Assessment for Glaucoma
Assessment includes demographic data , among others :
Age, primary glaucoma occurs in individuals older than 40 years.
Jobs, especially those at risk of experiencing eye trauma.
In addition it must be known before any eye problems or at the time, a history of the use of antihistamines (causes dilation of the pupil which can ultimately lead to Angle - Closure Glaucoma), a history of trauma (especially that of the eye), another disease that is suffered (DM, Arterioscierosis, High myopia).
Psychosocial history includes the presence of anxiety is characterized by fast-talking, easy to change the topic, difficulty concentrating and sensitive, and mourning the loss of vision.
Physical Examination
1. Neurosensory
- Visual disturbances (blurred / not clear), bright light can cause glare with a gradual loss of peripheral vision, difficulty focusing close work / feel in the dark room (cataracts), looks halos / rainbows around lights, loss of peripheral vision, photophobia (acute glaucoma) glass eyes / treatment does not improve vision.
- Signs : the pupil narrows and red / hard eyes with colored cornea, increased tears.
- Physical examination performed by using an ophthalmoscope to determine the presence of cupping and atrophy of the optic disc. Optic disc becomes more widespread and deep in primary acute glaucoma, because the anterior shallow, turbid aqueous humor and blood vessels radiating out from the iris.
- Examination of the peripheral visual field, in the acute state of the visual field rapidly declined significantly and the chronic state will decrease gradually.
- Examination through inspection, to determine the presence of inflammatory eye, the sclera redness, cloudy cornea, dilated pupils, was that failed to react to light.
2. Pain / comfort
- Mild discomfort / watery eyes (chronic glaucoma).
- Sudden pain / severe persistent or pressure in and around eyes, headache (acute glaucoma).
Diagnostic examination
1. Snellen Card / Telebinocular
Used to find the eye and central visual acuity.
2. Field of vision
There was a decline caused by CSV, the tumor on the pituitary / brain, carotid / pathophysiological, cerebral arteries or glaucoma.
3. Tonograph
Assessing intraocular (IOP) (normal 12-25 mmHg).
4. Gonioscopy
Help distinguish open angle and closed angle.
5. Provocative test
Used in determining the type of glaucoma when IOP is normal / mild increases only.
6. Ophthalmoscopic exam
Examine internal ocular structures, noting the optic disc atrophy, papilledema, retinal hemorrhage and microaneurysms.
7. Complete blood, LEDs
Anemia showed systemic / infection.
8. ECG , serum cholesterol and lipid checks.
Ensuring atherosclerosis, PAK.
9. Glucose tolerance test
Determining the presence of DM.
Nursing Diagnosis for Glaucoma
1. Acute pain related to an increase in intraocular pressure.
2. Disturbed Sensory Perception (specify : visual) related to the loss of peripheral sight.
3. Low Self - esteem is related to blindness.