Glaucoma

What is Glaucoma?

Glaucoma is an Optic Nerve disorders that result in optic nerve damage, leading to vision loss. The most common finding in glaucoma is raised intra-ocular tpressure (IOP) although in approx 5% cases it may occur even in normal IOP also. There can be two common types of glaucoma- Primary open-angle glaucoma (POAG) and Angle-closure glaucoma (ACG).

• Primary Open-Angle Glaucoma (POAG): This is the most prevalent form and manifest without any symptoms in early stages. The drainage system of an eye (Trabecular meshwork) is partially blocked, leading to increased intraocular pressure (IOP), which in turn damages the optic nerve.
• Angle-Closure Glaucoma (ACG): This type is less common and can occur suddenly (acute) or gradually (chronic). It happens when the iris is very close to the drainage angle in the eye, blocking the fluid from draining.
  
  

Symptoms of Glaucoma

Glaucoma is often called the “silent thief of sight” because many types, particularly POAG, have no warning signs until significant damage has occurred. Some common symptoms include:

• Primary Open-Angle Glaucoma: Gradual loss of peripheral vision, mild heaviness or headache in early stages which is often overlooked & tunnel vision in advanced stages.
• Angle-Closure Glaucoma: Severe eye pain, nausea, vomiting, blurred vision, halos around lights, and eye redness.

Since symptoms can be subtle or nonexistent until advanced stages, regular eye check-ups are crucial for early detection.
Risk Factors

Risk Factors

Several factors increase the risk of developing glaucoma, including:

• Age: People over 60 are at higher risk.
• Ethnicity: African Americans and Hispanics are more susceptible to POAG, while Asians are more prone to angle-closure glaucoma.
• Family History: A family history of glaucoma increases the risk.
  High Refractive error – High number of glasses (Near sightedness or Far sightedness)
  
  

Diagnosis

Diagnosing glaucoma involves several tests that assess the condition of the optic nerve and measure intraocular pressure:

• Tonometry: Measures the pressure inside the eye.
• Ophthalmoscopy: Examines the optic nerve for damage.
• Perimetry: Tests for peripheral (side) vision loss.

Pachymetry: Thickness of the cornea which affects the value of measured IOP
Early detection through these tests is crucial in managing and slowing the progression of glaucoma.

Treatment Options

While there is no cure for glaucoma, treatments can significantly slow the progression and preserve vision. The main treatment strategies include:

• Medications: Eye drops or oral medications to reduce eye pressure.
• Laser Surgery: Procedures like trabeculoplasty for open-angle glaucoma and iridotomy for angle-closure glaucoma to improve fluid drainage.

Surgery – Trabeculectomy and valve surgery are the surgery options decided by the surgeon according to patient’s conditions.

Preventive Measures

Preventing glaucoma is primarily about reducing risk factors and ensuring early detection. Here are some steps to help prevent vision loss from glaucoma:

• Regular Eye Exams: Especially important for those over 40 or with risk factors.
• Protective Eyewear: To prevent eye injuries that could lead to glaucoma.
  
  

Conclusion

Glaucoma is a serious eye condition that can lead to irreversible vision loss if not managed properly. Understanding the symptoms, risk factors, and treatment options is crucial for patients and their families. Regular eye exams and early detection are key in preventing significant vision loss.