Glaucoma is fairly common over the age of 35, affecting 2 of every 100 persons. It is the second leading cause of blindness in people over 40. The number of persons affected by glaucoma is expected to rise dramatically as our population of ‘baby-boomers’ age.
What causes glaucoma?
There are several different types of glaucoma. Some types are caused by increased pressure within the eye that destroy the optic nerve, if not treated promptly. A constant level of liquid called the aqueous humor is maintained in the inner chamber of the eye. Fluid flows into the eye from several structures, and drains from the eye at a spongy outlet located at the angle where the cornea and sclera meet. If the outlet is clogged or the drainage system is overwhelmed by too much liquid production, a buildup of fluid occurs and causes a pressure increase inside the eyeball. This places pressure on the optic nerve and its blood supply that can cause serious irreversible damage. Eye injury, tumor, hemorrhage, or infection can cause a blockage in the drainage system (and the resulting increase pressure).
What are the symptoms of glaucoma?
In most cases there are no symptoms.
Are there different types of glaucoma?
Yes there are many different kinds of glaucoma, but there are two major types: chronic and acute.
Chronic, open angle glaucoma, also known as primary open-angle glaucoma, is the most common type of glaucoma. This type of glaucoma primarily occurs in those persons over age forty and is often symptomless. It progresses very slowly as the eye’s drainage system becomes clogged. The intraocular pressure rises because the fluid cannot drain out of the eye adequately. Most people who have chronic glaucoma feel fine and have 20/20 vision. There are no early warning symptoms of chronic glaucoma, which is why this common form is often called the ‘sneak thief’ of sight. Fortunately, this form of glaucoma progresses slowly and responds well to medications such as eyedrops or pills. It can sometimes be treated with laser surgery as well.
Acute, closed angle glaucoma or primary ‘narrow angle’ glaucoma is a relatively rare form. It is very different from chronic glaucoma because the eye pressure goes up very quickly. The pressure rises because the drainage canals are suddenly blocked or covered over, very much like the sudden blockage that would occur in a sink if the drain becomes plugged up. This type of glaucoma can occur suddenly at any age and is a true ocular emergency. The symptoms of acute glaucoma can include: eye pain, nausea, rainbows around lights, severely blurred vision. Treatment for acute glaucoma can include eye drops and oral medication to firstly reduce the pressure, then usually followed by laser surgery.
How is glaucoma diagnosed?
Prevention involves early detection through a comprehensive eye health examination especially after age 35. Sometimes the level of pressure may be normal, yet there are no symptoms, so an eye examination is the only way to discover the problem. An instrument called a tonometer is used to measure the pressure of the eye. The optic nerve is assessed by a procedure called ophthalmoscopy, which uses specialized equipment to look inside the eye. A visual field analyzer checks for blind spots in the field of vision.
Who develops glaucoma?
People with a family history are more likely to develop the problem, as are those who are nearsighted. Some diseases that impact the entire body, such as diabetes, anemia, or hardening of the arteries increase the risk of developing the condition.
How is glaucoma treated?
The primary form of treatment is still medication. These medications either increase the drainage of fluid or decrease the production of fluid to lower the pressure within the eye. Laser surgery is also a treatment in some cases as is specialized microsurgery. The goal of glaucoma treatment is to prevent further damage and to preserve the highest possible level of vision.
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