What is Glaucoma?

April 9, 2022 Lifestyle Diseases 335 Views

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What is the meaning of Glaucoma?

Glaucoma is a serious eye problem in which the optic nerve in the human eye is damaged. The optic nerve carries visual information from the retina, which is the eye film where the image is formed, to the brain where the image is interpreted. The most common cause of glaucoma is increased pressure inside the eye. Glaucoma can occur in people of any age but is more common in older people. The initial symptoms of glaucoma are not noticeable, but in the advanced stages, it can cause complete loss of vision. If a person’s vision is lost due to glaucoma, then it cannot be recovered hence, early diagnosis and prevention are the keys. Therefore, if there is any problem with the eyes, especially regarding vision, it should be checked by an ophthalmologist as soon as possible.\

If the treatment of glaucoma is done at the right time, then a person can control this problem quickly without letting it interfere with day-to-day life.

In today’s article, we are going to tell you about glaucoma in detail.

  • What are the Types of Glaucoma?
  • What are the Causes of Glaucoma?
  • Who is at a Risk to get Glaucoma?
  • What are the Symptoms of Glaucoma?
  • Diagnosis of Glaucoma
  • What are the Treatments for Glaucoma?
  • What are the Complications of Glaucoma?
  • How to Prevent Glaucoma?

What are the Types of Glaucoma?

There are three types of glaucoma, including:

  • Open-angle (chronic) glaucoma – The fluid that drains gradually becomes clogged in people affected by this type of glaucoma. It is called an open-angle because the drainage angle is open. It causes a gradual increase in the pressure inside the eyes. It includes primary open angle glaucoma, normal tension glaucoma, juvenile open angle glaucoma, ocular hypertension, secondary open angle glaucoma.
  • Angle-closure glaucoma – In this type, the pressure inside the eye increases because the eye fluid cannot circulate properly due to the narrow drainage angle. A general eye test can help determine whether the angle is normal or abnormal. Gonioscopy is a special test to visualise the angle. Narrow angle can cause sudden rise in eye pressure and cause severe diminution of vision in seconds to minutes. This causes an emergency and is called Acute angle closure attack. Angle closure includes primary, secondary and chronic angle closure glaucoma.
  • Congenital/Childhood glaucoma – In this type, the trabecular system (responsible for draining the fluid from the eye) is blocked due to malformation of the drainage system during pregnancy. It usually occurs with other deformities or diseases of the eye or in the body too.

What are the Causes of Glaucoma?

Glaucoma is caused by damage to the optic nerve, resulting in blind spots in the visual field. This nerve damage is most commonly, but not always, related to increased pressure in the eye. Raised eye pressure is the result of the build-up of the fluid that flows inside the eyes. The fluid starts to accumulate at the angle between the lens and the cornea(transparent layer covering the coloured portion of the eye) of the eye.

The normal eye produces aqueous humour which is a clear, watery fluid at the rate of 2.5 µL/min. There are 2 natural outflow mechanisms that help to get rid of the aqueous fluid from time to time.  About 80% of the aqueous outflow occurs from the corner of the eye via a structure called the trabecular meshwork.

 The outflow system of the eye is compared to the drainage system of the bathroom of our house. The floor drain is compared to the trabecular meshwork, the drain leads to a pipe which is compared to the Schlemm’s canal, this leads to a large drainage pipe out of the house which is compared to the axillary vein. The aqueous, like the wastewater, flows to the corner of the eye to get filtered through the trabecular meshwork. This aqueous then flows into a canal called Schlemm’s canal which carries the aqueous to the outskirts of the eye. From here the final drainage is done by the axillary vein to the outside of the eye.

The intraocular pressure (IOP) of the eye is raised because of 2 reasons:

1. Increased production of the aqueous

2. Decreased outflow of the aqueous due to blockage or some other pathology

This increased IOP may, in turn, damage the optic nerve and cause glaucoma.

Who is at a Risk to get Glaucoma?

The high-risk groups of glaucoma are- 

  • Family history of Glaucoma
  • History of any eye injury
  • Eye surgery (Know more about- What is Corneal Transplant ? )
  • High minus numbers
  • Certain medical conditions like diabetes, heart disease, high blood pressure
  • Old age
  • Decreased blood flow to the optic nerve (hypoperfusion).
  • Prolonged use of certain eye drops e.g. steroids

What are the Symptoms of Glaucoma?

 The symptoms of glaucoma depend on its type:

Open-angle glaucoma

  •    Damage to the optic nerve. 
  •    Blind spots in the visual field.
  • In this type, there are no visible symptoms in the beginning, but as the condition progresses, it can cause serious damage to the eyes.

Angle-closure glaucoma

This type of glaucoma does not show any symptoms initially, but when severe, the following symptoms may occur:

Congenital/Childhood Glaucoma

  •    Watering
  •     Intolerance to light
  •     Forceful closure of eyelid

Diagnosis of Glaucoma

Glaucoma can be diagnosed with:

  1. First, the doctor conducts a general examination of the patient, in which he may ask about the past disease history and level of diabetes. He may take information about the genetic disease and the symptoms you are experiencing. 
  2. Other tests that can help confirm the diagnosis of glaucoma  include:
  3. Tonometry test: The IOP is measured with the help of an instrument called the tonometer. The tonometer can detect the pressure in your eye by flattening your cornea a little bit. Your ophthalmologist will adjust the tension until they get a proper reading. Your ophthalmologist will put numbing eye drops before the test so you will feel no pain.
  4. Perimetry: This is a test for the visual field. For the test, you are made to sit and look inside a bowl-shaped instrument called a perimeter. You are asked to stare at the center of the bowl while a light flashes at different positions. You are asked to press a button each time you see a flash. The computer records the spot of each flash and if you correctly pressed the button when the light flashed in that spot. This way the doctor can detect where exactly in your visual field there is a problem.
  5. Gonioscopy: It is done to examine the drainage angle. Gonioscopy is done with the head positioned in the slit lamp which is a special type of microscope used to look at the eyes. A special contact lens is placed directly on the eye of the patient and a beam of light is used to illuminate and examine the angle. Your ophthalmologist will put numbing drops in your eyes to avoid causing you any pain.
  6. Pachymetry test: This is done to measure the corneal thickness. A probe called a pachymeter is placed on the cornea to measure the corneal thickness.

 What are the Treatments for Glaucoma?

Glaucoma is a serious progressive condition that leads to vision loss and if left untreated, complete blindness. Once the vision is lost it cannot be reversed. So early detection and treatment is the key to halt the progression of the disease. The treatment of glaucoma depends on its type and severity. However, treatment includes eye drops, and surgery. To control glaucoma, doctors recommend the use of eye drops. Usually, glaucoma disease does not cause eye pain, but people tend to be a little careless about eye drops. Eye drops can help control eye pressure and prevent damage.

Do not use any medication without consulting a doctor, as it can damage the eyes. If you do not get any results by using eye drops, the doctor may recommend some other medicines.

When medicines do not work and the condition is severe, the doctor may perform the following surgical procedures-

  1. Laser surgery
  2. Filtering surgery
  3. Cyclophotocoagulation (CPC)
  4. Drainage Implant Surgery
  5. Drainage tube
  6. Angle-closure glaucoma is a medical emergency in which the doctors may use a procedure called laser peripheral iridotomy for immediate treatment.

What are the Complications of Glaucoma Surgery?

Glaucoma can have the following complications depending on the type of treatment.

Some of the complications following glaucoma surgery are:

  1. Increased risk of cataract
  2. Irritation in the eyes ( Know more about- What causes itching in the eyes? 
  3. Bleeding inside the eyes
  4. Weakening of the eyesight  ( Know more about- What is Blurred Vision ? )
  5. High or low pressure in the eyes
  6. Pain in the eyes
  7. Redness in the eyes

How to prevent Glaucoma?

Glaucoma is a degenerative, progressive condition so it is advised to take appropriate preventative measures. Some self-care steps to follow are:

  1. Get regular eye examinations
  2. Be well aware of your family history of glaucoma
  3. Do regular aerobic exercises for at least 45 minutes.
  4. If detected with glaucoma, take the prescribed medications meticulously to avoid surgery
  5. Wear eye protection. 

We hope that we could answer your questions regarding Glaucoma through this article.

You can contact an ENT Specialist for more information and treatment of Glaucoma. 

We only aim to give you information through the article. We do not recommend medication or treatment in any way. Only a doctor can give you the best advice and correct treatment plan. 

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