Glaucoma

What is Glaucoma?

Glaucoma is a disease of the optic nerve, which carries the images we see to the brain. When damage to the optic nerve fibers occurs, blind spots develop. If the entire nerve is destroyed, blindness results. Glaucoma is often caused by raised eye pressure and is a leading cause of blindness, but early detection and treatment are key to preventing vision loss. Since it can be asymptomatic in the early stages, regular eye checkups, especially after the age of 40, are crucial.

Causes and Types

A clear liquid called aqueous humor circulates inside the front of the eye. An imbalance in the production and drainage of this fluid can cause pressure inside the eye to increase, damaging the optic nerve.

Chronic Open-Angle Glaucoma

This is the most common form of glaucoma. The drainage angle of the eye becomes less efficient over time, causing a gradual increase in eye pressure. It typically has no symptoms in its early stages until significant vision loss has occurred.

Closed-Angle Glaucoma

In this type, the iris (the colored part of the eye) is too close to the drainage angle and can block it completely. This causes a rapid buildup of pressure, leading to an acute attack. Symptoms include:

• Red eye
• Blurred vision
• Severe eye pain and headache
• Rainbow-colored halos around lights
• Nausea and vomiting

This is a true eye emergency that requires immediate medical attention to prevent blindness.

Risk Factors

The most important risk factors include:

• Age
• Elevated eye pressure
• Family history of glaucoma
• Farsightedness or nearsightedness
• Past eye injuries
• Systemic health problems like diabetes and high blood pressure

Diagnosis

Glaucoma is detected through a comprehensive eye examination that includes measuring intraocular pressure (tonometry), inspecting the drainage angle (gonioscopy), evaluating the optic nerve, and testing the visual field (perimetry).

Treatment

Damage from glaucoma is irreversible, but treatment can control the progression of the disease. Treatment options include:

• Medications: Eye drops are the most common treatment to lower eye pressure.
• Laser Surgery: Procedures like trabeculoplasty can help the drainage angle work more efficiently. A laser iridotomy can create a new channel for fluid to flow in cases of narrow angles.
• Surgical Procedures: If medication and laser therapy are not effective, your ophthalmologist may recommend a trabeculectomy to create a new drainage channel.

Regular follow-ups are essential to monitor the condition and ensure the treatment is effective.