Glaucoma Disease

The optic nerve at the back of the eye can be damaged by increased pressure or poor blood flow. This damage is known as glaucoma. When everything functions properly, the eye generates a clear fluid called aqueous that fills the anterior chamber between the iris and the cornea. A system of drains allows the aqueous to flow out of the anterior chamber. Intraocular pressure is determined by the ebb and flow of the production and drainage of the aqueous. When the drains don't function properly, the intraocular pressure increases, and the damage to the optic nerve occurs. The damage is not reversible and, without treatment, will worsen until blindness results.

Types

• Open-angle glaucoma is the most common type. Although the anterior chamber of the eye looks normal, aqueous fluids build here, putting pressure on the optic nerve. This can result in injury to the optic nerve and retina. Another form of glaucoma, called acute-angle glaucoma, only occurs about 10 percent of glaucoma patients. Usually the space between the cornea and iris is thinner than normal, diminishing the amount of aqueous that can flow through it. If it becomes completely blocked, intense eye pain, distorted vision, rainbows around lights and queasiness may occur. Complete blindness can result in just a few days if not treated immediately. Secondary glaucoma is contracted as the result of some other medical condition like diabetes or eye trauma. Congenital glaucoma is very rare, seen only in infants and nearly always requiring surgery to correct.

Symptoms

• Glaucoma is often an invisible disease, as the more common open angle form has no symptoms until some vision loss is noted by the patient. That loss is not recoverable. Acute angle closure does has recognizable symptoms, including intense pain in the eye, headache, possible nausea and vomiting, blurry or decreased vision and sensitivity to light, possibly with rainbows appearing around lights. These symptoms are serious, and urgent care should be sought immediately. Congenital glaucoma is recognized by an enlarged cornea, sensitivity to light and tearing of the eye.

Risk Factors

• Some risk factors may indicate a higher chance of developing glaucoma. A family history of the disease, previous injuries to the eyes, the presence of diabetes, migraine headaches and being nearsighted increase the odds of contracting the disease. Ethnic background plays a part: African Americans are six times as likely to develop glaucoma as Caucasians, though the reasons are unclear. Anyone over 60 has an increased risk, too. Heart disease and high blood pressure elevate the risk, as does the use of corticosteroids over long periods of time.

Prevention

• People over 40 should have their intraocular pressure checked annually to detect glaucoma. Early detection can allow the progression of the disease to be slowed or halted. Maintain a healthy weight and keep your blood pressure at recommended levels. Protect your eyes by wearing protective eyeglasses when playing sports or working with tools or any other equipment that could cause injury to the eye. Eye injuries can lead to glaucoma. Sip fluids slowly and frequently. Drinking large amounts of fluids at one time can cause the intraocular pressure to increase.

Treatment

• Treatment is usually the application of eye drops. Sometimes more than one type is used together to help relieve the pressure from the optic nerve. A combination of eye drops and oral medications may be prescribed. Laser treatment or surgery may be required if medication doesn't lower the intraocular pressure enough. Laser surgery is done in the doctor's office and typically lasts 10 to 20 minutes, the purpose being to open the clogged drains so the aqueous can drain. One type of surgery called a trabeculectomy involves an incision in the sclers or white of the eye to remove a tiny section of the trabecular meshwork. This allows the aqueous to drain. The hole is covered, and antibiotics are prescribed. Drainage implants are sometimes used for children or patients with secondary glaucoma.