Glaucoma
Definition:
Glaucoma is damage of the optic nerve usually caused by increased pressure within the eye. It is the leading cause of blindness, gradually damaging vision until glaucoma is in its advanced stages.
The most common type of glaucoma, primary open-angle glaucoma, has no signs or symptoms except for gradual vision loss. There are other types of glaucoma, including acute angle-closure glaucoma and secondary glaucoma, which can be caused by certain medications or diseases.
Symptoms:
Primary open-angle glaucoma symptoms:
- Gradual loss of peripheral vision, usually in both eyes (tunnel vision)
Symptoms of an acute angle-closure glaucoma attack include:
- Reddening of the eye
- Halos around lights
- Severe eye pain
- Blurred vision
- Visual disturbance in low lighting
- Nausea and vomiting
Acute angle-closure glaucoma occurs suddenly when the fluid exit for the aqueous humor is blocked, causing a quick, severe, and painful rise in eye pressure. It is very important to get emergency treatment during an acute angle-closure glaucoma attack.
Congenital glaucoma affects about one in 10,000 babies born in the U.S. Symptoms are usually noticed when the child is a few months old:
- Cloudiness in the front of the eye
- Enlargement or one or both eyes
- Red eye
- Sensitivity to light
- Tearing
Exams/Testing:
Scheduling regular eye exams is the key to avoiding a glaucoma diagnosis. Groups that may be especially at risk for developing glaucoma include:
- People with a family history of glaucoma
- African Americans should be examined every three to five years from ages 20 to 29, every two to four years from age 30 to 40, and every two years afterward
- People over the age of 60, especially Mexican Americans
Tests that may diagnose glaucoma include:
- Gonioscopy – special lens used to examine the eye’s outflow channels
- Tonometry test – measures eye pressure
- Optic nerve imaging – photographs the inside of the eye
- Pupilliary reflex response
- Retinal exam
- Slit lamp exam
- Visual acuity test
- Visual field measurement
Contact your doctor immediately if you experience the following symptoms of an acute angle-closure glaucoma attack:
- Severe headache
- Eye or eyebrow pain
- Nausea
- Blurred vision
- Rainbow halos around lights
Outlook/Prognosis:
Open-Angle Glaucoma
Most patients can manage their condition without vision loss if glaucoma is detected early.
Acute Angle-Closure Glaucoma
Accurate treatment and rapid diagnosis are keys to saving your vision. Your doctor may perform an iridotomy, a laser procedure that creates a small hole in the iris providing relief to the aqueous humor.
Congenital Glaucoma
If diagnosed early enough, patients may have eye surgery and experience no future problems.
Patients diagnosed with glaucoma may be prescribed eye drops or oral medications to lower intraocular pressure or surgery if other traditional glaucoma treatments are intolerable or ineffective. Some medications that may be prescribed to treat glaucoma:
Causes:
Open-Angle Glaucoma
- Caused by an increase in eye pressure slowly overtime, but the cause of this increased pressure is unknown.
- People with a family history may be more likely to have this type of glaucoma.
Acute Angle-Closure Glaucoma
- Dilating eye drops and other medications have been known to cause this type of glaucoma.
- Patients who have already had an attack in one eye have a higher risk for attack in the other eye.
- Patients with a narrow drainage angle have a higher risk of attack.
- Anithistamines like Clarinex and Zyrtec, and antidepressants like Sinequan and Vivactil have been known to trigger cause type of glaucoma.
Congenital Glaucoma
- Results from abnormal development of fluid channels in the eye
Secondary Glaucoma
- Medications, especially corticosteroids like Durezol
- Eye diseases such as uveitis, a swelling and inflammation of the middle layer of the eye, which provides a blood supply to the retina
- Systemic diseases
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