Increased Intraocular Pressure for Certified Emergency Nursing (CEN)

Increased intraocular pressure is just what it sounds like, an increase in the pressure of the eye. For our purposes, we are going to talk about 2 conditions which can cause that increase:

Central Retinal Artery Occlusion (CRAO)
Acute Angle Closure Glaucoma (AACG)

Central retinal artery occlusion is a condition which causes sudden, painless, unilateral blindness. Failure to restore circulation to the retina can cause permanent loss of vision within 60-90 minutes. It can be caused by:

Emboli (maybe a-fib)
Thrombosis
Hypertension
Giant Cell arteritis
Angiospasm

Acute Angle Closure Glaucoma occurs when aqueous humor cannot escape the anterior chamber. For those who don’t know, aqueous humor is the clear fluid filling the space in the front of the eyeball between the lens and the cornea. I know, it always makes me think of good humor which makes me think of ice cream, but I digress.

The resulting pressure eventually compresses the optic nerve. Just like the retinal occlusion, this is an emergency that requires prompt treatment.

Pathophysiology:

In CRAO occlusion of the central retinal artery from one of the earlier mentioned conditions, results in retinal ischemia, vision loss, and eventual necrosis.

An acute attack of angle-closure glaucoma is precipitated by pupillary dilatation, leading to increasing iris and lens contact increasing the pupillary block.[7] The increasing pupillary block leads to bulging of the iris, acutely closing the angle between the iris and cornea, thus obstructing the aqueous humor outflow tract. The intraocular pressure rises acutely, leading to symptomology.

Clinical Presentation:

CRAO
Sudden, painless, unilateral blindness
Patients have stated this feels like “a curtain shade coming down over the eye”
Elevated intraocular pressure. Normal is 10-21 mm Hg as measured by a tonometer.

Increased Intraocular Pressure for Certified Emergency Nursing (CEN)

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Outline

Increased Intraocular Pressure:

Definition/Etiology:

Pathophysiology:

Clinical Presentation:

Collaborative Management:

Evaluation | Patient Monitoring | Education:

Linchpins: (Key Points)

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For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD https://greatnurses.com/

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For more great CEN prep, got to the link below to purchase the “Emergency Nursing Examination Review” book by Dr. Laura Gasparis Vonfrolio RN, PHD
https://greatnurses.com/