Glaucoma is an eye disease that damages the optic nerve , a nerve at the back of the eye that can cause sudden vision loss. You may not notice the symptoms as they start slowly. A comprehensive dilated eye exam is the only way to determine if you have glaucoma.
Glaucoma is the world’s second leading cause of blindness and one of the least treated eye diseases . It can have serious results as there are no early signs making it difficult to diagnose or treat.
types of glaucoma
Glaucoma is a category of eye diseases distinguished by physical features , such as open-angle glaucoma and angle-closure glaucoma.
It can also be differentiated into primary and secondary , depending on whether there is no other pre-existing disease in the patient’s (primary) eye, or if glaucoma has developed in an eye that already has previous disease.
Open-angle glaucoma is the most frequent , since 9 out of 10 people with glaucoma suffer from it. It usually shows no symptoms until vision loss begins, although it may not be immediately noticeable. It is caused by the gradual clogging of the eye’s drainage tubes, causing an increase in eye pressure. It is called open angle because the iris (the colored part of the eye) and the cornea are wide angled and open more than they should be. It takes a long time to develop and eventually becomes a lifelong disease.
As for angle-closure glaucoma , it is less frequent, and occurs due to obstructions in the drainage channels, which produce a sudden increase in intraocular pressure. This can cause the iris and cornea to have a closed or narrow angle. Unlike the open angle, this category develops quickly. In this case, the outer edge of the iris prevents fluid from flowing out the front of the eye, so it builds up quickly, increasing eye pressure. This type of glaucoma can cause blindness in just a few days if not treated right away.
There is another type of glaucoma that is congenital , that is, you are born with it. It develops in babies when the drainage canals of the eye do not develop properly or completely during the perinatal period. It is a rare disorder that can be passed from generation to generation. In some cases, resorting to medication is solved, but on other occasions surgery is required. Microsurgery usually completely solves the simplest structural problems.
causes of glaucoma
Your eye is always full of aqueous humor . The amount of aqueous humor that enters the eye must be balanced with the amount that must drain. It drains out through a region known as the drainage angle, a routine process in the eye that helps maintain a constant intraocular pressure (IOP) in the eye. When the drainage angle doesn’t work, fluid tends to build up in the eye, increasing pressure, which can damage the optic nerve (the one that connects your eye to the brain to interpret what you’re seeing).
More than a million microscopic nerve fibers make up the optic nerve. If these fibers die , you will begin to have blind spots in your vision , which may not be noticeable until most of the optic nerve fibers are gone. Once all the fibers die, you will go blind .
The exact reason why the pressure increases remains a mystery to scientists, although there are some external factors that contribute to the accumulation of aqueous humor, which could be: the use of dilating eye drops, the taking of medications for other purposes, like corticosteroids, when blood flow to your optic nerve in the eye is reduced, comorbidities like high blood pressure, etc.
In addition, as we have said, it is a genetic disease that can be transmitted from generation to generation. What’s more, genes linked to excessive eye pressure and optic nerve damage have been discovered in some people.
Symptoms
Different types of glaucoma have different symptoms , and depending on how it manifests, doctors will be able to diagnose and treat the disease.
In the early stages of open-angle glaucoma, there are no warning signs or symptoms, but blind spots in peripheral vision (side vision) develop as the disease progresses. Therefore, people who suffer from it do not detect any change in their vision until the disease has progressed to the point of being irreversible. For this reason, glaucoma is known as the “silent thief of sight.” Regular eye exams can help your ophthalmologist detect this condition before it causes vision loss.
When glaucoma is angle-closure, people usually do not have previous symptoms, but they appear suddenly very quickly. Blurred vision, halos, minor headaches, and eye pain are some of the first signs of a “glaucoma attack,” as this condition is colloquially called. People experiencing these symptoms should see an ophthalmologist as soon as possible.
treatment options
It should be noted that the most important thing is to try to detect glaucoma in time , and for this to be possible it is advisable to have complete eye exams from time to time, and to have good eye health.
It should be noted that people who have diabetes and high blood pressure are at greater risk of suffering from this problem, so it is more important in these cases to have regular check-ups.
If glaucoma is diagnosed while it is still in its early stages, it can be treated with medication in the form of daily eye drops. These drops help lower eye pressure, or even reduce the amount of watery fluid the eye produces. Others help fluid flow better through the drainage angle, reducing pressure. Some of these medications can cause side effects, such as persistent itching or stinging, red eyes, etc., so it is important that you follow your doctor’s instructions when using them and, if alarm symptoms appear, consult your doctor if necessary. normal or if you need to change the treatment.
On other occasions, laser surgery has to be used to treat glaucoma . There are mainly two types: Trabeculoplasty and Iridotomy.
Trabeculoplasty is an operation that can be used instead of or in addition to drugs for people who have open-angle glaucoma. This intervention is used in order to improve the drainage angle. After this surgery, the fluid drains effectively and the eye pressure decreases.
The iridotomy , on the other hand, is that laser operation with which patients with closed-angle glaucoma are treated. The ophthalmologist uses a laser to make a small hole in the iris that facilitates the passage of fluid to the drainage angle.
References:
Boyd, K., McKinney JK. & Turbert D. (2021, 22 de Septiembre). What Is Glaucoma? Symptoms, Causes, Diagnosis, Treatment. American Academy of Ophthalmology. https://www.aao.org/eye-health/diseases/what-is-glaucoma
Glaucoma Research Foundation (2020, 2 de Junio). Types of Glaucoma. Glaucoma Research Foundation. https://www.glaucoma.org/glaucoma/types-of-glaucoma.php
Holland, K. (2017, March 31). Glaucoma. HealthlineMedia. https://www.healthline.com/health/glaucoma
Lee, D. A., & Higginbotham, E. J. (2005, 1 de Abril). Glaucoma and its treatment: A review. American Journal of Health-System Pharmacy, 62(7), 691–699. https://doi.org/10.1093/ajhp/62.7.691
National Eye Institute (2021, September 10). Glaucoma. Nih.gov. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma
National Eye Institute (2021, 10 de Septiembre). Types of Glaucoma. Nih.gov. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma
