Glaucoma: Glaucoma is a disease of the eye in which fluid pressure within the eye that damage the optic nerve, and can result in vision loss and blindness. However, early detection and treatment, you can protect the eyes against serious vision loss & eventually, lead to blindness.
Symptoms & Types of Glaucoma
There are four types of glaucoma-
- Open-angle glaucoma
- Closed-angle (angle closure) glaucoma
- Secondary glaucoma
- Childhood glaucoma
Open-angle glaucoma, sometimes also known as chronic open angle glaucoma. It is the most common type of glaucoma.
In this type of glaucoma, the part of the eye where fluid drains away isn’t blocked, but the fluid doesn’t drain properly. This can leads to increased pressure in the eye.
The condition usually often develops very slowly over many years and doesn’t may any noticeable symptoms at first.
People often don’t realize, because the outer areas of vision (peripheral vision) are affected first. Without treatment, vision towards the center may also be lost.
Primary open angle glaucoma is commonly picked up during a routine eye test.
Closed-angle (angle closure) glaucoma
Closure glaucoma is less common and that occurs when a part of the eye that drains fluid becomes blocked, causing pressure up in the eye.
Symptoms can include:
Severe eye pain
Tenderness around the eyes
Secondary glaucoma is the less common type of glaucoma and caused by another eye problem.
Secondary glaucoma caused by inflammation of the middle layer of the eye, eye injuries and certain eye treatments, such as medication or operations. The symptom may include:
Peripheral vision loss gradually
Childhood glaucoma, a type of congenital or developmental glaucoma, that affects babies and young children.
It usually occurs in the development of the eyes, which can cause fluid and pressure up inside the eye.
The child may have some of the following symptoms:
Dislike of bright lights
Larger eyes than usual
Rubbing their eyes frequently
Red, watery or cloudy eyes
A number of factors that raises the risk of developing glaucoma.
Old age – Age of 60 years have a higher risk of developing glaucoma.
Ethnic background – East Asians, because of their anterior chamber depth, have a higher risk of developing glaucoma. People of African-American are three to four times more likely to develop glaucoma. Females are three times to develop glaucoma as males.
Eye injuries – some eye injuries are linked to a higher glaucoma risk. Eye inflammations and eye tumors may also a cause of glaucoma.
Some illnesses and conditions – People with hypothyroidism or diabetes have a much higher risk of developing glaucoma.
Eye surgery – Have a higher risk of glaucoma.
Myopia – People having myopia have a higher risk of glaucoma.
Corticosteroids – Long-term corticosteroids have a higher risk of developing glaucoma. The risk is greater with eye drops containing corticosteroids.
Diagnosis of Glaucoma
Eye pressure test
The eye pressure test (tonometry) uses an instrument called tonometer to measure the pressure inside the eye.
A small amount of anesthetic medication and dye is placed onto the front of the eye. Light from the tonometer is gently held against the eye to measure the pressure inside.
High pressure in the eye can be a sign that you have glaucoma or are at increased risk of developing glaucoma.
Gonioscopy is an examination of the front outer edge of the eye, between the cornea and the iris.
A gonioscopy can help to determine whether this area is open or closed, which may affect how fluid drains out of the eye.
Visual field test
A visual field test also known as perimetry – checks for missing areas of vision.
Optic nerve assessment
The optic nerve can become damaged in glaucoma.
For the test, eye drops will be used to enlarge the pupils. Your eyes are then examined with a slit lamp to assess the optic nerve.
Optical coherence tomography
Optical coherence tomography (OCT) is a type of scan where special rays of light are used to scan the back of the eye and produce an image of it.
This can help detect any damage to the retina or optic nerve caused by glaucoma.
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Treatment Plan for Glaucoma
Treatment depends on types of glaucoma you have-
Primary open angle glaucoma is treated with eye drops, or laser treatment or surgery if the drops don’t help
Primary angle closure glaucoma needs immediate treatment in hospital with medication to reduce pressure in the eye, and followed by the laser treatment
Secondary glaucoma is usually treated with eye drops, laser treatment or the surgery depends on the underlying cause.
Childhood glaucoma can require surgery to correct the problem.
Types of eye drops:
There are several different types that are used, but they all reducing pressure in the eyes.
The main types of eye drops:
Prostaglandin analogs, such as latanoprost, tafluprost bimatoprost, and travoprost.
Carbonic anhydrase inhibitors, such as dorzolamide and brinzolamide
Sympathomimetics, such as brimonidine tartrate
Beta-blockers, such as levobunolol hydrochloride, betaxolol hydrochloride, and timolol
Miotics, such as pilocarpine
Eye drops can cause side effects, such as eye irritation. You may need to try to several types that work best for you.
If eye drops don’t improve the symptoms, laser treatment may be recommended.
Types of laser treatment include:
Laser trabeculoplasty – a laser is used to open up the drainage tubes within your eye
Cycle diode laser treatment – a laser is used to destroy some of the tissue in the eye, which can reduce pressure in the eye
Laser iridotomy – a laser is used to create holes in the iris ( to allow fluid to drain from your eye )
You may still need to use eye drops after laser treatment.
Surgery may recommend alternative laser treatment in some cases.
Types of glaucoma surgery include:
Trabeculectomy – Common type of operation, that involves removing part of the eye drainage tubes to allow drain more easily
Trabeculotomy – similar as trabeculectomy, but an electric current is used to remove a small part of an eye drainage tubes
Viscocanalostomy – operation to remove part of the sclera, so fluid can drain from your eye more easily
Deep sclerectomy operation – an operation to widen the drainage tubes in the eye
Trabecular stent bypass – operation to place a tiny tube into the eye to increase the drainage of the fluids. Glaucoma surgery can be carried out under local anesthetic or general anesthetic.