Glaucoma Details

Glaucoma Details

What is Glaucoma?

The eye is like a balloon filled with watery substance. This fluid which is being continuously secreted and drained out at the same time.

In glaucoma the out flow of this fluid is stopped or reduced, thus leading to accumulation and increase in the pressure of the eye.

Glaucoma is a disease that can lead to blindness or loss of vision. It is caused by damage to the eye’s optic nerve. If detected and treated early, permanent damage can be minimized or even avoided. Once damage occurs, however, it cannot be reversed.

There are many types of glaucoma. The most common form is open angle glaucoma, also called chronic glaucoma.

Open angle glaucoma is caused by high pressure in the eye, which damages the optical nerve and impairs vision. Increased eye pressure does not always mean you will get glaucoma, but it does increase your risk. Another type of glaucoma is low-tension or normal tension glaucoma, which occurs when the optic nerve is damaged despite seemingly normal pressure levels. Treatment is the same as open angle glaucoma. Closed-angle glaucoma is also common, caused when the iris and lens essentially stick together, preventing fluid flow from the eye.

Glaucoma can also occur as a result of an injury such as being hit in the eye by a baseball. This is called secondary glaucoma.

Facts about Glaucoma

There are two basic types of Glaucoma, open-angle and narrow-angle (or angle-closure) glaucoma.

  • Open-angle is the most common form, accounting for 90% of all cases and is associated with aging.
  • When a person ages, the eye’s drainage apparatus may not work as effectively as it should.
  • In narrow-angle glaucoma, the eye pressure is normal until the drainage angle becomes suddenly blocked. Eye pressure rises abruptly to dangerous levels. Immediate treatment is necessary.
  • Increased eye pressure means you are at risk for glaucoma, but does not mean you have the disease.
  • Glaucoma can develop without increased eye pressure.

Symptoms

  • Glaucoma initially can absolutely symptom less thus most often missed by the patient.
  • At first, open-angle glaucoma has no symptoms. It causes no pain, and vision stays normal.
  • If glaucoma is untreated, vision slowly worsens. Peripheral vision (to the sides) is usually the first to deteriorate thus slowly reducing the field of vision.
  • If glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye.
  • If treatment is not given, vision reduces until no vision remains.
  • Glaucoma can develop in one or both eyes.

Detection

There are many tests that can be done by your doctor or eye care professional to detect glaucoma. Usually intraocular pressure tests and visual field tests are performed in combination to determine the eye’s pressure and the pressure’s affect on the optic nerve. Photographs of the optic nerve may also be taken to determine the health of the optic nerve. These simple tests can ensure that the disease is diagnosed early, so it can be treated before permanent damage is caused.

Diagnostic Testing Includes:

  • Humprey Visual Field
  • Goldman Visual Field
  • Tanget Screen Perimnetry
  • Optical Coherence Tomography
  • Scanning Laser Polarimetry (GDx)
  • Electrophysiologic Testing
  • Treatment Options

There is no cure for glaucoma. Damage done to the optic nerve is permanent. There are, however, many treatment options that can minimize the effect and prevent further damage. Treatments include eye drops, laser trabeculoplasty, or conventional surgery. These treatments are often used together.

 

Majority of patients are managed by simple eye drops alone. There are plenty of combinations of these available and your doctor decides what is best for you. Medication can be used to reduce eye pressure, preventing further damage to the optic nerve. Eye drops are the most common type of medicine. Pills may also be used.

 

Laser trabeculoplasty is a treatment performed by a doctor or eye care professional. A laser machine is used to improve the drainage in the eye. This is a longer-term solution than medicine, but the effect will reduce over time.

Laser treatment of glaucoma including:

  • Selective Laser Trabeculoplasty (SLT)
  • Argon Laser Trabeculoplasty (ALT)
  • YAG Laser Iridoplasty
  • Endoscopic Cyclophotocoagulation (ECP)
  • Argon Laser ciliary body ablation
  • Diode Laser ciliary body ablation
  • Surgical treatment of glaucoma including:
  • Trabeculectomy with and without antimetabolites
  • Non-penetrating glaucoma surgery: Aquaflow and Viscocanalostomy
  • Glaucoma implant surgery: Ahmed, Baeveldt, Molteno, and Krupin implants

In conventional surgery, a small piece of tissue is removed from the eye, which creates a new opening for the fluid to leave the eye.

Age-Groups at risk:

  • Glaucoma can affect anyone. The most common groups who are affected are as follows:
  • Persons of African descent over the age of 40 and persons of Mexican descent
  • Everyone over age 60
  • People with a family history of glaucoma
  • From 35 on, everyone should have regular check-ups for the early signs of glaucoma

Classical Presentation

Mr. Jha was an active and healthy 52 year old man. He never had problems with his vision or eyes.

He went for a regular health check-up with his doctor, who recommended that he have eye tests done to see if he was affected by glaucoma.

The doctor explained that people are often not aware that they have glaucoma and remain symptomless until permanent damage has already occurred. Vision can slowly get worse, and people do not notice a sudden change until a lot of vision is lost.

Mr. Jha agreed to have the pressure of his eyes checked and to have a visual field test.

Once the tests were done, the doctor explained that it was coincidental that Mr. Jha had increased eye pressure and that some damage had been done to his optic nerve. Fortunately, his glaucoma was detected early so he only lost a small amount of his peripheral vision.

The doctor recommended that he should use eye drops to control his eye pressure.

The doctor suggested waiting to see how the medication controlled the problem before deciding whether laser surgery was necessary.

Mr. Jha was surprised that he needed to take medicine because he had no problems with his vision and did not have any pain. Glaucoma, however, is a sneaky disease that causes such gradual changes that the patient does not realize that their vision is deteriorating.

Mr. Jha now returns for regular check ups with the doctor. He has not had any problems with his vision and continues to use eye drops as prescribed by the doctor.

Fequently Asked Questions

What is Glaucoma?

Glaucoma is an eye disease in which the normal fluid pressure inside the eyes slowly rises, leading to vision loss—or even blindness.

 

Facts about Glaucoma?

  • There are two basic types of Glaucoma, open-angle and narrow-angle (or angle-closure) glaucoma
  • Open-angle is the most common form, accounting for 90% of all cases and is associated with aging
  • When a person ages, the eye’s drainage apparatus may not work as effectively as it should
  • In narrow-angle glaucoma, the eye pressure is normal until the drainage angle becomes suddenly blocked. Eye pressure rises abruptly to dangerous levels. Immediate treatment is necessary.
  • Increased eye pressure means you are at risk for glaucoma, but does not mean you have the disease
  • Glaucoma can develop without increased eye pressure

Who is at risk?

  • Anyone can develop glaucoma. Some people are at higher risk than others. They include:
  • African Americans over age 40
  • Everyone over age 60, especially Hispanic Americans
  • People with a family history of glaucoma

How do you know if you have Glaucoma?

At first, open-angle glaucoma has no symptoms. It causes no pain. Vision stays normal. As glaucoma remains untreated, people may miss objects to the side and out of the corner of their eye.

close
refresh