Nursing Assessment

• Patient’s ability to understand and comply with treatment
• Patient’s psychologic reaction to sight-threatening disorder
• Family reaction and support
• Caregiver availability

Nursing diagnoses

• Risk for injury related to visual acuity deficits
• Self-care deficits related to visual acuity deficits
• Acute pain related to pathophysiologic process and surgical correction
• Noncompliance related to the inconvenience and side effects of glaucoma medications

Planning

• Expected Goals
  • No progression of visual impairment
  • Understanding of disease process and rationale for therapy
  • Compliance with all aspects of therapy
  • No postoperative complications

Nursing implementation

• Health Promotion
  • Teach patient and family risks of glaucoma, and that it increases with age
  • Emphasize importance of early detection and treatment
  • Provide ophthalmologic examinations
• Acute Care
  • Administer medication to lower IOP
  • For surgical patients
    • Provide postop instructions
    • Relieve discomfort
• Ambulatory Care
  • Remind patient to follow therapy
  • Teach about
    • Disease process
    • Treatment options and their rationale
    • Information about purpose, frequency, and technique for administration of anti-glaucoma drugs

Evaluation

• Expected Outcomes
  • No further loss of vision
  • Compliance with recommended therapy
  • Safe functioning in the environment
  • Pain relief from disease and surgery

Gerontologic considerations

• Tend to special needs of older adult
  • Caution about potential drug interactions that occur with systemic illnesses and their treatments
  • Teach that occluding puncta will limit systemic absorption of glaucoma medications

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