Glaucoma

Glaucoma is an eye disorder that leads to progressive damage to the optic nerve. People with glaucoma can lose nerve tissue, resulting in gradual vision loss. The optic nerve is a bundle of about a million individual nerve fibers that transmits the visual signals from the eye to the brain.
primary open-angle glaucoma causes an increase in pressure of the eye which causes progressive damage to the optic nerve and loss of nerve fibers. This can also happen in patients with normal eye pressures and often goes undetected. Advanced glaucoma or end-stage glaucoma leads to irreversible blindness.

Symptoms

The most common type of glaucoma is primary open-angle glaucoma. It has no signs or symptoms except gradual vision loss which can go undetected most of the time. For that reason, it’s important that you get a yearly comprehensive eye exam by your ophthalmologist,
Acute angle-closure glaucoma, also known as narrow-angle glaucoma, is a medical emergency. See your doctor immediately if you experience any of the following symptoms:

  • Severe eye pain
  • Nausea
  • Vomiting
  • Redness in your eye
  • Sudden vision disturbances
  • Seeing colored rings around lights
  • Sudden blurred vision

Causes

Aqueous humor is a clear fluid produced from the eye which leaves the eye through the trabecular meshwork. If these channels are blocked or partially obstructed, the natural pressure in your eye, which is called intraocular pressure (IOP), may increase. As your IOP increases, your optic nerve may become damaged. As damage to your nerve progresses, you may begin to lose sight of your eye.
risk factors for glaucoma

  1. Glaucoma is more common in hypermetropes.
  2. Blocked or restricted drainage in your eye
  3. Medications, such as corticosteroids
  4. Poor or reduced blood flow to your optic nerve
  5. Genetics

Types

Five major types of glaucoma exist. These are:

  • Open-Angle (Chronic) Glaucoma

Open-angle, or chronic, glaucoma has no signs or symptoms except gradual vision loss. This loss may be so slow that your vision can suffer irreparable damage before any other signs become apparent.

  • Angle-Closure (Acute) Glaucoma

If the flow of your aqueous humor fluid is blocked, the rapid buildup of fluid may cause a severe, quick, and painful increase in the pressure. Angle-closure glaucoma is an emergency situation. You should call your doctor immediately if you begin experiencing symptoms, such as severe pain, nausea, and blurred vision.

  • Congenital Glaucoma

Children born with congenital glaucoma have a defect in the angle of their eye, which slows or prevents normal fluid drainage. Congenital glaucoma usually presents with symptoms, such as cloudy eyes, excessive tearing, or sensitivity to light. Congenital glaucoma can run in families.

  • Secondary Glaucoma

Secondary glaucoma is often a side effect of injury or another eye condition, such as cataracts or eye tumors. Medicines, such as corticosteroids, may also cause this type of glaucoma. Rarely, eye surgery can cause secondary glaucoma.

  • Normal-Tension Glaucoma

In some cases, people without increased eye pressure develop damage to their optic nerve. The cause of this isn’t known. However, extreme sensitivity or a lack of blood flow to your optic nerve may be a factor in this type of glaucoma.

Risk Factor

According to the World Health Organization (WHO), glaucoma is the second leading cause of blindness around the world. The risk factors for glaucoma include:

  • Age

People over 60 are at increased risk of glaucoma, warns the NEI, and the risk of glaucoma increases slightly with each year of age. If you’re African-American, your increase in risk begins at age 40.

  • Ethnicity

African-Americans or people of African descent are significantly more likely to develop glaucoma than Caucasians. People of Asian descent are at a higher risk of angle-closure glaucoma, and people of Japanese descent have a higher risk of developing low-tension glaucoma.

  • Eye Problems

Chronic eye inflammation and thin corneas can lead to increased pressure in your eyes. Physical injury or trauma to your eye can also cause your eye pressure to increase.

  • Family History

Some types of glaucoma may run in families. If your parent or grandparent had open-angle glaucoma, you’re at an increased risk of developing this condition.

  • Medical History

People with diabetes and those with high blood pressure and heart disease have an increased risk of developing glaucoma.

  • Use of Certain Medicines

Using corticosteroids for extended periods may increase your risk of developing secondary glaucoma.

Prevention

Glaucoma can’t be prevented, but it’s still important to detect it early so you can begin treatment that will help prevent it from progressing. The best way to detect any type of glaucoma is to have an annual preventive eye care appointment. Make an appointment with an ophthalmologist. Simple tests performed during these routine eye checks may be able to detect damage from glaucoma before it advances and begins causing vision loss.

Diagnosis

Your doctor will want to know what symptoms you’ve been experiencing and if you have any personal or family history of glaucoma. They’ll also ask for a general health assessment to determine if any other health conditions may be impacting your eye health, such as diabetes or high blood pressure.

  • Tonometry Test

This class of tests measures your eye’s internal pressure.

  • Pachymetry Test

People with thin corneas have an increased risk of developing glaucoma. A pachymetry test can tell your doctor if your corneas are thinner than average.

  • Perimetry Test

This test, also known as a visual field test, can tell your doctor if glaucoma is affecting your vision by measuring your peripheral, and your central vision.

  • Glaucoma OCT

It tells you the amount of damage that has happened to your optic nerve by glaucoma

  • Monitoring Your Optic Nerve

If your doctor wants to monitor for gradual changes to your optic nerve, they may take photographs of your optic nerve to conduct a side-by-side comparison over time.

Treatment

The goal of glaucoma treatment is to reduce IOP to stop any additional vision loss. , your doctor may suggest one of the following treatments:

  • Medications

Several medicines designed to reduce IOP are available. These medicines are available in the form of eye drops or pills, but the drops are more common. Your doctor may prescribe one or a combination of these.

  • Surgery

If a blocked or slow channel is causing increased IOP, your doctor may suggest surgery to make a drainage path for fluid or destroy tissues that are responsible for the increased fluid.

Treatment for angle-closure glaucoma is different. This type of glaucoma is a medical emergency and requires immediate treatment to reduce eye pressure as quickly as possible. Medicines are usually attempted first, to reverse the angle closure, but this may be unsuccessful. A laser procedure called laser peripheral iridotomy may also be performed. This procedure creates small holes in your iris to allow for increased fluid movement.

If intraocular pressure is reduced, vision loss can be slowed or even stopped.