3 Glaucoma Nursing Care Plans


Learn about the importance of a comprehensive nursing diagnosis for glaucoma patients and how it can be used to develop effective care plans. Discover common nursing diagnoses for glaucoma and how they can improve patient outcomes.

What is Glaucoma?

Glaucoma or Increased intraocular pressure (IOP) is the result of inadequate drainage of aqueous humor from the anterior chamber of the eye. It is a condition that causes damage to your eye’s optic nerve and gets worse over time. The increased pressure causes atrophy of the optic nerve and, if untreated, blindness. Glaucoma tends to be inherited and may not show up until later in life.

There are two primary categories of glaucoma: (1) open-angle and (2) closed-angle (or narrow-angle). Chronic open-angle glaucoma is the most common type, accounting for 90% of all glaucoma cases. It develops slowly, may be associated with diabetes and myopia, and may develop in both eyes simultaneously. Chronic glaucoma has no early warning signs, and the loss of peripheral vision occurs so gradually that substantial optic nerve damage can occur before glaucoma is detected.

Narrow-angle, or angle-closure, glaucoma is the less common form and may be associated with eye trauma, various inflammatory processes, and pupillary dilation after the instillation of mydriatic drops. Acute angle-closure glaucoma is manifested by sudden excruciating pain in or around the eye, blurred vision, and ocular redness. This condition constitutes a medical emergency because blindness may suddenly ensue.

Nursing Care Plans

Nursing care planning and management for patients with glaucoma include: preventing further visual deterioration, promoting adaptation to changes in reduced visual acuity, and preventing complications and injury.


Here are three (3) nursing care plans (NCP) and nursing diagnosis for glaucoma: 

  1. Disturbed Sensory Perception: Visual
  2. Anxiety
  3. Deficient Knowledge

Disturbed Visual Sensory Perception

Glaucoma is a condition that damages the optic nerve, which is responsible for transmitting visual information to the brain. As a result, patients with glaucoma may experience disturbed visual sensory perception due to the altered status of their sense organs, the eye, and the impaired transmission of visual signals to the brain.

Nursing Diagnosis

  • Disturbed Sensory Perception

May be related to

  • Altered sensory reception: altered status of sense organ

Possibly evidenced by

  • Progressive loss of visual field

Desired Outcomes

  • The client will participate in the therapeutic regimen.
  • The client will maintain the current visual field/acuity without further loss.

Nursing Assessment and Rationales

1. Determine the type and degree of visual loss.
Affects the choice of interventions and the patient’s future expectations.

2. Allow expression of feelings about loss and the possibility of a loss of vision.

Although early intervention can prevent blindness, the patient faces the possibility or may have already experienced a partial or complete loss of vision. Although vision loss cannot be restored (even with treatment), further loss can be prevented.

Nursing Interventions and Rationales

1. Implement measures to assist patients to manage visual limitations such as reducing clutter, arranging furniture out of travel path; turning heads to view subjects; correcting for dim light and problems of night vision.
Reduces safety hazards related to changes in visual fields or loss of vision and papillary accommodation to environmental light.

2. Demonstrate administration of eye drops (counting drops, adhering to the schedule, not missing doses).
Controls IOP, preventing further loss of vision.

3. Assist with the administration of medications as indicated:
These direct-acting topical myotic drugs cause pupillary constriction, facilitating the outflow of aqueous humor and lowering IOP. Note: Ocusert is a disc (similar to contact) that is placed in the lower eyelid, where it can remain for up to 1 wk before being replaced.

4. Stress the importance of meticulous compliance with prescribed drug therapy:
To prevent an increase in IOP, resulting in disk changes and loss of vision.

  • 4.1. Chronic, open-angle glaucoma Pilocarpine hydrochloride (Isopto Carpine, Ocusert [disc], Pilopine HS gel)
    Beta-blockers decrease the formation of aqueous humor without changing pupil size, vision, or accommodation. Note: These drugs may be contraindicated or require close monitoring for systemic effects in the presence of bradycardia or asthma.
  • 4.2. Timolol maleate (Timoptic), betaxolol (Betoptic), carteolol (Ocupress), metipranolol (OptiPranolol), levobunolol (Betagan)
    Carbonic anhydrase inhibitors decrease the rate of production of aqueous humor. Note: Systemic adverse effects are common, including mood disturbances, GI upset, and fatigue.
  • 4.3. Acetazolamide (Diamox), methazolamide (Neptazane), dorzolamide (Trusopt)
    Contracts the sphincter muscles of the iris, deepens the anterior chamber and dilates vessels of the outflow tract during an acute attack or before surgery.
  • 4.4. Narrow-angle (angle-closure) type Myotics (until the pupil is constricted); Carbonic anhydrase inhibitors like acetazolamide (Diamox); dichlorphenamide (Daranide); methazolamide (Neptazane)
    Decreases secretion of aqueous humor and lowers IOP.
  • 4.5. Sympathomimetics: dipivefrin (Propine), brimonidine (Alphagan), epinephrine (Epifrin), apraclonidine (Iopidine), latanoprost (Xalatan)
    Adrenergic drops also decrease the formation of aqueous humor and may be beneficial when the patient is unresponsive to other medications. Although free of side effects such as miosis, blurred vision, and night blindness, they have the potential for additive adverse cardiovascular effects in combination with other cardiovascular agents. Note: Light-colored eyes are more responsive to these drugs than dark-colored eyes, necessitating added considerations when determining the appropriate dosage.

5. Provide sedation, and analgesics as necessary.
Acute glaucoma attack is associated with sudden pain, which can precipitate anxiety and agitation, further elevating IOP. Medical management may require 4–6 hr before IOP decreases and pain subsides.

6. Prepare for surgical intervention as indicated:

  • 6.1. Laser therapy such as argon laser trabeculoplasty (ALT), trabeculectomy, or trephination
    Filtering operations (laser surgery) are highly successful procedures for reducing IOP by creating an opening between the anterior chamber and the subconjunctival spaces so that aqueous humor can bypass the trabecular mesh block. Note: Apraclonidine (Lopidine) eye drops may be used in conjunction with laser therapy to lessen or prevent postprocedure elevations of IOP.
  • 6.2. Iridectomy
    Surgical removal of a portion of the iris facilitates drainage of aqueous humor through a newly created opening in the iris connecting to normal outflow channels. Note: Bilateral iridectomy is performed because glaucoma usually develops in the other eye.
  • 6.3. Postoperative care after peripheral iridectomy includes cycloplegic eye drops.
    To relax the ciliary muscle and decrease inflammation, thus preventing adhesions. Cycloplegics must be used only in the affected eye. the use of these drops in the normal eye may precipitate an attack of acute angle-closure glaucoma in this eye, threatening the patient’s residual vision.
  • 6.4. Malento valve implant
    Separates ciliary body from the sclera to facilitate outflow of aqueous humor.
  • 6.5. Cyclocryotherapy
    Used in intractable glaucoma.
  • 6.6. Diathermy or cryosurgery
    If other treatments fail, the destruction of the ciliary body reduces the formation of aqueous humor
  • 6.7. Aqueous-venous shunt
    Experimental ocular implant device corrects and prevents scarring over or closure of drainage sac created by trabeculectomy.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues and on electrolytes and acid-base balance.

NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by the NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis…. subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other ophthalmic nursing care plans:


Matt Vera, a registered nurse since 2009, leverages his experiences as a former student struggling with complex nursing topics to help aspiring nurses as a full-time writer and editor for Nurseslabs, simplifying the learning process, breaking down complicated subjects, and finding innovative ways to assist students in reaching their full potential as future healthcare providers.

5 thoughts on “3 Glaucoma Nursing Care Plans”

  1. Hello, just wanted to alert you that the description for meds are switched up. Timolol is beta blocker (not carbonic anhydrase inhibitor) pilocarpic is cholinergic which contracts the iris (not beta blocker) and acetazolamide is carbonic anhydrase inhibitor. There must have been a mix up when creating the table. My prof shared this with the class and I was like wait a min but she didnt believe me because nursing profs act like they know everything and are infallible and students are never right. This type of toxic culture that exists in nursing education can really be discouraging. One day I will be the nursing prof who is different and treats everyone with empathy, compassion, and respect.

    • I completely understand. I am in the final months of nursing school. It’s not that easy to just switch instructors. I wish it was. Anyway thank you for wanting to be that better person/Instructor. I have the same plan.

    • Thank you for sharing BeAnon, I feel you in so many levels. The good thing is that not every professor is/has been like that, but there are a few that are. I’m happy to hear you want make it to a Nurse educator and be a better professor, that those who just “know it all”. Good luck in your nursing journey.

  2. Sir, not all professors act alike. As with ethnic groups, generalizations about anyone are very damaging and borne of ignorance.
    If you have a professor who “acts like they know everything,” I suggest you find a new professor. Even those of us with doctoral degrees continue to learn every day. That’s why the NLN espouses the Spirit of Inquiry.


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