Glaucoma: eye-drop adherence and acute angle-closure as an emergency
- Safe practice
The nurse keeps glaucoma drops going in hospital, teaches correct technique and treats a sudden painful red eye with halos as an emergency.
What it is
Glaucoma is a group of eye diseases that damage the optic nerve, usually because the pressure inside the eye is too high; it is one of the most common causes of blindness. Open-angle glaucoma, the most frequent type, causes no symptoms until a lot of side vision is lost and cannot be cured, so the patient uses drops for life to protect sight. Acute angle-closure glaucoma is different: drainage is blocked suddenly, the pressure rises fast, and the patient has severe eye pain, a red eye, blurred vision, halos and often nausea and vomiting. It is an emergency. The nurse keeps the usual drops going on the ward, teaches technique and adherence, warns the team before dilating drops and recognises an acute attack.
What it requires
- The patient's own drop schedule continued in hospital as ordered.
- Correct drop technique: clean hands, no contact with the dropper tip, one drop in the lower-lid pocket.
- Regular follow-up with the eye team to check pressure and the optic nerve.
- Rapid recognition of acute angle-closure and immediate referral.
Components
- Medicine reconciliation of the eye drops on admission.
- Teaching of technique and adherence.
- Safety before dilating drops or new medicines.
- Recognition of the acute attack.
How it is applied (and why)
- On admission, ask which drops the patient uses, in which eye and when, and continue them as ordered: treatment protects sight.
- Wash your hands, tilt the head back and pull down the lower lid to form a pocket: a clean, steady technique gets the drop in.
- Instil one drop without touching the tip to the eye; the patient closes the eye for 2–3 minutes and the tear duct is pressed gently.
- Wait at least five minutes before a different drop in the same eye, as the eye-drop instructions state.
- Do not wipe or rinse the dropper tip, and put the cap back on tightly.
- Before dilating drops or a new medicine, remind the prescriber that the patient has glaucoma: some can trigger an attack.
- Sudden eye pain, red eye, halos, blurred vision, nausea or vomiting: tell the doctor at once and seek emergency eye care.
- Explain that open-angle glaucoma gives no warning until vision is lost: that is why the drops continue every day.
- Encourage regular eye checks for the patient and examinations for relatives: early detection protects sight.
In nursing practice
- Open-angle glaucoma is treated with drops, often more than one type, and with laser or tablets if needed; surgery is used when these fail.
- Acute angle-closure is treated with drops, tablets, IV medicines and often laser iridotomy or surgery, sometimes in both eyes.
- Higher risk of open-angle glaucoma: family history and African descent.
- Secondary glaucoma can follow corticosteroid use, uveitis, diabetes or an eye injury.
- People at risk of angle-closure may be offered preventive treatment.
Common mistakes
- Stopping or forgetting the drops in hospital because vision seems normal.
- Giving several eye drops one after the other without waiting.
- Giving dilating drops without telling the team that the patient has glaucoma.
- Delaying the call for a sudden painful red eye with halos.
Test yourself
Think of the answer, then tap the question to see it.
Why does a patient with open-angle glaucoma keep using drops when vision feels normal?
Open-angle glaucoma causes no symptoms until significant side vision is lost, and it cannot be cured; treatment protects the remaining sight.
Which symptoms suggest acute angle-closure glaucoma?
Sudden severe eye pain, a red eye, blurred or cloudy vision, rainbow halos around lights, and nausea and vomiting. It is an emergency.
What should the nurse check before dilating eye drops are given?
Whether the patient has glaucoma or risk of angle-closure, and tell the prescriber: dilating drops can trigger an attack.
What is done after instilling an eye drop?
The patient closes the eye for 2–3 minutes with the head tipped down, the tear duct is pressed gently, and the dropper tip is not wiped or rinsed.
Elsewhere in DurgiPedia
Connections
Educational content for students; it does not replace your institution's protocols, supervised clinical training or a prescriber's order. Dose-calculation examples use made-up numbers: they are educational, not a clinical order.
Sources: Glaucoma (MedlinePlus, U.S. National Library of Medicine, 2025); How to use eyedrops (MedlinePlus, U.S. National Library of Medicine, 2025).
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Representative model, for educational purposes only.