Glaucoma: Causes, Types, Symptoms and Treatment
Been called the silent thief of sight, Glaucoma is the second leading cause of blindness in the world.
A rise in the fluid pressure inside the eyes directly affects the optic nerve. This may eventually lead to blindness if left untreated.
The main types of Glaucoma are open-angle and closed-angle.
In this article, we will dig into the causes, types and symptoms of Glaucoma. We will also have a detailed overview regarding its diagnosis and treatment.
Glaucoma and its Causes
When the pressure starts building up inside the eye, it starts to effects the optic nerve directly.
A small space is located on the front side of the eye and is called the anterior chamber. The clear fluid constantly flows in and out of this chamber. This fluid provides nourishment to the nearby tissues.
What is Glaucoma?
During the onset of Glaucoma, the rate of fluid flowing outside the anterior chamber reduces. As a result, the fluid starts to build up. This eventually leads to increased pressure inside the eye.
It is important to bring this pressure down. If left untreated, the increased pressure starts to damage the optic nerve and other parts of the eye. This can lead to the loss of vision.
Glaucoma generally leaves an impact on both eyes. Though, one eye is more likely to be affected as compared to the other eye.
Causes of Glaucoma:
The back of our eye is responsible for constantly making a clear fluid. This clear fluid is called aqueous humor.
As soon as this fluid is being made, it quickly fills the front part of our eye. After this, it gradually leaves the eye through small channels in the iris and cornea.
If these channels become obstructed or blocked, the pressure within the eye called the intraocular pressure (IOP), may rise.
As the pressure rises, the optic nerve may begin to damage. Eventually, the damage to the optic nerve leads to the loss of vision.
List of Possible Causes
Following are the factors that may play a significant role in causing glaucoma:
- obstructed or limited drainage in the eye
- An elevated level of blood pressure
- Decreased rate of blood flow to the optic nerve
- Certain eye drops that cause dilation
- Use of corticosteroids or other medications
List of Possible Risk Factors
Certain factors may trigger the onset of glaucoma and are the possible risk factors. Some of them are listed below:
- Having an elevated pressure inside the eye (Intraocular pressure)
- Age above 60
- Being Asian, Hispanic or black
- Family history of glaucoma
- Having eyesight problems
- If the center of your corneas are thin
- Personal history of an eye injury
- Having undergone certain types of eye surgery
- Prolonged intake of eye drops having a component of corticosteroid
- History of certain medical conditions like blood pressure, diabetes, heart diseases and sickle cell anemia
Types of Glaucoma
Glaucoma has two main types: closed-angle glaucoma and open-angle glaucoma.
The other types include low-tension glaucoma and pigmentary glaucoma.
This is also called acute angle-closure glaucoma.
It comes on suddenly. You may experience pain in your eyes and a rapid loss of vision. Fortunately, these initial symptoms of discomfort and pain make you seek a doctor’s help.
As a result of an early intervention and treatment, you can save yourself from a lot of damage.
Primary Open Angle Glaucoma is also called chronic glaucoma.
At the start, it is asymptomatic. You may not feel any kind of pain or distress. Even, the loss of vision is so minor to be noticed.
As a result, you would not feel the need of seeking medical help until the case complicated. The complications can cause permanent damage to the eye.
This type of glaucoma is rare. Even the experts are not being able to understand it fully.
In low-tension glaucoma, the optic nerve damages even though the eye pressure remains normal.
Some experts believe that the reduced blood supply can be the underlying cause.
This is another kind of open-angle glaucoma.
This type of glaucoma develops during adulthood. The most likely phases include early or middle adulthood.
There are certain type of pigment cells that arise from the iris. These pigment cells are usually dispersed throughout the eyes.
These cells can start building up in the channels that generally drain fluid from the eyes. As a result, the normal flow of fluid would be disturbed. Eventually, the eye pressure would start to increase.
Another type is Congenital Glaucoma, the intraocular pressure increases because there is a birth defect in the development of the angel of the eye as a result of poor development of the eye.
Symptoms of Glaucoma
The stage and type of your glaucoma determines the signs and symptoms of your condition.
Therefore, symptoms for open-angle glaucoma and closed-angle glaucoma may vary.
Symptoms of Open-angle Glaucoma:
The symptoms of primary open-angle glaucoma include:
- Seeing patches of blind spots in the central or peripheral vision, usually in both eyes
- Having tunnel vision during the advanced stages
Symptoms of Closed-Angle Glaucoma:
The signs and symptoms for closed-angle glaucoma include:
- Pain in eyes
- Redness of eyes
- Having severe headache
- Nausea and vomiting
- Blurred and unclear vision
- Halos around lights
It is important to consult your doctor as soon as the symptoms start showing. Any delays can lead to the loss of vision.
Infact, even after seeking medical help, about 15% of people having glaucoma lose their sight in at least one of the eyes within 20 years.
When to See a Doctor:
Visit your ophthalmologist (eye doctor) as soon as you start to experience any of the symptoms of open-angle or closed-angle glaucoma.
Regular visits to doctor, particularly if you have eyesight problems, is a good practice.
More on this in the next section!
Prevention of Glaucoma
As always said, prevention is better than cure.
Once you have started to experience the symptoms of glaucoma, there are various self-care steps that can help you detect the problem in initial stages.
Prevention can save you from blindness and would also slow down the process of vision loss. Some of the preventive measures include:
Get your Regular Eye Examinations
Having regular appointments with an ophthalmologist can help to detect glaucoma in its initial stages. This can save you from a lot of complications and damage.
The American Academy of Ophthalmology suggests undergoing a detailed eye examination every
- 5 to 10 years if you are below 40 years of age
- 2 to 4 years if you are 40-55 years of age
- 1 to 3 years if you fall in the age range of 55-65
- 1 or 2 years if you are above age 65.
You will be needing more frequent screening if you are at risk of glaucoma. You can ask your doctor to recommend a screening schedule as per your needs.
Know the history of your family’s eye health
Glaucoma usually runs in families. If any of your family members have a history of glaucoma, it is recommended to go for frequent screening.
An appropriate and safe program for exercise can save you from building elevated eye pressure. Talk with your doctor in order to have a regular and moderate exercise plan.
Regular Usage of Prescribed Eye Drops
Daily usage of prescribed eye drops can significantly reduce the risk of elevated intraocular pressure. Do not miss on your prescribed eye drops even if you don’t have any symptoms.
Wear Eye Protection
Always use eye protection equipment while using power tools or playing high-speed sports specially in enclosed spaces. This can save you from a lot serious eye injuries which lead to glaucoma.
Diagnosis and Treatment
An ophthalmologist undergoes a detailed eye examination in order to diagnose and treat glaucoma.
He’ll mostly look for the signs of damage, including nerve tissue lose and will implement a treatment plan accordingly.
How is Glaucoma Diagnosed?
Apart from the detailed eye exams, he would use one or more of the following procedures and tests in order to diagnose glaucoma:
Comprehensive Medical History
Your doctor will be having a detailed history of the type and duration of symptoms you have been experiencing. He will also ask if you have any family or personal history of glaucoma.
He will also be probing into your general health status in order to check if any other health condition is being the underlying cause of eye problem. These health conditions may include diabetes or high blood pressure.
This test is designed to measure the status of your eye’s internal pressure.
If you have thin corneas, then you are at a higher risk of developing glaucoma. Doctors use pachymetry tests in order to assess the thickness of your corneas.
This test is also called a visual field test. It measures your central and peripheral vision and gives your doctor an idea about how glaucoma is affecting your vision.
Monitoring the Optic Nerve
Ophthalmologists take photographs of your optic nerve from time to time. They then compare the photographs side-by-side to monitor the gradual changes over time.
How is Glaucoma Treated?
The main goal of glaucoma treatment is to decrease the intraocular pressure in order to stop the process from complicating.
To start with the treatment, your doctor is most likely to prescribe eye drops. If they don’t reduce IOP or more advanced treatment procedures are required, he may suggest any one of the following treatments:
Medications for Glaucoma
There are several medications that are particularly designed to decrease intraocular pressure. These medications are available either in the form of eye drops or pills. Your ophthalmologist may prescribe one of these or both in combination.
Surgery for Glaucoma
If there is an obstruction in a channel that is causing an elevation in IOP, your doctor may suggest surgery. A surgery would make a path for fluid to drain properly. Surgery can also help to destroy tissues that are causing pressure build-up.
In some cases, the doctor might recommend laser treatment or trabeculoplasty. This laser treatment is a simple procedure, that works by using a laser to help the fluid in your eye drain away, which in turn helps to lower the pressure inside your eye.
Laser peripheral iridotomy may also be used. This procedure creates small gaps in your iris in order to increase the movement of fluid.