Glaucoma

Glaucoma

Glaucoma is an eye condition that causes damage of the optic nerve. Abnormal high pressure in the eye is often a cause of the condition. The damage may cause a loss of vision or blindness. People with glaucoma may not notice the signs of the condition until it is developed to a severe stage. The serious result of this condition is unrecoverable therefore it is important to have eye exams regularly to prevent, control and slow the vision loss.

Symptoms

The signs and symptoms of glaucoma differs from its type and severity.

Open-angle glaucoma

People with this type of glaucoma may experience:

• Patchy blind spots in peripheral (side) or central of the vision which normally occur in both eyes
• Tunnel vision in severe cases

Acute angle-closure glaucoma

People with acute angle-closure glaucoma may have

• severe headache
• eye pain
• vomiting and nausea
• eye redness
• blurred vision
• halos around lights

Causes

Glaucoma is caused by an increased pressure in the eye causing the damage of the optic nerve. Aqueous humor or a fluid flowing throughout the inside of the eye is found relating to the elevated pressure. When the drainage system works inappropriately, the fluid is limited to flow properly and cause the increase of pressure in the eye. Genetics is considered one of the factors that trigger the condition.

Types of glaucoma include:

• Open-angle glaucoma
  This is the most common glaucoma, It occurs when the drainage angle developed by the cornea and iris remains open. The symptoms of this type of glaucoma is slowly developed and people with this type of glaucoma may slowly lose their eye vision.
• Angle-closure glaucoma
  This is the cause of swollen iris that narrow or block the drainage angle. Angle-closure glaucoma normally occurs suddenly and is a medical emergency.
• Normal-tension glaucoma
  This kind of glaucoma occurs when the optic nerve is damaged within normal range and leads to the lack of blood flow to the optic nerve.
• Glaucoma in children
  A drainage blockage or an underlying medical condition may cause glaucoma in infants and children which might be able to occur at birth.
• Pigmentary glaucoma
  This is caused by pigment granules from the iris in the drainage channels that slow and block the fluid to drain out and lead to the increased pressure in the eye.

Risk factors

There are several factors that may trigger glaucoma which may include:

• Intraocular pressure or internal eye pressure
• Age over 60 years old
• Family history of glaucoma
• Some medical conditions such as diabetes, heart disease and high blood pressure
• Having corneas that is thin in the center
• Extremely nearsighted or farsighted
• Eye injury or some kinds of eye surgery
• Taking corticosteroid medications

Diagnosis

The doctor may conduct some eye exams including:

• Tonometry to measure intraocular pressure
• A dilated eye examination and image tests to test for optic nerve damage
• Visual field test to check for the areas of vision loss
• Pachymetry to measure corneal thickness
• Gonioscopy to inspect the drainage angle

Treatment

The damage caused by glaucoma cannot be recovered but the aim of the treatment is to decrease eye pressure or intraocular pressure.  The treatment may include:

• Eye Drops medication such as
  • Prostaglandins
  • Beta blockers
  • Alpha-adrenergic agonists
  • Carbonic anhydrase inhibitors
  • Rho kinase inhibitor
  • Miotic or cholinergic agents
• Oral medications
  The doctor may prescribe an oral medication to lower your eye pressure. It may cause some side effects such as frequent urination, tingling in the fingers and toes, depression, stomach upset and kidney stones.
• Surgery and other therapies
  The doctor may recommend some procedures according the condition of individuals including:
  • Laser therapy
  • Filtering surgery
  • Drainage tubes
  • Minimally invasive glaucoma surgery (MIGS)
• Treatment for acute angle-closure glaucoma
  Urgent treatment is needed for patients with acute angle-closure glaucoma. The aim is to decrease the pressure in the eye. the doctor may either prescribe some medications or conduct some procedures including laser or surgery.

Change of lifestyle and home treatment

People with glaucoma are advised to

• Eat a healthy diet
• Exercise safely
• Limit caffeine
• Drink water or other fluid frequently
• Sleep with elevated head
• Take prescribed medicine strictly

Preparing for the appointment

Before your appointment, you may prepare yourself including:

• The symptoms
• All of medications you are taking
• Previous eye problems
• Family history with glaucoma
• Previous test of glaucoma
• Questions that you want to ask the doctor

During the consulting, the doctor may ask some questions including the information such as:

• Discomfortness of the eye
• Signs and symptoms that concerns you
• Family history of glaucoma
• Previous eye screen test
• previous diagnosis of glaucoma
• Medications, vitamins or supplements that you are taking