Glaucoma

Overview – Glaucoma is a condition of the eye characterized by high pressure in the eye.

High pressure can cause damage to the optic nerve which may lead to blindness.

The exact cause of increased pressure in the eye is not known. Glaucoma tends to run in families.

The two main kinds of glaucoma are open-angle glaucoma and angle-closure glaucoma. The other kinds of glaucoma are pigmentary glaucoma, normal-tension glaucoma.

Open-angle glaucoma is the most common form and this occurs when the drainage angle formed by cornea and iris remains open and the trabecular meshwork is partially blocked. The fluid (aqueous humor) drainage normally occurs through the trabecular meshwork. Because of the blockage, there is a gradual increase in pressure.

Angle-closure glaucoma occurs when the angle formed by cornea and iris is blocked. Iris bulges forward to narrow or block the drainage angle. As a result, fluid cannot drain and builds up increasing the pressure.

Angle-closure glaucoma is a medical emergency. Seek immediate medical help if you experience severe headache and/or pain in the eye and/or blurred vision.

 

Symptoms of open-angle glaucoma

  • People with open-angle glaucoma rarely experience any symptoms.
  • Central visual field loss (patchy blind spots) is a late manifestation of open-angle glaucoma.

 

Symptoms of Angle-closure glaucoma

  • Severe headache
  • Pain in the eye
  • Blurred vision
  • Nausea and vomiting
  • Eye redness
  • Halos around lights

 

Complication of glaucoma

  • If left untreated glaucoma can damage the optic nerve and lead to blindness.

 

Diagnosis

  • The diagnosis is made with an eye examination. Your eye doctor will check the intraocular pressure, optic nerve damage, visual field, drainage angle and corneal thickness.

 

Medical management

  • Prostaglandins increase the drainage of fluid in the eye. Latanoprost, travoprost, tafluprost, bimatoprost, and latanoprostene are prescription eye drops used in glaucoma.
  • Beta-blockers such as betaxolol, timolol are used to reduce the production of fluid in the eye.
  • Carbonic anhydrase inhibitors such as dorzolamide, brinzolamide are used to reduce the production of fluid in the eye.
  • Other medications that may be used are alpha-adrenergic agonists (apraclonidine, and brimonidine), cholinergic agents (pilocarpine), Rho-kinase inhibitors (netarsudil).
  • Surgical treatment options include laser therapy, trabeculectomy, drainage tubes.

 

Lifestyle management

  • The American Academy of ophthalmology recommends having eye exam – Every 5 to 10 years if you are under 40 years old; every 2 to 4 years if you are 40 to 54 years old; every 1 to 3 years if you are 55 to 64 years old, and every 1 to 2 years if you are older than 65.
  • If you have a family history of glaucoma, you may need frequent screening.
  • Follow a healthy diet and exercise program as recommended by your doctor.

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