Glaucoma (open-angle, closed-angle, and normal-tension) – pathology, diagnosis, treatment
Posted On September 17, 2020
a nurse is caring for a client who has acute angle closure glaucoma This is a topic that many people are looking for. chibariku.com is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, chibariku.com would like to introduce to you Glaucoma (open-angle, closed-angle, and normal-tension) – pathology, diagnosis, treatment. Following along are instructions in the video below: Medicine is hard work osmosis makes it easy. It takes your lectures and notes to to create a personalized study. Plan with exclusive videos practice questions and flashcards and so more try it free today. Glaucoma is actually a group of of eye diseases. That are usually due to intraocular hypertension or increased pressure in the eye which damages the optic nerve. And if left untreated can lead to blindness taking a closer look at this cross section of the eye you can see that its split up into different chambers. The anterior chamber includes the area from the cornea to the iris. The posterior chamber is this really narrow space between the iris and the lens and then this larger vitreous chamber includes the space between the lens and the back of the eye not to be too confusing. But both the anterior and posterior chambers. Are located in the anterior section of the eye. While the vitreous chamber is part of the posterior section of the eye typically all of the chambers in the eye are filled with fluid the chambers in the anterior section are filled with a liquid called aqueous humor and the posterior section is filled with vitreous humor. The aqueous humor is a transparent watery fluid that is secreted by the ciliary epithelium. Which in addition to secreting aqueous humor and providing nutrients to the lens and cornea. It provides structural support and helps to keep the shape of the eye. So that fluids secreted into the posterior chamber and then flows through a narrow space between the front of the lens and the back of the iris through the pupil to the anterior chamber. From there the fluid flows out of the eye through the trabecular meshwork. Which is a spongy tissue that acts like a drain. And this allows the fluid to go down into a circular channel called the canal of schlemm and finally into aqueous veins. That are part of the episcleral venous system the veins around the sclera of the eye in glaucoma part of this aqueous humor drainage pathway becomes partially or completely blocked so that fluid cant easily drain out this causes. The pressure within the fixed space of the anterior chamber to quickly build up causing intraocular. Hypertension which is defined as pressure greater than 21 mmhg or 28kpa. The high pressure affects all of the structures in the eye including the optic nerve. Which is the nerve that carries visual information from the eyes to the brain.
And this means that over time. As the optic nerve gets damaged glaucoma leads to vision loss. Now. Therere a couple types of glaucoma first theres open angle glaucoma. Which is actually the most common and it has this name because the angle between the cornea and the iris is open in this type. The drainage system slowly gets clogged over time. So theres a gradual increase in pressure on the optic nerve. This increase in pressure initially results in atrophy of the outer rim of the nerve resulting in a decrease in peripheral vision as that pressure increases even more. Though theres continued damage to the optic nerve. Which eventually leads to a loss in central vision. As well closed angle glaucoma also called angle closure glaucoma or narrow angle glaucoma and this is due to the angle between the iris of the cornea being too small meaning that the passageway for aqueous humor. Outflow is too narrow and this is as a result of the lens being pushed up against the iris. The result is that the drainage system gets blocked again. But this time causes a rapid buildup of pressure within the eye causing an abrupt onset of severe eye pain eye redness blurry. Vision headaches. Nausea and visual haloes. Finally normal tension. Glaucoma or low. Tension. Glaucoma happens. When the pressures normal in the eye. The cause of normal tension glaucoma is largely unknown. Although its thought that the optic nerve becomes damaged due to hypoperfusion or poor blood flow as well as potentially genetic hypersensitivity to pressures that are even in the normal range for diagnosis of glaucoma tonometry can be used to assess for increased intraocular pressure.
Also though visual field testing can be done as well as looking for optic nerve damage either through imaging or by direct observation in particular that pressure on the optic nerve results in a thinning of the outer rim of the nerve. Which starts to give it this cup shape. And this is called cupping and its often seen in individuals with glaucoma while glaucoma is not curable. It can be slowed with treatment. If the underlying issue is intraocular hypertension. Then it can be managed by taking medications that decrease the pressure in the eye. This can be done in a couple ways first by decreasing. The production of aqueous humor. With medications like beta adrenergic receptor. Antagonists and carbonic anhydrase. Inhibitors. Also though you can increase the outflow of aqueous humor by taking prostaglandin analogs or finally. Some medications both decrease production and increase outflow like alpha adrenergic agonists. In addition to medications. There are also laser treatments. Available for example. Trabeculoplasty is a treatment. Where a laser is used to open the trabecular mesh network and this helps treat open angle glaucoma and theres also iridotomy. Which uses a laser to punch a tiny hole in the iris. Which helps treat closed angle glaucoma and there are also laser treatments for example ones that destroy the humor producing cells. Which reduces production of the fluid and in serious cases sometimes they can be used to create a new channel through which the aqueous humor can be drained out and finally there are implants that shunt fluid out of the anterior chamber by bypassing. The trabecular meshwork and collecting system alright as a quick recap glaucoma is an eye disease where a buildup of aqueous humor causes increased pressure in the eye and this damages. The optic nerve and can result in blindness. .
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