Glaucoma refers to a group of ophthalmological diseases that cause optic nerve damage. It is the commonest type of optic nerve damage that causes loss of vision. The fluid accumulation in the eye puts pressure on the front part of the eye. This increased pressure gradually damages the optic nerve. The pressure is called intraocular pressure or eye pressure. Some people with normal eyes also have glaucoma. Poorly managed or untreated glaucoma can cause irreversible and permanent loss of vision and blindness.
Most patients have bilateral glaucoma, although the disease may initially be worse in one eye. In open-angle glaucoma, one eye may have mild to extensive damage, while the other may be mildly affected. Those with closed-angle glaucoma in one eye have 40-80% chance of having the same glaucoma type in the other eye within 5-10 years.
Glaucoma is a common ophthalmological condition affecting lots of Indians yearly. It is the second leading cause of blindness after cataracts.
Glaucoma is of several types, including:
Open-angle glaucoma is the commonest type of glaucoma that affects around 90% of patients with glaucoma. It develops due to resistance build up in the drainage canals of the eyes. The drainage canals apparently function normally and appear to be normal. Over a period of months or years, the fluid in the eye can accumulate and exert pressure on the optic nerve. The disease may not be diagnosed for years as most patients are asymptomatic.
For some type of glaucoma, there are no symptoms and changes to vision happen slowly over time, making the symptoms easier to miss. Because many patients of open-angle glaucoma don’t present with noticeable symptoms, it is vital to undergo routine eye exams so that this disease can be detected in its earlier stages. The damage caused by glaucoma is irreversible, so early detection and treatment of the disease is important to prevent blindness and vision loss. The symptoms of angle-closure glaucoma are more severe and tend to develop suddenly.
The general symptoms associated with any type of glaucoma include headaches, eye pain or pressure, blurred vision, low vision, narrowed vision, rainbow-coloured halos, red eyes, and nausea and vomiting.
Glaucoma occurs when the optic nerve undergoes damage. As the function of this nerve deteriorates gradually, blind spots develop in the field of vision. This nerve damage is usually linked with increased eye pressure.
Excessive amount of eye pressure develops due to fluid accumulation throughout the inside of the eye. This fluid is also referred to as aqueous humour and usually drains through a tissue at the angle of the eye where the cornea and iris meet. This tissue is also called the trabecular meshwork. The cornea has a crucial role to play in vision as it allows light to enter the eyes. When the eyes produce an excessive amount of fluid or when the drainage system is not working properly, the pressure inside the eyes increases.
This is the commonest type of Glaucoma, where the drainage angle formed by the cornea and the iris remains open. However, other parts of the drainage system don’t drain properly. This may result in a gradual increase in eye pressure.
This type of Glaucoma occurs when there is a bulge in the iris. This bulging iris blocks the drainage angle either partially or completely. Therefore, the fluid can’t circulate through the eye, and the pressure goes on increasing. Angle-closure Glaucoma may either occur suddenly or gradually.
The exact cause of optic nerve damage on increased eye pressure is unknown. The optic nerve may either become more sensitive or experience less blood flow. The decreased blood flow may occur as a result of accumulation of fatty deposits in the arteries or other medical conditions causing damage to the circulatory system. Fatty deposit accumulation in the arteries is also known as atherosclerosis.
Some babies are born with glaucoma while others develop the disease within the first few years after birth. Blocked drainage from the eyes, eye injury, or an underlying medical problem may cause optic nerve damage.
In this type of Glaucoma, small pigment granules flake off from the iris and slow or obstruct the drainage of fluid from the eyes. Activities like jogging may sometimes cause the pigment granules to stir up. This leads to the accumulation of pigment granules on the tissue located at the eye angle where the cornea meets the iris. This deposition of granules can increase the pressure inside the eyes.
Glaucoma tends to have a familial predisposition. Scientists have identified that in some people, there are genes related to increased eye pressure and optic nerve damage.
Anyone can be affected by glaucoma, however, the risk of developing the disease increases with age. Those belonging from the Black and Hispanic are more susceptible to developing the disease than people from other ethnic groups. They also tend to have the disease earlier in life. The Asian population is also more likely to develop closed-angle glaucoma or angle-closure glaucoma.
Diabetes patients are twice more likely to develop glaucoma. Other risk factors contributing to the development of the disease include hyperopia or farsightedness, family history of glaucoma, long-term corticosteroid use, high or low blood pressure, myopia or nearsightedness, and the previous eye injury or surgery.
You can have glaucoma and not know about it. Regular eye check up is important to detect the disease in its earlier stages. Eye examination can help evaluate optic health and detect the loss of vision.
To diagnose glaucoma, an ophthalmologist may perform one or more of the following tests:
If left untreated, glaucoma can cause faster onset of blindness or permanent loss of vision. Timely care and treatment can slow down additional vision loss, however, they can’t restore the lost vision. It is vital to visit an ophthalmologist immediately if you experience severe headaches, eye pain, or vision problems.
Even though there is no definitive cure for glaucoma, your symptoms can be kept in control with treatment and the disease progression can be stopped or slowed.
There is no best glaucoma treatment that suits every patient. Your doctor may suggest one type of treatment plan for you and something else for some other patient.
The best way to protect eye health and prevent the loss of vision is by early detection through routine eye exams. You should be tested by glaucoma every:
Blindness is very rare in patients with glaucoma, as long as it is detected early. However, glaucoma is a progressive, chronic condition that can result in some degree of vision loss over time. The earlier glaucoma is caught and the treatment is started, the better are the odds of preventing the loss or severe impairment of vision. If you are at an increased risk of developing glaucoma, you should undergo regular eye exams.
You must call your doctor if you experience eye floaters, halos, or flashers, blurred or low vision, sensitivity to light, sudden, severe eye pain or headaches, and loss of vision.
Following are some questions you may want to ask from your healthcare provider:
Although glaucoma does not have a complete cure, treatment can help keep eye pressure under control and prevent significant loss of vision. The disease can be detected early with eye exams and the eye sight can be saved. If you are susceptible to developing glaucoma, you can ask your ophthalmologist about how often you need to undergo screenings. You must use your eye drops as prescribed by your doctor and ask him about laser treatments and surgical options. You can keep glaucoma from worsening with proper care and prevent blindness or irreversible loss of vision.
The Department of Ophthalmology at Kokilaben Dhirubhai Ambani Hospital, Indore offers primary ophthalmological care services, including ophthalmologic checkups and routine and emergency medical and surgical management of a vast range of ophthalmological conditions. Annual ophthalmological exams, consultation for eyeglasses, and referrals for fitting contact lenses are also offered.
Consult highly qualified ophthalmologists in Indore who have years of experience in the field and is equipped with the latest state-of-the-art technology and ophthalmologic instruments.
Comprehensive diagnostic services available include assessment of refractive errors, visual acuity, slit lamp evaluation, tonometry, ophthalmoscopy, gonioscopy, pachymetry, visual field testing, and fundus photography. The typical disorders diagnosed and treated in the department include contact-lens-related problems, blepharitis and dry eye, corneal ulcers, pterygium, herpes zoster and herpes simplex infections, allergic conjunctivitis, cataract, diabetes, glaucoma, macular degeneration, refractive errors like myopia, hypermetropia, and astigmatism, and ocular trauma.