Glaucoma

Glaucoma is the second leading cause of blindness in the United States, but it doesn’t have to be a problem you need to fear later in life. If caught early, treatment is possible. Here you will find all the information needed to understand and prevent glaucoma.

Definition

Glaucoma is a group of eye conditions that cause damage to the optic nerve, the nerve which carries visual information to the brain. If the damage to this nerve is severe enough, blindness can result. The eye is filled with aqueous humor, a clear fluid that is made behind the iris, the colored part of the eye. The fluid leaves the eye trough channels in the eye, called the anterior chamber angle, or simply the angle. This helps keep pressure within the eye at the proper level. If they flow of fluid from the eye is blocked or slowed in any way, pressure will begin to rise. In the case of glaucoma, pressure reaches high enough for a long enough period of time to cause damage to the optic nerve.

Types And Causes Of Glaucoma

There are four major types of glaucoma.

• Open angle or chronic glaucoma is the most common form of the disease. It occurs over a long period of time and the pressure that builds up in the eye pushes on the optic nerve, usually with no pain at all. The cause of open angle glaucoma is unknown, however it does run in families and those of African-American decent are at a particularly high risk of developing it.
• Angle closure or acute glaucoma is very serious. This occurs when the flow of aqueous humor suddenly becomes blocked causing a very fast and very painful rise in pressure. If this occurs it is cause for a trip to the emergency room. It’s also important to note that someone who has had acute glaucoma in one eye is at an increased risk of having it occur in the other eye, so their doctor may prescribe preventative treatment. Dilating eye drops and certain medications can be the cause of acute glaucoma.
• Congenital glaucoma is seen in babies at birth and is hereditary. It is thought to be caused by abnormal development of the eyes in utero.
• Secondary glaucoma is caused by a number of different things including medications such as corticosteroids, eye diseases, systemic diseases, or trauma to the eye. In other words, the glaucoma is a secondary condition to something else that is causing it.

Symptoms

The symptoms of glaucoma vary based on the type of glaucoma that a person has.

Open Angle or Chronic Glaucoma

• Often those affected have no symptoms at all
• Those affected experience no pain
• Once a person loses their vision, the damage to the optic nerve is already severe
• Peripheral vision (vision to the side) is lost slowly, called tunnel vision
• If left untreated this type of glaucoma leads to blindness

Angle Closure or Acute Glaucoma

• Symptoms can either come and go, or steadily become worse
• A person may experience sudden, severe pain in one eye
• Decreased, cloudy, or steamy vision is sometimes reported
• Nausea and/or vomiting
• Rainbow-like halos around lights
• Red eye
• A feeling of swelling in the eye

Congenital Glaucoma

• Symptoms are usually present at birth, but not noticed until the child is a few months old
• Cloudiness in the eyes
• Enlargement of one or both eyes
• Red eyes
• Child demonstrates an abnormal sensitivity to light
• Tearing of the eyes

Treatment

Treatment is aimed at reducing the pressure in the eye and preventing damage to the optic nerve from occurring or worsening. Treatment will depend upon the type of glaucoma that a person has.

If a person has open angle glaucoma, typically eye drops are prescribed that will reduce the pressure in the eye and prevent further damage to the optic nerve. New medications are just as effective with fewer side effects than the eye drops used in the past. Depending upon the severity of each individual case, pills may be used in conjunction with the drops to lower eye pressure more effectively.

In more serious cases, such as in the case of angle closure glaucoma, more aggressive medications may be used to reduce eye pressure, including intravenous (IV) medications. In the case of this type of glaucoma, blindness can occur within a few days if it is left untreated. Surgery may also be used.

Babies born with congenital glaucoma are always treated with surgery performed under general anesthetic. Secondary glaucoma can be treated by treating the cause. Whether it’s a change in medication or treating an injury to the eye, treatment will depend upon whatever the underlying cause is.

Long Term Outlook

The long term outlook for someone with glaucoma depends upon the type of glaucoma that they have. Someone with chronic glaucoma cannot be cured, however further damage to the optic nerve can be prevented with close treatment. Someone with acute glaucoma usually fares well after treatment, but acute glaucoma is a medical emergency and blindness can result if it isn’t treated. Children with congenital glaucoma usually suffer no long term effects provided that the condition is treated early. Otherwise blindness will result. The same is true with secondary glaucoma.

Glaucoma need not be a devastating condition. With proper treatment and by communicating closely with their doctor, those with glaucoma can mitigate the damage to their optic nerves and stop further sight loss.

Sources:

• PubMed Health
• Glaucoma.org
• Mayo Clinic
• National Eye Institute