Glaucoma

Glaucoma appears when the eye’s optic nerve gets damaged. The optic nerve connects the eye to the brain and once it gets damaged, this can seriously affect the vision. The optic nerve is affected by the increased intraocular pressure. Therefore, the images transmitted to your brain have a lower quality and in time, glaucoma can cause a permanent vision loss. Many studies show that this condition is inherited and what is worse, the effects are not visible until later in life.

However, once this condition appears, immediate treatment is necessary. In case it is neglected and not treated accurately, it can cause total permanent blindness within a couple of years. This is a misleading condition as it does not have any symptoms or pain and so it is unfortunately discovered when it is sometimes too late.

What Can Cause Glaucoma?

As mentioned above, glaucoma appears when the intraocular pressure increases at abnormal levels. The high intraocular pressure appears once the liquid in the front part of the eyes does not circulate properly. This fluid is called aqueous humor and it flows out of our eyes through a mesh-like channel. As soon as the mesh-like channel is blocked, then the liquid builds up and so it increases the intraocular pressure that leads to glaucoma.

The reason why this blockage appears is still unknown, but the doctors have various scenarios. One of the most common causes is the positive family history. It has been proved that the risk of developing glaucoma is increased for the persons who have a sibling with this condition.

On the other hand, ethnicity may also be a factor that produces glaucoma. The persons coming from East-Asia are more exposed to developing angle closure glaucoma. For example, the Inuit populations have demonstrated a higher rate of glaucoma. Moreover, the open-angle glaucoma is the cause for approximately 90% of the cases discovered in the United States. Less than 10% of the glaucoma cases in the United States have been caused by closed-angle glaucoma.

Apart from ocular hypertension, there are also other factors that can cause “secondary glaucoma”. For example, the intensive use of steroids or severe diabetic retinopathy can also cause this type of condition. Furthermore, the chemical injury of the eye or the severe eye infection can also cause glaucoma. However, these are rare factors that can still lead to glaucoma appearance.

What Are The Types of Glaucoma?

There are two major types of glaucoma. The most common type is open-angle glaucoma. It appears when the eye does not drain the fluid as it should be. Therefore, the intraocular pressure starts to grow and it gradually damages the optic nerve. What is even worse about this type of glaucoma is that it does not cause any pain and it does not affect the vision in the beginning.

The second type of glaucoma is called “closed-angle glaucoma” or “narrow-angle glaucoma”. It appears when the iris is very close to the drainage angle of the eye. This means that the iris is blocking the drainage angle. Once it is blocked, then the eye pressure increases rapidly. As soon as this happens, the person experiences an acute attack. When this happens, the patient should go immediately to the ophthalmologist as he is having an eye emergency and it may even cause instant blindness.

What Are The Symptoms of Glaucoma?

Those who have experienced glaucoma, call this condition the “silent thief of the sight”. This name was given because glaucoma progresses undetected until it causes an irreversible damage of the eye and there is nothing the patient can do about it.

Once the acute angle-closure glaucoma is installed, there are various symptoms that appear. For example, the persons affected by this type of glaucoma can experience blurry vision, intense eye pain, nausea or even vomiting. When these symptoms are installed, the person should see immediately the doctor and start the treatment to prevent permanent vision loss.

However, glaucoma usually does not have any symptoms. Therefore, it can be detected only during a routine eye test. It develops slowly over the years and the first damage it provokes is the loss of peripheral vision. What is more, it usually affects both eyes, while sometimes is can severely damage only one eye. One thing is certain. Without treatment, glaucoma might lead to permanent blindness.

How is glaucoma detected?

Usually, because it does not cause any pain, glaucoma is detected when it is already too late. There are various ways how it can be detected. Usually, a comprehensive dilated eye exam can tell if a person is developing this condition or not. This exam includes the following procedures:

  • Visual acuity test. The patient is asked to have an eye chart test that tells how well he sees at different distances.
  • Visual field test. This test measures the side vision. This is an excellent test that will tell you if you have lost your peripheral vision, which is a clear sign that you have glaucoma.
  • Dilated eye exam. In this exam, the ophthalmologist uses drops to widen, or dilate, the pupils. Then the doctor checks the retina and optic nerve for signs of damage and other eye problems.
  • Tonometry is used by the doctor to measure the pressure inside the eye by using an instrument called a tonometer.
  • Pachymetry is the measurement of the thickness of the cornea. The eye care professional applies a numbing drop to the eye and uses an ultrasonic wave instrument to measure the thickness of the cornea.

Can Glaucoma Be Treated?

Once glaucoma has caused the loss of vision, it is not possible to reverse it. As soon as the glaucoma is diagnosed, there are some treatment options that can prevent your vision loss. Depending on the type of glaucoma you develop and its severity, there are various treatments that your ophthalmologist can recommend you:

  • eye drops – will help you reduce the pressure in your eyes
  • laser treatment – is used to open up the blocked drainage tubes in your eyes or reduce the production of fluid in your eyes
  • surgery – the doctors use it to improve the drainage of fluid from your eyes

Each option of treatment can have its own effects, but everything depends on your condition severity and the patient characteristics. Therefore, the eye drops have two possible effects. They may either reduce the formation of fluid in the eye or increase its outflow. However, the eye drops bring also some side effects. Thus, the patients may experiences allergies, blurred vision, irritated eyes or redness. As soon as some of these symptoms appear, the patient should announce the doctor immediately.

The laser surgery, on the other hand, is used for people with open-angle glaucoma and helps them to increase the flow of the fluid from the eye. For those patients who experience closed-angle glaucoma, the surgery can stop fluid blockage. The surgery procedure includes:

  • Trabeculoplasty is used to open the drainage area;
  • Iridotomy makes a tiny hole in the iris. Therefore, it lets the fluid to flow more freely;
  • Cyclophotocoagulation treats the areas of the middle layer of the eye and helps to reduce the fluid production.

For those who suffer from congenital glaucoma, meaning that the patient was born with it, the most efficient way of treatment is the surgery.

Can Glaucoma Be Prevented?

The answer to this question is definitely not. However, those who visit the ophthalmologist regularly have a big chance to discover it at an early stage. What is more, those who have family members suffering from glaucoma should visit the doctor more regularly.

References:

https://en.wikipedia.org/wiki/Glaucoma#History

https://www.aao.org/eye-health/diseases/glaucoma-treatment

http://www.allaboutvision.com/conditions/glaucoma.htm

http://www.nhs.uk/conditions/glaucoma/Pages/Introduction.aspx#symptoms

 

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