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VISUAL ALTERATION

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VISUAL ALTERATION

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    1. VISUAL ALTERATION GLAUCOMA TREATMENT

    2. Glaucoma Drug Therapy Purpose: - constrict the pupil -reduce production or increase absorption of aqueous humor DRUGS Prostaglandin agonists Adrenergic agonists Beta-adrenergic blockers Cholinergic agonists Carbonic anhydrase inhibitors

    3. DRUGS: PROSTAGLANDIN AGONIST HOW DO THESE TREAT GLAUCOMA? EXAMPLES OF DRUGS: -Latanoprost (Xalatan) -bimatoprost (Lumigan) -travoprost (Travatan): not to be used with pregnancy

    4. DRUGS: Adrenergic Agonists EXAMPLES: -brimonidine tartrate ( Alphagan): Nursing Implications: -cannot combine with MAOI (monoamine oxidase inhibitor) -Can precipitate hypertensive crisis -Instill without contact lens in

    5. DRUGS: BETA ADRENERGIC BLOCKERS EXAMPLES: -levobunolol HCl (Betagen Liquifilm) -betaxolol HCl (Betoptic) -timolol (Betimol, Timoptic) Nursing Implications -WHAT PRECAUTIONS MUST BE USED WITH ORAL BETA BLOCKERS AND CALCIUM CHANNEL BLOCKERS?

    6. Drugs: Cholinergics EXAMPLES -carbochol(Carboptic, Isopto Carbachol, Miostat) -pilocarpine(Adsorbocarpine, Piloptic, Pilopine) Nursing Considerations: -can cause increase with saliva, sweating -pupil becomes smaller (miosis)

    7. DRUGS: CARBONIC ANHYDRASE INHIBITORS: EXAMPLES: -brinzolamide (Azopt), -dorzolamide (Trusopt) Nursing Implications : -check if allergic to sulfonamide -has a diuretic effect -don’t use with contacts

    8. SURGERY FOR BOTH TYPES OF GLAUCOMA PURPOSE: to create a permanent way to drain fluid TYPES (Open Angle Glaucoma) -Laser trabeculectomy: laser burns trabecular meshwork -Filtering microsurgery: creates drainage hole in iris If patient doesn’t respond to surgery, then a shunt or glaucoma drainage device may be implanted Closed Angle Glaucoma: peripheral iridectomy PURPOSE: to create a permanent way to drain fluid TYPES 1. Laser Trabeculectomy 2. IridectomyLASER TRABECULECTOMY: removal of a section of the drainage network allowing fluid to drain freely. IRIDECTOMY: incision made through the cornea so a portion of the iris drawn out and excised. PREVENTS the iris from bulging forward to crowd the chamber angle and permits drainage of aqueous humor from anterior chamber decreasing the IOP PURPOSE: to create a permanent way to drain fluid TYPES 1. Laser Trabeculectomy 2. IridectomyLASER TRABECULECTOMY: removal of a section of the drainage network allowing fluid to drain freely. IRIDECTOMY: incision made through the cornea so a portion of the iris drawn out and excised. PREVENTS the iris from bulging forward to crowd the chamber angle and permits drainage of aqueous humor from anterior chamber decreasing the IOP

    9. Glaucoma Surgical Treatment

    10. Glaucoma Video http://video.google.com/videoplay?docid=-2504983511038511848#

    11. POSTOP NURSING CARE Clinical setting: outpatient services Precautions: measures to prevent increased IOP Postop complications: choroidal hemorrhage

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