You may have heard of a family member or acquaintance having glaucoma surgery, but did you know that glaucoma is the leading cause of irreversible blindness?
It is known as the ‘sneak thief of sight’ as it creeps up on you and by the time you have symptoms the damage has been done, so early detection is the key to preventing permanent loss of vision. Glaucoma affects over 3 million Americans, according to the CDC, and over 60 million worldwide.
What is Glaucoma
Glaucoma refers to a group of eye conditions that affect the optic nerve in a progressive manner, which can lead to loss of nerve tissue and permanent loss of vision. In many cases, it is related to increased intraocular pressure (pressure in the front chamber of the eye) but sometimes is related to lack of adequate blood supply to the optic nerve. The cause of glaucoma is not clear as yet, but there is a definite genetic link involved.
Different Types of Glaucoma
A tiny gland, called the ciliary body, produces a steady supply of aqueous humor that circulates through the anterior chamber, to nourish the cornea and tissue in the chamber. This fluid is drained through the trabecular meshwork in the angle where the cornea and the iris meet.
If this gets clogged up, it slows down the drainage and then pressure builds up, which will affect the optic nerve as it leaves the eye. Why it blocks up is not clear; it is inherited, or caused by trauma to the eye, inflammation, severe infections, blocked blood vessels or in rare cases eye surgery.
* Open-angle or Wide-angle Glaucoma
The most common type, where fluid does not drain as it should, despite the mesh appearing to be normal.
It develops slowly, without symptoms, and will eventually affect peripheral vision, before moving on to the central vision. If not treated early, it can lead to blindness.
* Angle-closure Glaucoma
Sometimes referred to as acute or chronic angle-closure, or narrow-angle glaucoma, this occurs when the drain space narrows, which could cause a sudden build-up of pressure and presents abruptly with symptoms of severe eye pain, blurred vision, seeing halos around lights and striking headaches.
Risk factors for Glaucoma
Family history is a big risk factor for glaucoma, and as you often do not show symptoms before the damage is done, it is important to get a regular eye exam performed if you have a family history or any other risk factors, such as:
* Medical conditions, such as diabetes, hypertension, heart disease, or sickle cell anemia.
* Previous eye injury or some types of eye surgery.
* Long term use of corticosteroids (especially eyedrops)
* Over 60 years of age.
* Asian, Hispanic or Black heritage.
* Being extremely far-sighted or near-sighted.
* Thinner corneas.
* Chronic Eye Inflammation.
* High IOP (intraocular pressure).
When to get Emergency Care
If you experience sudden eye-pain, blurred vision, and severe headache, visit your ophthalmologist’s office or the Emergency Room immediately, as these are symptoms of acute angle-closure glaucoma.
Diagnosis
The goal should be early detection and diagnosis, which mandates a routine eye exam at least every two years. Tools used to diagnose glaucoma include the Tonometer (measuring pressure), Pachymeter (measures the central thickness of the cornea), a Visual Field Test and Ophthalmoscopy (looking through the pupil at the optic nerve), the most important test. New imaging technology is also available to evaluate the retinal nerve fibre layer and optic nerve.
How is it Treated?
Patient education to prevent disease progression is a given. Other treatments include medications to reduce pressure and glaucoma surgery, which may be done by laser or implants, flaps, and trabeculectomy.
Early detection, appropriate treatment, and ongoing monitoring can help prevent blindness.
