Everything You Need To Know About Glaucoma
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Glaucoma is a condition that causes damage to your eye’s optic nerve, which transmits images to your brain. Glaucoma can be categorized into two major types—open-angle glaucoma and closed-angle glaucoma. Now, let’s know a bit more about both these types.
March 11—17 marks the annual World Glaucoma Week this year. This collaborative project between the World Glaucoma Association and the World Glaucoma Patient Association contributes to the elimination of glaucoma blindness by encouraging people to have regular eye check-ups, including optic nerve checks.
What is glaucoma?
Glaucoma is a condition that causes damage to your eye’s optic nerve, which transmits images to your brain. In this disease, the fluid pressure within the eye rises and affects the vision. The increased pressure, called intraocular pressure, can damage the optic nerve. If left untreated, glaucoma may lead to vision impairment and even blindness. The disease usually affects both the eyes, although one may be more severely affected than the other. Glaucoma can be categorized into two major types—open-angle glaucoma and closed-angle glaucoma. Now, let’s know a bit more about both these types.
Open-angle glaucoma, also known as primary or chronic glaucoma, is the most common form of glaucoma. Ninety per cent people who suffer from glaucoma are detected with open-angle type glaucoma. It is caused by the slow clogging of the drainage canals which results in an increased eye pressure. The eyes of a person with open-angle glaucoma look like the eyes of a healthy person—the angle where the iris meets the cornea is as wide and open as it should be. Moreover, the patient may not feel any symptoms; even a slight loss of vision may go unnoticed. Since there is no physical change in the eye structure and the symptoms are hardly noticeable, it can’t be detected easily. It often develops slowly and triggers the need for medical attention only after the damage has been done.
Closed-angle glaucoma, also known as acute or chronic angle-closure or narrow-angle glaucoma, is the less common form of glaucoma. In this type of glaucoma, the angle between iris and cornea is too narrow and the iris is in the way. Due to this, a sudden pressure can build up in the eye. Closed-angle glaucoma is often caused due to disorders such as a tumour, diabetes, an advanced cataract, or inflammation. It can come suddenly with symptoms such as pain and irritation in the eyes, redness, and blurred vision, which, also at times, may be accompanied by nausea and vomiting. This condition demands immediate medical attention.
What causes glaucoma?
While closed-angle glaucoma has several causes such as a tumour, diabetes, an advanced cataract, or inflammation, causes of open-angle glaucoma are still not known. However, the following factors can contribute to glaucoma.
- Old age: Glaucoma is a disease that mainly affects older adults. Most patients suffering from glaucoma are above the age of 45.
- Ethnic background: East Asians, African Americans, and those of Hispanic descent have a higher risk of developing glaucoma when compared to Caucasians.
- Some illnesses and conditions: Like discussed above, conditions like diabetes, tumours, or any sort of illness that affects immunity can increase your chances of developing glaucoma.
- Eye injuries or conditions: Eyes are a very sensitive organ; even a minor injury can cause abnormalities that can lead to glaucoma. Eye infections or eye conditions such as cataract and myopia can also make your eyes prone to glaucoma.
- Eye surgery: An eye surgery, if not properly conducted, can do your eyes more harm than good and can lead to disorders like glaucoma.
- Family history: People who have a family history of glaucoma are prone to the disease than people who don’t.
How is glaucoma diagnosed?
A glaucoma test isn’t a very complicated one. The doctor generally begins the test by adding eye drops to a patient’s eyes. This is done to open the patient’s pupils. After that, the doctor examines the vision and oral carbonic anhydrase inhibitors and examines the optic nerve, and if the patient is diagnosed with glaucoma, the doctor may take photographs of the nerve to keep track of the disease over time. Then the doctor will do a test called tonometry, which is done to check eye pressure. If necessary, the doctor will do a visual field test. Most of the times, glaucoma tests are painless and take very little time.
How is glaucoma treated?
Treatments for glaucoma involve either improving the flow of fluid from the eye, reducing its production, or both. In most of the cases, initial treatment for glaucoma includes eye drops. If the patient doesn’t get the desired results by this, the doctor prescribes oral carbonic anhydrase inhibitor. If that too isn’t effective, the doctor may suggest the patient a laser surgery or microsurgery.
- Eye drops: Eye drops are given to either reduce the formation of fluid in the eye or increase its outflow. Side effects of eye drops can include stinging, redness, eyelash growth, change in eye colour, and occasionally retinal detachments and difficulty in breathing.
- Oral medications: In case eye drops don’t work for the patient, oral carbonic anhydrase inhibitors are prescribed to the patient. Initial side effects can include tingling in the fingers and toes and frequent urination. In most cases, these side effects get resolved within a few days.
- Laser surgery: If eye drops and oral medications are not sufficient, or they don’t suit the patient, a surgical intervention may be an option. For people with open-angle glaucoma, a laser surgery is often done to improve the flow of the fluid from the eye. Closed-angle glaucoma is treated as a medical emergency in which case, the surgery is performed to stop the fluid blockage.
Here are a few examples of the surgeries that are conducted to improve the condition of a glaucoma patient:
In this process, a laser beam is used to unblock clogged drainage canals, making it easier for the fluid inside the eye to drain out.
Here, a tiny hole is made in the iris to let the fluid flow more freely.
In Cyclophotocoagulation, areas of the middle layer of your eye are treated to reduce fluid production.
How can you prevent glaucoma?
There is no prescribed method which can prevent glaucoma. However, if the disease is diagnosed in the initial stages and is treated immediately, vision loss can be minimized. It’s recommended that older adults and individuals with diabetes should get themselves tested every year after the age of 35 to spot early detection, if any. This year’s theme of the Glaucoma Week is ‘B-I-G’—Beat Invisible Glaucoma. To mark this, ophthalmologists of Ireland are promoting early detection, which is the key to the slowing progression of glaucoma, and encouraging regular eye tests which is the only way to detect ‘symptomless’ glaucoma early. At a later stage, glaucoma is irreversible and results in sight loss and blindness.