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Birla Eye and Child Hospital
Chota Choraha, 2-NA-22, Extension Kota, Dadabari, (Raj.)

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Glaucoma

What is Glaucoma?

Glaucoma is a chronic eye condition that causes progressive damage to the optic nerve. This nerve, essential for transmitting visual information from the eye to the brain, can be irreversibly harmed, often due to increased intraocular pressure (IOP). Glaucoma is one of the leading causes of blindness globally and disproportionately affects older adults, although it can occur at any age.

Early detection and timely intervention are critical, as vision loss from glaucoma is permanent. There are multiple types of glaucoma, each with distinct characteristics.

Anatomy of the Eye and Glaucoma

The eye’s health and function depend on the balance of fluid (aqueous humor) production and drainage. The buildup of fluid can lead to elevated IOP, which damages the optic nerve over time. However, not all types of glaucoma involve high IOP, making it a multifaceted condition.

Types of Glaucoma

  1. Primary Open-Angle Glaucoma

This is the most common type of glaucoma. It develops slowly over time, often without symptoms, and leads to a gradual loss of peripheral vision.

  • Key Features: Open drainage angle, slow progression.
  • Symptoms: None in early stages, eventual tunnel vision.
  1. Angle-Closure Glaucoma

This form occurs when the drainage angle between the iris and cornea becomes blocked, leading to a sudden increase in IOP.

  • Key Features: Rapid onset, medical emergency.
  • Symptoms: Severe eye pain, blurred vision, nausea, and halos around lights.
  1. Normal-Tension Glaucoma

Here, optic nerve damage occurs despite normal IOP levels, possibly due to poor blood flow or heightened optic nerve sensitivity.

  • Symptoms: Gradual loss of vision, typically unnoticed until advanced stages.
  1. Secondary Glaucoma

This type results from another medical condition, injury, or prolonged use of medications like steroids.

  • Causes: Trauma, inflammation, or tumors.
  • Symptoms: Depend on the underlying cause.
  1. Congenital Glaucoma

A rare form present at birth due to improper development of the eye’s drainage system.

  • Symptoms: Enlarged eyes, cloudiness, and excessive tearing.

Symptoms of Glaucoma

Early Symptoms

  • Gradual loss of peripheral vision (open-angle glaucoma).
  • Mild eye discomfort.

Advanced Symptoms

  • Tunnel vision.
  • Intense eye pain and redness (angle-closure glaucoma).
  • Halos around lights.
  • Blurred vision.

Causes and Risk Factors

Primary Causes

  • Elevated intraocular pressure due to fluid buildup.
  • Optic nerve damage.

Risk Factors

  1. Age: More common in individuals over 60.
  2. Genetics: Family history increases susceptibility.
  3. Ethnicity: Higher prevalence in African Americans, Asians, and Hispanics.
  4. Health Conditions: Diabetes, hypertension, and myopia.

Diagnosis of Glaucoma

Early detection involves routine eye exams and specialized tests:

  • Tonometry: Measures IOP.
  • Ophthalmoscopy: Examines the optic nerve.
  • Visual Field Test: Assesses peripheral vision.
  • Optical Coherence Tomography (OCT): Provides detailed imaging of the optic nerve.

Treatment Options

  1. Medications

Prescription eye drops reduce IOP by decreasing fluid production or increasing drainage. Common drugs include prostaglandins, beta-blockers, and carbonic anhydrase inhibitors.

  1. Laser Therapy

Laser trabeculoplasty improves drainage efficiency, often used for open-angle glaucoma. In angle-closure glaucoma, laser iridotomy creates a small hole in the iris to restore fluid flow.

  1. Surgical Interventions
  • Trabeculectomy: Creates a new drainage pathway.
  • Drainage Implants: Inserts tiny tubes to drain fluid.
  • Minimally Invasive Glaucoma Surgery (MIGS): Reduces IOP with less recovery time.
  1. Lifestyle Modifications
  • Maintaining a healthy diet rich in antioxidants.
  • Avoiding activities that strain the eyes.
  • Regular monitoring and adhering to prescribed treatments.

Frequently Asked Question (FAQ)

1. Can glaucoma be cured?

No, but it can be managed effectively with early detection and treatment.

Individuals over 60, those with a family history, and people with diabetes or high blood pressure.

Most types, like open-angle glaucoma, are painless, but angle-closure glaucoma can cause severe pain.

Every 1-2 years, or more frequently if you’re at high risk.

Foods rich in antioxidants, such as leafy greens, fish high in omega-3s, and citrus fruits, may support eye health.

Yes, if left untreated, glaucoma can lead to permanent blindness.

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