Glaucoma is a group of eye conditions that damage the optic nerve, which is vital to good vision. This damage is often caused by an abnormally high pressure in your eye.
Glaucoma is one of the leading causes of blindness in the World. It can occur at any age but is more common in older adults.
The most common form of glaucoma has no warning signs. The effect is so gradual that you may not notice a change in vision until the condition is at an advanced stage.
Vision loss due to glaucoma can’t be recovered. So it’s important to have regular eye exams that include measurements of your eye pressure. If glaucoma is recognized early, vision loss can be slowed or prevented. If you have the condition, you’ll generally need treatment for the rest of your life.
Open-angle glaucoma gives few warning signs until permanent damage has already occurred. Regular eye exams are the key to detecting glaucoma early enough to successfully slow or prevent vision loss. If left untreated, glaucoma will eventually cause blindness. Even with treatment, about 10 percent of people with glaucoma become blind in at least one eye within 20 years.
Acute angle-closure glaucoma is another type of Glaucoma and the signs and symptoms vary , for example:
- Severe headache
- Eye pain
- Nausea and vomiting
- Blurred vision
- Halos around lights
- Eye redness
Glaucoma is the result of damage to the optic nerve. As this nerve gradually deteriorates, blind spots develop in your visual field. For reasons that doctors don’t fully understand, this nerve damage is usually related to increased pressure in the eye.
Elevated eye pressure is due to a buildup of a fluid (aqueous humor) that flows throughout your eye. This fluid normally drains into the front of the eye (anterior chamber) through tissue (trabecular meshwork) at the angle where the iris and cornea meet. When fluid is overproduced or the drainage system doesn’t work properly, the fluid can’t flow out at its normal rate and pressure builds up.
Glaucoma tends to run in families. In some people, scientists have identified genes related to high eye pressure and optic nerve damage.
Types of glaucoma:
Open-angle glaucoma is the most common form of the disease. The drainage angle formed by the cornea and iris remains open, but the trabecular meshwork is partially blocked. This causes pressure in the eye to gradually increase. This pressure damages the optic nerve. It happens so slowly that you may lose vision before you’re even aware of a problem.
There are different types of open angle glaucoma, Pigmentary glaucoma, Primary open-angle glaucoma, Pseudoexfoliation glaucoma,…
Angle-closure glaucoma, also called closed-angle glaucoma, occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and iris. As a result, fluid can’t circulate through the eye and pressure increases. Some people have narrow drainage angles, putting them at increased risk of angle-closure glaucoma.
Angle-closure glaucoma may occur suddenly (acute angle-closure glaucoma) or gradually (chronic angle-closure glaucoma). Acute angle glaucoma is a medical emergency. It can be triggered by sudden dilation of your pupils.
In normal-tension glaucoma, your optic nerve becomes damaged even though your eye pressure is within the normal range. No one knows the exact reason for this. You may have a sensitive optic nerve, or you may have less blood being supplied to your optic nerve. This limited blood flow could be caused by atherosclerosis — the buildup of fatty deposits (plaques) in the arteries — or other conditions that impair circulation.
-Glaucoma in children
It’s possible for infants and children to have glaucoma. It may be present from birth or developed in the first few years of life. The optic nerve damage may be caused by drainage blockages or an underlying medical condition.
Because chronic forms of glaucoma can destroy vision before any signs or symptoms are apparent, be aware of these risk factors:
- Having high internal eye pressure (intraocular pressure)
- Being over age 60
- Having a family history of the condition
- Having certain medical conditions, such as diabetes, heart disease, high blood pressure and sickle cell anemia
- Having certain eye conditions, such as nearsightedness
- Having had an eye injury or certain types of eye surgery
- Early estrogen deficiency, such as can occur after removal of both ovaries (bilateral oophorectomy) before age 43
- Taking corticosteroid medications, especially eyedrops, for a long time
- Being black (pigmentary glaucoma) or people from Scandinavian countries (pseudoexfoliation glaucoma)
The ophthalmology may perform several tests, including:
- Measuring intraocular pressure (tonometry)
- Testing for optic nerve damage. Optical coherence tomography (OCT) allows the retinal nerve fiber layer to be assessed for any changes.
- Checking for areas of vision loss (visual field test)
- Measuring corneal thickness (pachymetry)
- Inspecting the drainage angle (gonioscopy)
Treatments and drugs
The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stage.
The goal of glaucoma treatment is to lower pressure in your eye (intraocular pressure). Depending on your situation, your options may include eyedrops, laser treatment or surgery.
Glaucoma treatment often starts with prescription eyedrops. These can help decrease eye pressure by improving how fluid drains from your eye or by decreasing the amount of fluid your eye makes.
-Surgery and other therapies-laser-.
Other treatment options include laser therapy and various surgical procedures. You’ll need to see your doctor for follow-up exams. And you may eventually need to undergo additional procedures if your eye pressure begins to rise or other changes occur in your eye.
The following techniques are intended to improve the drainage of fluid within the eye, lowering pressure:
- Laser therapy. Laser trabeculoplasty is an option for people with open-angle glaucoma. It’s done in your doctor’s office. He or she uses a laser beam to open clogged channels in the trabecular meshwork. It may take a few weeks before the full effect of this procedure becomes apparent.
- Filtering surgery. With a surgical procedure called a trabeculectomy, your surgeon creates an opening in the white of the eye (sclera) and removes part of the trabecular meshwork.
- Drainage tubes. In this procedure, your eye surgeon inserts a small tube in your eye.
- Your doctor may suggest to remove tissue from the trabecular meshwork using a small electrocautery device called a Trabecutome.
Treating acute angle-closure glaucoma
Acute angle-closure glaucoma is a medical emergency. If you’re diagnosed with this condition, you’ll need urgent treatment to reduce the pressure in your eye. This generally will require both medication and laser or other surgical procedures.
You may have a procedure called a laser peripheral iridotomy in which the doctor creates a small hole in your iris using a laser. This allows fluid (aqueous humor) to flow through it, relieving eye pressure.
You may not be able to prevent glaucoma. But these self-care steps can help you detect it early, limit vision loss or slow its progress.
- Get regular eye care. Regular comprehensive eye exams can help detect glaucoma in its early stages before irreversible damage occurs. As a general rule, have comprehensive eye exams every 2 years beginning at age 40 and every year from age 65. You may need more frequent screening if you’re at high risk of glaucoma. Ask your doctor to recommend the right screening schedule for you.
- Know your family’s eye health history. Glaucoma tends to run in families. If you’re at increased risk, you may need more frequent screening.
- Take prescribed eyedrops regularly. Glaucoma eyedrops can significantly reduce the risk that high eye pressure will progress to glaucoma. To be effective, eyedrops prescribed by your doctor need to be used regularly even if you have no symptoms.