CHILDHOOD GLAUCOMA AND THE ROLE OF THE NURSE AUTHOR: INSTITUTION: Glaucoma Glaucoma belongs to a large class of eye disorders that cause damage to the optic nerve that is responsible for offering sensation to the structures of the eye. Statistics reveal that glaucoma is the third common cause of blindness around the whole world…
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Glaucomas are majorly classified into two classes depending on the angle that the iris of the eye forms with the cornea at the anterior chamber of the eye. The two classifications are open-angle and closed-angle glaucoma. They may also be divided into primary types or secondary types. Childhood glaucoma is a very dangerous disorder due to the fact that the child may develop blindness and other eye complications if at all the condition are not corrected early. To suffer blindness at such an early age would make life difficult for the child. It may also make the life of the parents difficult as they attend to the child. Such a child requires massive care from the nurses of health institutions. The nurses also have a role of teaching the care principles to the parents or siblings of the affected child. My discussion will illustrate the disease process of glaucoma. I will then analyze the management measures directed by the nurses to aid in the recovery of the child, or to assist the child lead a normal lifestyle. The disease process The optic nerve is responsible for transmission of visual images from the eye towards the brain. These contribute to perception of images by the brain. In glaucoma, components (axons) of this nerve are destroyed. They result in the death of the cells of the ganglions of the optic nerve. This in turn causes atrophy of the nerve. The result is that images are not transmitted to the brain for perception. This explains the vision loss in patches. There are many conditions causing the destruction of these neurons, however, the commonest cause is an increase in the contents of the eye. This is termed to as an increase in the intraocular pressures (IOP) of the eyes. Increased IOP may be due to obstruction of secretions of the eye or inhibition of flow. The major secretions of the eye are the aqueous humor and the vitreous humor. Physical injuries and congenital causes play a role in the obstruction of flow. The commonest congenital form of glaucoma in children is referred to as Primary Infantile Glaucoma also referred to as congenital glaucoma. In this condition, there is hindrance to the passage of a secretion the eye referred to as aqueous humor of the infant or child. This raises the IOP with a possible damage of the optic nerve. This causes patchy blindness in the child or infant. Statistics reveal that the incidence of affecting one eye is 40% while in both of the eyes it is 60% (Merck Manual of Diagnosis, 2010). Primary infantile glaucoma may occur in infants following traumatic events or after surgery involving the ocular structures. Signs and symptoms The primary symptom in a child with infantile glaucoma is the swelling of the eye beyond its normal size. This is because of thee the IOP cause stretching of collagen fibers of the sclera of the eye. The infant or child affected experiences intolerance to bright light (photophobia) and tearing. The cornea of the eye becomes thin. It is normally about 12mm. The cornea of the eye may also be cloudy. If the condition is not given urgent medical care, the cloudiness may progress, the optic nerve will be destroyed and patchy blindness occurs. Surgical intervention is the cardinal correction measure. Diagnosis: role of the nurse Early diagnosis of the condition is very important in children because some children have the condition without the parents
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