Is there any relation b/w glaucoma and no PERRLA?

  1. I am a student nurse in the first clinical semester.
    I am wondering if PERRLA is seen with a client with glaucoma. I saw another thread that says nurses need to ask if the client has glaucoma before pupil testing. Does it mean that the testing is stressful or harmful to a glaucoma client? PERRLA should be observed even with a client with glaucoma , or not?
    This may be too basic question. But I just could not find any key from searching the Internet. I hope I can get some information. Thank you.
  2. Visit kooko profile page

    About kooko

    Joined: Apr '09; Posts: 3


  3. by   classicdame
    Glaucoma interferes with the peripheral vision first, then works towards the center. The effect is on the retina, as the optic nerve is slowly dying.

    Pupils may be greatly affected by glaucoma meds. They generally cause miosis, especially Pilocarpine. If only one eye is being treated there may be unequal pupil sizes. Glaucoma meds may also interfere with accommodation (when the lens zooms in and out for close/far vision). Meds will "freeze" the pupil so that the lens cannot accommodate to light or to distance.

    Be sure to ask if they are putting ANYTHING in their eyes. Neosynephrine drops (found in some anti-histamine preparations) have similar affects to the pupil.
  4. by   twow
    Quote from kooko
    PERRLA should be observed even with a client with glaucoma , or not?
    I guess you should consider the information in the previous post.

    All I know off hand is that I once had a pt with glaucoma whose pupils were equal and round, but not reactive to light. My CI was with me while I was doing the assessment. When I brought this to her attention, she asked the pt if she had glaucoma.
  5. by   jennyfyre
    Just from my own experience... my left pupil no longer reacts to light and is fixed at mid dilation... ever since I had closed angle glaucoma. :wink2: It does kinda freak people out when my pupils are uneven!
  6. by   nerdtonurse?
    I had a pt with bilateral glaucoma who threw a stroke in the middle of my shift...and her normally "fixed" left pupil blew, just like a non-glaucoma -- no iris left at all. Now, is that the norm, or did I just have a weird, one off kind of pt? No idea....
  7. by   kooko
    Thank you so much!! It is so helpful
  8. by   BabyLady
    I did an assessment on a patient that had one eye that did not react to light.

    My instructor told me to go back and ask if she ever had a cataract removed.

    Sure enough, she had, same eye.

    I was told it was common.