Glaucoma: Symptoms, Causes, Diagnosis & Treatments

Glaucoma is an eye disorders that damages the optic nerve, which is a leading cause of blindness. In fact, according to a research, it is believed that around 60-70 million people worldwide are suffering from this eye disorder. In this disease, fluid pressure in the eye rises and leads to progressive, non-reversible vision loss. Similar to a ball requiring air-pressure to maintain its shape, the eyeball too needs fluid pressure. However, unlike the ball, if the pressure gets higher, eye doesn’t have any way to regulate or relieve the pressure. This results in constant stretch leading to optic nerve damage, which may results in glaucoma.

When glaucoma progresses, injury to neurons ultimately leads to eye damage in the form of peripheral vision loss. The eye continuously produces a fluid, called the aqueous humor that must drain from the eye to maintain healthy eye pressure. With the increased pressure of fluid within the eye, the anterior chamber, a small space in the front of the eye is not able to provide proper liquid flow to other part of the eye and thus the fluid is unable to nourish and bathe eye tissues. Because of Glaucoma, the fluid drains slowly, thereby leading to fluid build-up, which in turn increases the eye pressure called as intraocular pressure (IOP). Without reducing the pressure, the optic nerve or other parts of the eyes may get damaged resulting in loss of vision. This disease normally affect both the eyes, however, one eye may get more affected.

Types of Glaucoma:

There are several types of Glaucoma but they are many categorized into two major types: open-angle and closed-angle glaucoma.

Primary Open angle Glaucoma

Primary open angle glaucoma (POAG), also known as chronic Glaucoma progresses slowly and there may not be early warning signs. It has a strong genetic predisposition and patients usually do not seek medical help because of its gradual nature until permanent damage has already occurred.

Closed-angle glaucoma (acute angle-closure glaucoma)

Not a very common occurrence, closed angle glaucoma comes precipitously and patient can experience sudden pain and discomfort making the patient seek medical help which might result in proper treatment preventing permanent damage.

Low-tension Glaucoma

A rarer form of glaucoma, in low tension glaucoma, optic nerve damage may even occur without significant increase in eye pressure. Although the cause is not fully understood, experts believe that it might be because of reduced blood supply to optic nerve.

Pigmentary Glaucoma

A kind of open angle glaucoma, patients develop it during early or middle adulthood because of diffusion of pigment cells which might upset the normal fluid flow of aqueous, leading to increase in eye pressure.

Symptoms of Glaucoma:

For primary open-angle Glaucoma, there may not be any apparent symptoms except continuous vision loss. However, for acute angle closure glaucoma or closed angle glaucoma, patients could experience severe eye pain, nausea, eye redness, blurred vision, seeing halo-like rings around lights. It is important to seek immediate medical attention in case a patient experiences any of these symptoms. Nevertheless, it is advisable to go for regular comprehensive eye check-up for proper monitoring of vision.

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Causes of Glaucoma:

What causes glaucoma isn’t always known especially when it comes to understanding of primary glaucoma. However for secondary glaucoma, there may be several causes such as tumor, diabetes, reduced blood flow to optic nerve, dilating eye drops, inflammation, hypothyroidism and advanced cataract. Some other causes of Glaucoma include old age, eye surgery, near-sightedness (myopia). Research also found some ethnic group to be more prone to glaucoma. Those from Hispanic, African American, or East Asians descent are more prone to glaucoma as compared to Caucasians. Some eye drops containing corticosteroids may also cause glaucoma.

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Diagnosis of Glaucoma:

With comprehensive eye checkup, Glaucoma can be diagnosed. There are few types of diagnosis test that can determine if a patient has Gluacoma or not. Opthamologists check for detailed family history to understand genetics and other health conditions that might impact vision loss. Apart from this, there are other tests, which may be helpful in this evaluation.

  • Tonometry - one of the most common tests to check eye pressure is tonometry where the tone or firmness of eye surface is measured. After numbing the eyes with anesthetic eye drops, tonometer is placed against the front surface of the eye to check the pressure. Thin corneas may be a factor in determining glaucoma and once the opthamologist determines the thickness of cornea, it becomes easier to understand whether or not patient is suffering from glaucoma.
  • Gonioscopy – This test allows opthamologist to view interior of the eye from different direction to examine the drainage area of the eyes. A special type of contact lens is inserted into the eyes after the anesthetic drops and abnormalities are checked.
  • Ophthalmoscopy – This test is used to check the damage to optic nerve to determine there is a cupping to the optic disc. This is done through a hand-held device with a slit lamp to look directly inside the pupil.
  • Visual field testing – It is a form of test that detects signs of glaucoma through the damage to optic nerve. In this test, visual fields are measured with the help of computers.
  • Confocal laser scanning systems and optical coherence tomography – These are non-invasive tests that create a three-dimensional image of eye to measure the thickness of retina and the degree of optic nerve damage.

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Progression of Glaucoma:

Since Glaucoma is typically asymptomatic and gradually progressive disease, an untreated glaucoma can take a long time to manifest into blindness. Untreated glaucoma can take up to 15 years from damage to blindness depending on the intraocular pressure (IOP). In order to avoid the disease, it is advisable to go for regular eye pressure tests and eye check ups.

Treatments for Glaucoma:

The aim of the treatment is to reduce the eye pressure to stop any further vision loss. The treatment includes ways to either improve the flow of fluid from eyes or by reducing the production of fluid to reduce IOP. The doctor may suggest either medication or surgery.

Medication for Glaucoma

The medication can be either in form of eye drops or pills however, for majority of cases, eye drops or a combination of eye-drops and pills are prescribed.

Surgery for Glaucoma

If the medications are not enough or the patient is unable to tolerate them, eye pressure can be brought down through surgical intervention.

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Prevention of Glaucoma:

According to the current research, there are no known ways to prevent glaucoma however, the extent of damage can be prevented by early diagnosis. The best way to prevent is to have regular eye check-ups. It is all the more important for people with greater risks. Although getting eye checkup every six months is a good ballpark, a specialist may be able to provide a better time frame for eye checkups.

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Common Myths and Misconceptions about Glaucoma

Myth #1: Glaucoma only affects senior citizens

Although Glaucoma is most common among older adults generally over the age of 60 years, it can affect people of all ages. In fact, a lot of young adults get affected by Glaucoma and even many babies are born with this eye disease. Many common risk factors for Glaucoma includes diseases like tumors, hypertension, diabetes, eye injury and genetics.

Myth #2: Glaucoma can be cured

Glaucoma doesn’t have any cure at this point but it can be controlled and treated with eye-drops, pills, and surgery.

Myth #3: The symptoms of Glaucoma are easy to detect

One of the major reasons, why Glaucoma is dangerous and is even called a silent sight killer is because it causes gradual vision loss without any apparent symptoms. It can stay undetected until it might be too late and the damage is irreversible.

Myth #4: Glaucoma is only genetic disorder

Although, it is true that some Glaucoma forms are genetic and inherited, there are many other varieties of glaucoma that can happen without any family history of Glaucoma. A regular eye check-up is recommended to rule out glaucoma.

Myth #5: People with good eyesight cannot develop glaucoma

Even people with good eyesight can develop glaucoma since it depends on the eye pressure and sometimes, even people with normal eye pressure can develop glaucoma. Only regular eye exams can help you detect and prevent glaucoma.

Myth #6: You will become blind

Even though Glaucoma is not curable, with early detection people can get it diagnosed and treated. There are a variety of treatment options available for patients including medications, surgery, and treatments.

Frequently Asked Questions (FAQs)

1) Do glasses help with Glaucoma?

Ans: As per current research, eye glasses normally don’t help with Glaucoma. However, because of decreased vision it might become necessary to wear them.

2) Can you wear contact lenses if you have Glaucoma?

Ans: It generally depends on the kind of glaucoma treatment you are on. If you’re using eye drops, some eye drops might require to be put in when lenses are not inside the eyes. Also, there is surgery involved, the doctor might suggest not to use lenses as it may increase the risk of infection.

3) Does sunlight affect glaucoma?

Ans: Sunlight does not affect Glaucoma directly but if eyes are sensitive, it might be helpful to wear sunglasses.

4) Can games like football or swimming be played if you have Glaucoma?

Ans: If you have undergone surgery or if you are using specific eye drops, it is best to avoid games that may involve the risk of eye infection.  Most swimming pools have chlorine which might irritate Glaucoma affected eyes.

5) Do I need to stick to a particular diet?

Ans: So far, there is no established evidence that suggest a particular food or drink affect Glaucoma affected eyes. It is best to maintain a balanced diet.

6) Can I exercise?

Ans: Exercise is good however; exercises where head is lower than the body (for example, headstand) should be avoided, as these kinds of exercises tend to increase eye pressure.

7) Can I play wind instruments?

Ans: Playing wind instrument like trumpet or saxophone can increase eye pressure so it is always best to avoid playing high resistance wind instrument. However, the effect largely depends on how often the instrument is played.

8) Can I take other medicines along with glaucoma treatment?

Ans: Just like any other treatment, it is best to ask the doctor before continuing with other medicines.

9) What if I put more drops into my eye than I should have?

Ans: Although it is largely not very harmful, it is advised to stick to the prescribed number as there may be slight increase in general side effect.

10) What if I forgot to put the eye drops?

Ans: If you have forgotten to put a drop, put it in as soon as you remember. It is also a good idea to have a routine for eye drops so you don’t miss them. Although it is not important to put the eye drop at exact same time, it is good to put them at around the same time each day.

11) Do I need to get up in the night to put the eye drop?

Ans: Having a good night’s sleep is very important for the eyes. Space the eye drop timing such that you don’t have to get up in the night to put in the eye drop.

12) Where should I keep the drops?

Ans: The eye drops needs to be kept in a cool place in the door of the refrigerator, which is cool, but not like freezer.

13) Do I need to see the eye specialist regularly?

Ans: It is important to visit your eye specialist regularly to understand whether you have glaucoma and even after it is diagnosed and treated. Since, this disease normally comes without any apparent symptoms, the only way to stay on top of it is to monitor it to ensure that the treatments are working.

14) What if I develop an eye infection?

Ans: Any infection needs to be taken seriously and a visit to a doctor is required to commence the treatment ASAP.

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Last updated on : 24-12-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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