Glaucoma is a disease of the optic never-the part of eye that carries the images we see to the brain. The optic nerve is made up of many never fibers, like an electric cable that consists of numerous wires.
What Causes Glaucoma?
A clear liquid called aqueous humor circulates inside the front portion of the eye. To maintain a healthy level of pressure within the eye, a small amount of this fluid is constantly produced, while an equal amount flows out of the eye through a microscopic drainage system (this liquid is not part of the tears on the outer surface of the eye).
Because the eye is a closed structure, if the drainage area for the aqueous humor-called the drainage angle-is blocked, the excess fluid cannot flow out of the eye. Subsequently, fluid pressure within the eye increases, pushing against the optic never and causing damage.
What Are The Different Types Of Glaucoma?
Chronic open-angle glaucoma. The risk of developing chronic open-angle glaucoma increases with age. The drainage angle of the eye becomes less efficient over time, and the eye becomes sensitive even to normal eye pressure and is therefore at a risk of damage. Treatment is necessary to prevent further vision loss.
Typically, open-angle glaucoma has no symptoms in its early stages, and vision remains normal. However, as the optic nerve is progressively damaged, blank spots begin to appear in the field of vision. You typically won’t notice these blank spots in your day-to-day activities, until the optic nerve is significantly damaged, and these spots become large. If all the optic nerve fibers die, it will result in irreversible blindness.
Closed-angle glaucoma. In some persons, the iris (the colored part of the eye) is too close to the drainage angle. In these eyes, which are often small and farsighted, the iris can be pushed forward, blocking the drainage channel completely. Since the fluid cannot exit the eye, pressure inside the eye rapidly builds up and causes an acute closed-angle attack.
Symptoms may include:
This condition is a true eye emergency. If you have any of these symptoms, call your ophthalmologist immediately. If this type of glaucoma is not quickly treated, it will result in blindness. Two-thirds of those with closed-angle glaucoma develop it slowly without any symptoms prior to an attack.
Who Is At Risk For Glaucoma?
The most important risk factors include:
How Is Glaucoma Detected?
Regular eye examinations by your ophthalmologist are the best way to detect glaucoma. A glaucoma screening that checks only the pressure of the eye is not sufficient to determine if you have glaucoma. The only sure way to detect glaucoma is a complete eye examination.
During your glaucoma evaluation, your ophthalmologist will
Photography of the optic nerve or other computerized imaging may be recommended. Some of these tests may not be necessary for everyone. These tests may need to be repeated on a regular basis to monitor any changes in your condition.
How Is Glaucoma Treated?
Damage caused by glaucoma cannot be reversed. Eye drops, laser surgery, and surgery in the operating room lower the eye pressure and help prevent further damage. In some cases, oral medications may also be prescribed. For any type of glaucoma, periodic examinations are very important to prevent vision loss. Because glaucoma can progress without your knowledge, adjustments to your treatment may be necessary from time to time.
Glaucoma is usually controlled with daily administration of eye drops. These medications lower the eye pressure, either by decreasing the amount of aqueous fluid produced within the eye or improving the flow through the drainage angle.
Never Change Or Stop Taking Your Medications Without Consulting Your Ophthalmologist.
Glaucoma medications can preserve your vision, but they may also produce side effects. You should notify your ophthalmologist if you think you may be experiencing side effects.
Some eye drops may cause:
All medications can have side effects or interact with other medications. Therefore, it is important that you make a list of the medications you take regularly, and share this with each doctor you visit.
Laser surgery treatments may be recommended for different types of glaucoma.
In open-angle glaucoma, the drain itself is treated. The laser is used to modify the drain (trabeculoplasty) to help control the eye pressure.
In closed-angle glaucoma, the laser creates a hole in the iris (iridotomy) to improve the flow of aqueous fluid to the drain. Laser treatment is an OPD procedure.
When surgery for glaucoma has to be conducted in the operating room, the ophthalmologist uses fine microsurgical instruments to create a new drainage channel for the aqueous fluid to leave the eye. Surgery is recommended if your ophthalmologist feels its necessity to prevent further damage to the optic nerve. This surgery is called trabeculectomy.
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