Eye Diseases

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Glaucoma

Summary:

Glaucoma is the result of a blockage of the flow of aqueous humour, a watery fluid produced by the ciliary body.
It is one of the most common and most dangerous eye diseases.
It affects all ages, including infants, but can be more common in adults.
Permanent vision loss (blindness) is one of glaucoma complications.
Treatment aims to control the damage caused to vision, not return it to previous state.

Overview:

Glaucoma occurs when the eye aqueous humour (ciliary fluid) does not drain properly. This increases the pressure in the eyes and the optic nerve (which carries visual images to the brain and contains a very large number of nerve fibers), and can lead to vision loss if not detected and treated at early stages. Glaucoma does not always cause symptoms in its early stages, it can affect people of all ages, including infants, however; it is most common in adults. It is one of the most common and most dangerous eye diseases.

Other names:

Ocular hypertension

Types of glaucoma:

Open-angle glaucoma: This type happens gradually as the eyes fail to normally drain the fluid inside. This results in an increase in the eye pressure, and that's when the optic nerve damage begins, usually in both eyes. Its rate of spread increases with age. This type is painless, does not cause vision changes at first, and is the most common. People with high blood pressure are also at a greater risk of getting this type of glaucoma.
Acute closed-angle glaucoma: This type usually affects people whose anterior angle of the eye is narrow, or those with long-sightedness. It is the number one cause of severe vision impairment worldwide.
Closed-angle glaucoma: Angle-closure glaucoma is a medical emergency. If the flow of your aqueous humor fluid is suddenly blocked, the rapid buildup of fluid may cause a severe, quick, and painful increase in pressure. If left untreated, this type of glaucoma can cause blindness in only a few days. You should call your doctor immediately if you begin experiencing symptoms.
Secondary glaucoma: Secondary glaucoma is often a side effect of an injury or another eye condition (e.g. iritis [inflammation of the colored part of the eyes], eye injuries, eye surgeries, and some medications).
Congenital glaucoma: It affects newborns due to a defect in the development of the angle of their eyes, which slows or prevents normal fluid drainage. Congenital glaucoma usually presents with symptoms, such as cloudy eyes, excessive tearing, sensitivity to light, and eyes that look bigger than usual.

Cause:

The back of your eye continuously makes a clear fluid called aqueous humor. As this fluid is made, it fills the front part of your eye. Then, it leaves your eye through channels in your cornea and iris. If these channels are blocked or partially obstructed, the natural pressure in your eye may increase, causing pressure on your optic nerve.

Risk factors:

Being over the age of 60.
A family history of glaucoma.
Vision problems.
Eye injuries.
Certain types of eye surgery.
Chronic diseases (e.g. diabetes, heart disease, high blood pressure, and sickle cell anemia).
Eye problems (e.g. thin cornea, optic nerve sensitivity, retinal detachment, eye tumors, and eye infections).

Some long-term use of medications (e.g. Cortisone).

Symptoms:

In the early stages of open-angle glaucoma, there are no obvious warning signs or symptoms, however; as the disease progresses, dark spots may appear in the side vision (the vision part near the nose). As for angle-closure glaucoma, symptoms are often sudden and severe. They include:

Sudden cloudy vision;
Severe headache;
Nausea and vomiting;
Severe eye pain;
Eye redness;
Seeing colored rings around lights.

When to see a doctor?

If you experience any of the following symptoms, see your doctor. The symptoms include: Severe headache, eye pain, and blurred vision. An annual examination of the eyes is also advisable.

Complications:

Permanent vision loss (blindness).

Diagnosis:

To diagnose glaucoma, your ophthalmologist will want to perform a comprehensive eye examination. They’ll check your eye pressure and examine your optic nerve and cornea thickness. They may also perform a visual field test.

Treatment:

Treatment depends on the type of glaucoma you have. The main methods of treatment include:
Eye drops to stop the pressure on the eyes.
Laser treatment to open blocked channels or reduce production of fluids in the eyes.
Surgery to enhance fluid drainage in the eyes.

Prevention:

Patients over 40 years of age are advised to undergo regular eye examinations by an ophthalmologist. People with risk factors are advised to get examined before the age of 40, depending on the estimations of their ophthalmologists.
Wearing protective glasses when performing tasks that could involve risks to the eyes.
Keeping medical conditions like diabetes and hypertension under control.
Maintaining a healthy weight, controlling blood pressure, being physically active, and avoiding smoking all helps avoid vision loss from glaucoma. These healthy habits will also help prevent type 2 diabetes and other chronic conditions.

FAQs:

Can I regain my vision if I lost it from glaucoma?

Eye damage from glaucoma is permanent, however; early diagnosis and medical intervention with proper treatment can reduce the incidence of blindness.

Myths & Truths:

You should not take medications if you do not have any symptoms.

Truth: If you were diagnosed with glaucoma by your doctor, you must take medication. Some types of glaucoma don’t cause symptoms until the optic nerve and eyes are damaged.

Clinical Education General Department

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