VISION II - Santa Rosa Junior College视觉-圣罗萨学院.pptVIP

VISION II S. Buckley RN, MSN Copyright 2008 COMMON CAUSES OF VISION LOSS Glaucoma Cataracts Diabetic Retinopathy Macular Degeneration GLAUCOMA Glaucoma: Includes A Group Of Ocular Disorders Characterized By Increased Intraocular Pressure, Optic Nerve Atrophy, And Visual Field Loss. Individual Patient Response CLASSIFICATIONS Primary Glaucoma Secondary Glaucoma Acute Chronic Open (Wide) Closed (Narrow) ETIOLOGY Primary Open Angle Glaucoma Occurs As A Result Of Aging. The Drainage Angle Of The Eye Becomes Less Efficient With Time. There Is A Degenerative Change In The Trabecular Meshwork, Resulting In Decreased Outflow Of Aqueous Humor. 90% Of Cases Primary Angle Closure Glaucoma Is Caused By Pupillary Block. The Lens Blocks The Pupillary Opening, Preventing The Flow Of Aqueous Humor Into The Anterior Chamber And Draining Through The Trabecular Meshwork. 10% Of The Cases. EYE EXAM Eye Exams Must Include Tonometry And Assessment Of The Optic Nerve Head. Normal Pressure is 10-21 mm hg. Abnormal Pressure is 22-32 mm hg. SECONDARY GLAUCOMA Secondary Glaucoma May Occur As A Result Of Trauma In Which You Get Lens Displacement, Hemorrhage Into The Anterior Chamber, Lacerations, And Contusions Which Can Disrupt The Flow Pattern Of Aqueous Humor. PATHOPHYSIOLOGY Intraocular Pressure Is Determined By: Intraocular Pressure Varies With: Increased Pressure Inhibits Blood Supply To The Optic Nerve And Retina. Ischemia And Loss Of Function Follow. DIAGNOSTIC FINDINGS Increased Intraocular Pressure. Cupping Or Indentation Of The Optic Nerve Head On Exam. Visual Field Defects Usually Not Noticed Until Peripheral Vision Is Severely Compromised. ACUTE ANGLE CLOSUREGLAUCOMA In Acute Angle Closure Glaucoma The Aqueous Flow Is Obstructed And Intraocular Pressure Elevates Markedly. Signs Symptoms: Severe Pain, Blurring Or Loss Of Vision, Rain Bow Halos, Nausea/Vomiting And Corneal Edema. Emergency Requiring Immediate Treatment. MEDICAL MANAGEMENTOF GLAUCOM