane in the back of the eye (the retina) from its supporting layers. Retinal detachment often occurs on its own without an underlying cause; however, it may also be caused by trauma, diabetes, or an inflammatory disorder. In fact, it is most often caused by a related condition called posterior vitreous detachment. Symptoms may include bright flashes of light, “floaters” in the eye, blurred vision, or partial visual field blindness. Surgery is the treatment of choice. • Conjunctivitis: This is the swelling (inflammation) or infection of the membrane lining the eyelids, the conjunctiva. Viruses are the most common cause of conjunctivitis, but it can also be caused by allergies, other disease, chemical exposure, and wearing contact lenses. Typically, tears in the eyes help protect the conjunctiva by washing away irritants. “Pink eye” is a highly contagious viral infection of the conjunctiva common in children. Symptoms of conjunctivitis may include blurred vision, eye pain, gritty feeling or itching in the eyes, redness of the eyes, photophobia, and excessive tearing. Treatment includes antibacterial agents, antibiotics, or corticosteroids.

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