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What is Glaucoma?

Glaucoma refers to a group of eye diseases that can lead to blindness. Glaucoma affects your vision and it is widespread in people who are ageing. This disorder is characterized by damage to the optic nerves. There are two types of glaucoma.

  1. Open angle glaucoma or chronic glaucoma is the most widespread among the two types. This type of glaucoma is the type that creeps in. Your eyesight is lost slowly and painlessly. This glaucoma works from the outside of the eye inwards. The nerve fibres at the sides of the eye are affected which will lead to the loss of peripheral vision and then the affected fibres work their way in to the centre. Eventually, all your vision will be lost. This type of glaucoma affects around two percent of people who are above forty years of age. At the age of seventy and above, this increases to ten percent.

  2. The other type of glaucoma is acute glaucoma. It is less common and gets its name from the narrowed angle in between the back of the eye and the iris. This narrowed angle increases the pressure in the eye and results in soreness and redness.

Other less common forms of glaucoma

Low tension glaucoma
In low-tension or normal-tension glaucoma, optic nerve damage and narrowed side vision occur in people with normal eye pressure. Lowering eye pressure at least 30 percent through medicines slows the disease in some people. Glaucoma may worsen in others despite low pressures.

A comprehensive medical history is important in identifying other potential risk factors, such as low blood pressure, that contribute to low-tension glaucoma. If no risk factors are identified, the treatment options for low-tension glaucoma are the same as for open-angle glaucoma.

Angle-closure glaucoma
In angle-closure glaucoma, the fluid at the front of the eye cannot reach the angle and leave the eye. The angle gets blocked by part of the iris. People with this type of glaucoma have a sudden increase in eye pressure. Symptoms include severe pain and nausea, as well as redness of the eye and blurred vision. If you have these symptoms, you need to seek treatment immediately. This is a medical emergency. If your doctor is unavailable, go to the nearest hospital or clinic. Without treatment to improve the flow of fluid, the eye can become blind in as few as one or two days. Usually, prompt laser surgery and medicines can clear the blockage and protect sight.

Congenital glaucoma
In congenital glaucoma, children are born with a defect in the angle of the eye that slows the normal drainage of fluid. These children usually have obvious symptoms, such as cloudy eyes, sensitivity to light, and excessive tearing. Conventional surgery typically is the suggested treatment, because medicines may have unknown effects in infants and be difficult to administer. Surgery is safe and effective. If surgery is done promptly, these children usually have an excellent chance of having good vision.

Secondary glaucomas can develop as complications of other medical conditions. These types of glaucomas are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumours, or uveitis (eye inflammation). Pigmentary glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. A severe form, called neovascular glaucoma, is linked to diabetes. Corticosteroid drugs used to treat eye inflammations and other diseases can trigger glaucoma in some people. Treatment includes medicines, laser surgery, or conventional surgery.

There are times where glaucoma can develop from other eye conditions that lead to an increase in the pressure in the eyes like eye injuries or eye diseases that cause the eye to be inflamed. This kind of glaucoma is referred to as secondary glaucoma.

There are times where glaucoma is present at birth. This is caused by structural abnormalities that affect the way fluids are drained from the eye. This kind of glaucoma is referred to as congenital glaucoma.

What are the symptoms of glaucoma?

If you have open angle glaucoma then symptoms aren’t usually evident until the later stages. During the later stages, most of the outer vision or the peripheral field of vision has been lost. Sometimes the optic nerve has already been damaged. People usually think that the loss of peripheral vision is part of growing old but the reality is that they may have some form of glaucoma already. Regular eye check-ups are needed after the age of forty so that glaucoma is spotted before it can get any worse.

Acute glaucoma is more severe and the symptoms include one or more of the following

  • misty vision
  • red eyes
  • enlarged pupils that are oval in shape
  • painful eyes
  • seeing halos around sources of light
  • eyeballs that are hard and sore

Acute glaucoma becomes very painful as it develops. The pain can be compared to a toothache or a headache and can lead to vomiting or nausea. The symptoms can last for a couple of hours, go away, and then return later on. Normally, only one of the eyes is affected although for every attack, the symptoms can lead to more loss of vision so you should see your doctor if you experience any of these. You should proceed to the nearest hospital if you notice these symptoms so that further loss of vision is prevented.

The symptoms of congenital glaucoma are difficult to spot especially because since it affects the children, they really don’t know if there is something wrong with their vision or not. If you see cloudy, hazy, white, protruding, or enlarged eyes then you should have your child checked right away. Congenital glaucoma occurs more often in boys than in girls.

What are the causes of glaucoma?

The eye is made up of a watery fluid referred to as aqueous humour and this fluid is responsible for giving the eye its shape and for providing the necessary pressure for the eye. Healthy eyes have a stable supply of this fluid and at the same time, they also dispense the fluid equally as well. This provides nourishment for the eye and allows it to discard waste. The fluid is drained into the bloodstream and a fresh supply is produced in order to keep the eye in balance.

Eyes that are affected by glaucoma have problems with this fluid aqueous humour. The flow of this fluid is altered because the tiny filters that are supposed to drain the fluid from the eye are partially blocked. This network of filters makes up the trabecular meshwork. The flow of fluid can also be altered if the iris moves forward and gets in the way of the filters. The pressure in the eyes builds up and affects the optic nerves including the nerve fibres of the retina. This will eventually lead to glaucoma.

The cause of glaucoma is not completely understood because there are cases where people still get optic nerve damage even without high pressure in the eye. Other factors like a lack of blood supply to the optic nerves or a weakness in these nerves can affect the eyes.

Which groups of people are more likey to get glaucoma ?

When people reach the age of seventy, ten percent of people experience an increase in their eye pressure. Chronic or acute angle glaucoma can run in families which mean that relatives of people with this disease are more likely to get it than those who have no relatives with glaucoma. The Afro-Caribbean group, diabetics, and people who are short-sighted are at a greater risk of getting open angle glaucoma.

How is glaucoma diagnosed?

Doctors will diagnose your glaucoma through routine eye exams. If you are over forty then you should have eye exams as regularly as possible. If you have a close blood relative who has glaucoma then you should be extra careful and have regular eye check-ups already. Doctors will perform three tests for glaucoma. They are painless and quick so you should not be worried. These three tests must be carried out at the same time so that the results are precise. Here are the three tests

  • Opthalmoscopy – This test will check the appearance of the optic nerve using a special torch which is brought near the eye for examination

  • Tonometry – Some anaesthetic is placed on the eye and then a drop of dye is put on the cornea. The cornea is the front part of the eye that is clear. From the head of the tonometer, a blue light is held against the eye in order to measure the level of pressure in it

  • Perimetry – The goal of this test is to find out if you are missing any areas in your vision. This test will show you a sequence of lights flashing in different areas and you will be asked to identify which flashing lights you see

After these series of tests, you will be referred to an ophthalmologist for further treatment if you have glaucoma.

How is glaucoma treated?

Vision that is lost due to glaucoma can not be restored. In the case of open angle glaucoma, worsening vision can be prevented. The goal is to lower the pressure in the eye so that further damage to the optic nerves is avoided. Here are some of the common treatments for glaucoma patients

Eye drops for glaucoma

Most of the cases of glaucoma are treated using eye drops although there are so many types of eye drops available in the market today. It is best to ask your doctor for a prescription so that you use the best kind of eye drops for yourself. Here are some of the eye drops that are available today

  • beta-blockers – these type of drops are used to reduce the production of fluids in your eyes although the main drawback of these eye drops is that you can’t use them if you have asthma. Sometimes you may even get asthma while using them. If this occurs then you should stop the treatment and consult with your doctor right away

  • alpha-agonists – these eye drops are used to reduce the production of fluids in your eyes and at the same time, these eye drops could also improve the outflow of fluids. There could be some side effects for these eye drops like dry mouth and general discomfort. This type of eye drop should not be used by kids

  • prostaglandin/prostamide analogues – these eye drops are made for helping fluid flow out of the eyes better. Some of the side effects of these eye drops are getting pink eyes for awhile, eyelashes that become thicker and darker, and changes in the colour of the eyes

  • carbonic anhydrase inhibitors – these are the eye drops that are used to reduce the production of fluids in the eyes. One of the side effects of these eye drops include getting a bitter taste

  • cholinergic agonists – these are the eye drops that are used to allow the fluids in the eye to flow out better. Some of the side effects of these eye drops are blurry vision, darkened vision, eye aches, and headaches

Laser Treatment for Glaucoma

Laser treatment can be used on the trabecular meshwork, the filtration system of the eyes. Lasers can be used to make the tiny holes in this meshwork bigger. This will ease the flow of the aqueous humour out of the eye and it will eventually reduce the pressure in the eye. This will prevent any further damage from happening to the eye. The nice thing about laser treatment is that it is painless and it is fast. There is no need to stay in the hospital at night. The results of the treatment will vary from person to person and the amount of eye drops used after the treatment will be significantly lower.

Glaucoma Surgery

Surgery is one of the last resorts to treat glaucoma since drug treatments and laser treatments nowadays can treat the disorder well. If the drug treatments and the laser treatments fail then surgery will be performed. If there is still pressure in your eyes then the surgery will simply create tiny openings in the wall of the eye in order to help in draining the fluids and alleviating the eye from too much pressure. Twenty percent of people who have gone through surgery still need to use eye drops after the treatment

What are some of the complications that can arise from glaucoma?

The complication of glaucoma if left untreated or if not detected in time will result in blindness. Glaucoma is one of the most widespread reasons for people going blind. The most common type of glaucoma that can remain undetected up to the advanced stages is open angle glaucoma. It is wise to have regular eye check-ups so that any symptoms of glaucoma can be spotted and treated right away. If you are over forty and if your family has some history of glaucoma then you should be even more wary about the disorder. You can get free eye tests if you are over sixty or if you are over forty and have relatives with glaucoma. When you have your eyes checked, you should make sure that the doctor does the three glaucoma tests because there are times where all three tests aren’t performed on a regular basis. You should tell your doctor if glaucoma runs in your family so that appropriate diagnoses are done.


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