Download Acute Angle-Closure Glaucoma

Acute Angle-Closure Glaucoma
Chrissy Truchok
Overview
• Glaucoma
▫ One of the most common causes of blindness in
United States
▫ Damage occurs to optic nerve causing vision loss
and blindness
▫ Most common types are Open-Angle and ClosedAngle Glaucoma
(Angle-Closure, 2015)
Clinical Manifestations
• Closed-Angle Glaucoma
▫ Medical Emergency
▫ Fluid in the eye is unable to empty through its
usual pathways
 Pressure builds up damaging the optic nerve
Pathogenesis
• Fluid found in the eye is called aqueous humor
▫ Helps to maintain normal eye pressure
 Normal eye pressure is 12-22 mm Hg (Angle-Closure, 2015)
• When something begins to obstruct the drainage
canals, aqueous humor builds up and will lead to
an increase in intraocular pressure
(Primary Angle, 2001)
•In many cases, the iris becomes bunched up over
the drainage canals, causing the backup
(Glaucoma, 2015)
Causes
• One of the greatest causes of acute-angle closure
is a sudden dilation of the pupils
▫ Medications causing the pupils to dilate suddenly
▫ Entering a dark room
Symptoms
• Sudden onset of:
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Severe headache
Eye pain
Blurred vision
Eye redness
Halos or rainbows around lights
Upon Presentation…
• Ask patient about family glaucoma history
• Obtain current medication list
(Primary Angle, 2001)
Diagnosis
• Tonometry Test
▫ Used to measure intra ocular pressure
(Five Common, n.d.)
Diagnosis
• Perimetry Test
▫ Used to test peripheral vision
(Shah, Bowd, Weinreb & Sample, 2006)
Diagnosis
• Gonioscopy
▫ Measures angle where iris meets the cornea
(Shah, Bowd, Weinreb & Sample, 2006)
Differential Diagnosis
• Optic Neuritis
▫ Patient will also experience color vision loss and
flashing lights
• Cataracts
▫ Patients experience more of a gradual vision loss
• Main determining factor for both of these
diseases is that the IOP will not be elevated!
Treatment
• Lower intra ocular pressure immediately
▫ Eye drops
▫ Surgery
(Primary Angle, 2001)
Outcomes
• Vision loss can be prevented
• Encourage yearly appointments
References
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Angle- Closure Glaucoma. (2015). Retrieved January 28, 2016, from http://www.glaucoma.org/glaucoma/angleclosure-glaucoma.php
Glaucoma. (2015). Retrieved February 1, 2016, from http://www.mayoclinic.org/diseasesconditions/glaucoma/basics/definition/con-20024042
Five Common Glaucoma Tests. (n.d.). Retrieved January 28, 2016, from
https://hooptometrist.wordpress.com/tag/glaucoma/
Primary Angle- Closure Glaucoma. (2001). Retrieved February 1, 2016, from
http://www.aoa.org/documents/optometrists/CPG-5.pdf
Shah, N. N., MD, Bowd, C., PhD, Weinreb, R. N., MD, & Sample, P. A., PhD. (2006). Combining Structural and
Functional Testing for Detection of Glaucoma. Opthamology. Retrieved February 1, 2016, from
http://www.sciencedirect.com.ezaccess.libraries.psu.edu/science/article/pii/S0161642006008384