Definition
Glaucoma is a group of eye disorders characterized by increased intraocular pressure. (Long Barbara, 1996)
Glaucoma often occurs in both eyes, but extra fluid pressure first begins to build up in one eye. If you don't seek treatment for glaucoma and can't control it, your peripheral vision will decrease by time and subsequent eye damage may easily lead to blindness.
Etiology
There are different types of glaucoma. Most occur when pressure in the eye (intraocular) increases, damaging the optic nerve but sometimes optic nerve damage can occur even when intraocular pressure is normal.
Other types of glaucoma are rare and are caused by abnormal eye development, drugs, eye infections or inflammatory conditions, interruption of blood supply to the eye, systemic diseases and trauma.
Symptoms:
- Headaches.
- Sensitivity to light.
- Blurred vision.
- Decreased peripheral vision- gradual loss.
- Nausea and vomiting.
- Severe pain in the eyes.
- Reddening of the eyes.
- One eye becoming bigger than the other.
- Seeing rainbows around the lights at night.
- Visual disturbance in low light.
- Adjustment issues entering a dark room.
- Excessive tearing.
- Swollen eyes.
Nursing Care Plan for Glaucoma
Assessment
a) Activity / Rest:
Change usually activities / hobbies in connection with visual impairment.
b) Food / Fluids:
Nausea, vomiting (acute glaucoma)
c) Neuro-sensory:
Visual disturbances (blurred / unclear), bright lights glare caused by the gradual loss of peripheral vision, feeling in the dark room (cataracts).
Cloudy vision / blurring, halos appear / rainbows around lights, loss of peripheral vision, photophobia (acute glaucoma).
Changes glasses / treatment not improve vision.
Signs:
Papil narrowed and red / hard eyes with cornea cloudy.
Increased tear.
d) Pain / Leisure:
Mild discomfort / watery eyes (chronic glaucoma)
Sudden pain / weight or pressure settled on and around the eyes, headache (acute glaucoma).
e) Guidance / Learning
Family history of glaucoma, diabetes, impaired vascular system.
Stress history, allergies, vasomotor disturbances (eg, an increase in venous pressure), endocrine imbalance.
Exposed to radiation, steroids / toxicity of phenothiazines.
Nursing Diagnosis for Glaucoma
Acute Pain r / t Increase in intraocular pressure (IOP)
Goal: Pain is lost or diminished.
Outcomes:
- The patient demonstrates knowledge of assessment of pain control.
- The patient said that the pain is reduced / lost.
- Relaxed facial expression.
Intervention:
- Assess the type and location of pain intensity.
- Assess the level of pain scale to determine the analgesic dose.
- Encourage rest in bed in a quiet room.
- Set Fowler position of 30 degrees or in a comfortable position.
- Avoid nausea, vomiting as this will increase the IOP.
- Divert attention to the fun stuff.
- Give analgesics as recommended.