VISIONII-SantaRosaJuniorCollege视觉-圣罗萨学院

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1、VISIONIIS.BuckleyRN,MSNCopyright2008COMMONCAUSESOFVISIONLOSSGlaucomaCataractsDiabeticRetinopathyMacularDegenerationGLAUCOMAGlaucoma:IncludesAGroupOfOcularDisordersCharacterizedByIncreasedIntraocularPressure,OpticNerveAtrophy,AndVisualFieldLoss.IndividualPatientResponseCLASSIFICATIONSPrimaryGlau

2、comaSecondaryGlaucomaAcute&ChronicOpen(Wide)&Closed(Narrow)ETIOLOGYPrimaryOpenAngleGlaucomaOccursAsAResultOfAging.TheDrainageAngleOfTheEyeBecomesLessEfficientWithTime.ThereIsADegenerativeChangeInTheTrabecularMeshwork,ResultingInDecreasedOutflowOfAqueousHumor.90%OfCasesPrimaryAngleClosureGlaucoma

3、IsCausedByPupillaryBlock.TheLensBlocksThePupillaryOpening,PreventingTheFlowOfAqueousHumorIntoTheAnteriorChamberAndDrainingThroughTheTrabecularMeshwork.10%OfTheCases.EYEEXAMEyeExamsMustIncludeTonometryAndAssessmentOfTheOpticNerveHead.NormalPressureis10-21mmhg.AbnormalPressureis22-32mmhg.SECONDARY

4、GLAUCOMASecondaryGlaucomaMayOccurAsAResultOfTraumaInWhichYouGetLensDisplacement,HemorrhageIntoTheAnteriorChamber,Lacerations,AndContusionsWhichCanDisruptTheFlowPatternOfAqueousHumor.PATHOPHYSIOLOGYIntraocularPressureIsDeterminedBy:IntraocularPressureVariesWith:IncreasedPressureInhibitsBloodSuppl

5、yToTheOpticNerveAndRetina.IschemiaAndLossOfFunctionFollow.DIAGNOSTICFINDINGSIncreasedIntraocularPressure.CuppingOrIndentationOfTheOpticNerveHeadOnExam.VisualFieldDefectsUsuallyNotNoticedUntilPeripheralVisionIsSeverelyCompromised.ACUTEANGLECLOSUREGLAUCOMAInAcuteAngleClosureGlaucomaTheAqueousFlow

6、IsObstructedAndIntraocularPressureElevatesMarkedly.Signs&Symptoms:SeverePain,BlurringOrLossOfVision,RainBowHalos,Nausea/VomitingAndCornealEdema.EmergencyRequiringImmediateTreatment.MEDICALMANAGEMENTOFGLAUCOMAEyeMedications:IncreaseOutflowOfOrSuppressTheSecretionOfAqueousHumor.EyeDropRegimenAndD

7、eliveryMethod:SterileTechniqueConsistentTiming3-5MinutesBetweenEachDrop(SameMedication).5-10MinutesBetweenDrops(DifferentMedications).ASSESSMENTDemographicDataMedicationListAllergiesChangesInVisionCopingWithVisionChanges/Los