Glaucoma

published on: 25th august, 2021

What is Glaucoma?

Glaucoma is the leading cause of irreversible blindness worldwide. It’s a disease that damages your nerve of eye – Optic nerve. About half of the patients may present with high eye pressure which is one of the risk factor causing progressive damage to the optic nerve.

What are the types of Glaucoma ?

Glaucoma is a spectrum of diseases which can be broadly classified as:

  • Primary or secondary

Primary glaucoma is usually seen in elderly, may be associated with history of glaucoma in the family. Secondary glaucoma is secondary to an obvious cause for the pressure rise in eye which can be controlled by treating the cause.

Open or narrow angle based on the drainage pathway of aqueous called angle.

Childhood glaucoma or adult onset glaucoma based on the age of onset.

What are the risk factors?

Some people have a higher than normal risk of getting glaucoma.

This includes people who-

  • are over age 40
  • have family members with glaucoma
  • are of African, Hispanic, or Asian heritage
  • have high eye pressure
  • refractive errors
  • have had an eye injury
  • use long-term steroid medications
  • have corneas that are thinner than normal
  • have diabetes, migraines, high blood pressure, poor blood circulation

What are the symptoms of Glaucoma ?

Most glaucoma are slowly progressive till the disease is advanced affecting good amount of your side vision or central vision. Very rarely, angle closure glaucoma can present with acute angle closure with sudden rise in eye pressure, severe pain, redness, decrease in vision, headache and vomiting which is an emergency. These attacks may have warning symptoms like frequent evening rise of eye pressure with one sided headaches, redness of eyes and blurred vision or seeing colored haloes around lights in dim illuminated settings.

How to diagnose Glaucoma?

The only sure way to diagnose glaucoma is by a ‘complete eye examination’. A glaucoma screening that only checks eye pressure is not enough to find glaucoma.

During a glaucoma examination, your eye doctor will:

  • measure your eye pressure
  • inspect your eye’s drainage angle
  • examine your optic nerve for damage
  • test your peripheral/side vision
  • take a picture of Optic nerve
  • computerized scanning of your optic nerve
  • measure the thickness of your cornea

Tests are not superior to clinical evaluation. But they are done to support clinical findings to establish or rule out glaucoma. They are also important as part of documentation. Tests are repeated periodically to know the stability of disease process.

Is Glaucoma treatable?

Glaucoma is a chronic progressive disease and loss of vision is permanent; it cannot be reversed. But treatment can help to stop or delay further progression of glaucoma and visual loss.

 

Medical Treatment

First level of treatment is eye drops and/or lasers as appropriate to bring down the eye pressure to an optimum range below which there won’t be any significant progression. Strict adherence to medications is very important even though you may not feel any obvious difference. But still we have to use them to keep the disease under control. (added).On the contrary, they may cause some local and body side-effects.

Common side-effects of glaucoma eye drops are:

  • red eyes
  • dry eyes & blurred vision, dry mouth
  • eyelash growth, changes in color of eyes & skin around eyes
  • changes in pulse, heartbeat and breathing
  • changes in energy level

Never suddenly quit taking your medicine unless your doctor tell you to do so. They should be stocked before they run out of your hands. Some drugs can cause problems when taken with other medications. It is important to inform your doctor regarding other medications if any.

Surgical Treatment Glaucoma may continue to progress with time. Hence the importance of regular follow up to assess the stability of disease and to look out for any side-effects. If the eye pressure is not adequately controlled with medications one can supplement with laser treatment.

  • Lasers are focused light which is used to improve drainage of aqueous in the angle thereby reducing the eye pressure. Lasers are first line treatment even before eye drops in angle closure glaucoma.
  • Minimally Invasive Glaucoma surgery- where the risks are less and requires less after care.
  • Conventional surgeries

How to deal with Glaucoma as a patient?

Glaucoma treatment is a lifelong process. Regular follow is equally important to discuss with doctor your concerns regarding treatment, to detect any side-effects of medications and to evaluate the stability of the disease process. This may vary between 3 to 6 months depending on the stage of disease. As glaucoma runs in families, its very important to check all your blood-relatives who are 40 years and above to rule out this disease.

Note: * The information on this website is not meant to be used to diagnose health conditions or to replace legitimate medical advice. All treatments mentioned are available for patients at Burjeel Hospital. Abu Dhabi at the concerned department.

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