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Glaucoma; types, causes , symptoms and treatment

Overview :  
Glaucoma is a type of eye problems  which  a damage  occurs to the optical nerve  that carries visual information from the eye to the brain,
The damage to the optic nerve is due to increased pressure in the eye, also known as intraocular pressure (IOP).
Causes and types:
The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is always being made in the back of the eye. It leaves the eye through channels in the front of the eye in an area called the anterior chamber angle, or simply the angle.
 Anything that blocks the flow of this fluid out of the eye or slow it will cause pressure  in the eye to increae . This pressure is called intraocular pressure (IOP). In most cases of glaucoma, this pressure is high and causes damage to the major nerve in the eye, called the optic nerve
There are four major types of glaucoma:
·        Open-angle (chronic) glaucoma.
·        Angle-closure (acute) glaucoma.
·        Congenital glaucoma.
·        Secondary glaucoma.
Open-angle (chronic) glaucoma: (the most common type of glaucoma).
·        The cause is unknown as the increase in eye pressure occurs slowly over time. The pressure pushes on the optic nerve and the retina at the back of the eye.
·        Open-angle glaucoma tends to run in families. So your risk is higher if you have a parent or grandparent with a history of (open-angle glaucoma) .
Angle-closure (acute) glaucoma: occurs when the exit of the aqueous humor fluid is suddenly blocked.
Angle-closure glaucoma is an emergency. This is very different from open-angle glaucoma, which painlessly and slowly damages vision.
If you have had Angle-closer glaucoma in one eye You are at risk for an attack in the second eye and  your doctor will  recommend preventive treatment.
Dilating eye drops and certain medications may trigger an acute glaucoma attack.
Congenital glaucoma often runs in families (is hereditary).
·        It is present at birth.
·        It results from the abnormal development of the fluid outflow channels in the eye.
 Secondary glaucoma is caused by:
·        Drugs such as corticosteroids.
·        Eye diseases such as uveitis.
·        Systemic diseases.
Symptoms:
OPEN-ANGLE GLAUCOMA
·        Most people have NO symptoms until they begin to lose vision.
·        Gradual loss of peripheral (side) vision (also called tunnel vision).
ANGLE-CLOSURE GLAUCOMA
·        Symptoms may come and go at first, or steadily become worse.
·        Sudden, severe pain in one eye.
·        Decreased or cloudy vision.
·        Nausea and vomiting.
·        Rainbow-like halos around lights.
·        Red eye.
·        Eye feels swollen. 
CONGENITAL GLAUCOMA
·        Symptoms are usually noticed when the child is a few months old.
·        Cloudiness of the front of the eye.
·        Enlargement of one eye or both eyes.
·        Red eye.
·        Sensitivity to light.
·        Tearing.
Exams and Tests
An eye exam may be used to diagnose glaucoma include an examination inside the eye by looking through the pupil.
 Note that checking the intraocular pressure alone is not enough for diagnosing as  eye pressure changes .As the normal Pressure about 25% of people with glaucoma. This is called normal-tension glaucoma. There are other problems that cause optic nerve damage.
Diagnose glaucoma include:
·        Gonioscopy (use of a special lens to see the outflow channels of the angle).
·        Tonometry test to measure eye pressure.
·        Optic nerve imaging (photographs of the inside of the eye).
·        Pupillary reflex response.
·        Retinal examination.
·        Slit lamp examination.
·        Visual acuity.
·        Visual field measurement.

 Treatment:
The goal of treatment is to reduce eye pressure. Depending on the type of glaucoma, this is done using medications or surgery.
Open-angle glaucoma treatment:
Most people with open-angle glaucoma can be treated successfully with eye drops. Most eye drops used today have fewer side effects than those used in the past. You may also treated with pills to lower pressure in the eye. Newer drops and pills are being developed that may protect the optic nerve from glaucoma damage.
 Some patients need other forms of treatment, such as a laser treatment, to help open outflow channels for fluid. But this procedure is usually painless. Others may need traditional surgery to open a new outflow channel.
Angle-closure glaucoma treatment:
Acute angle-closure attack is a medical emergency. Blindness will occur in a few days if it is not treated. Drops, pills, and  also medicine  injected  through a vein (by IV) are used to lower the  pressure. Others  need an emergency operation, called (iridotomy ). This procedure uses a laser to open a new channel in the iris. The new channel relieves pressure and prevents another attack.
Congenital glaucoma treatment:
This form of glaucoma is almost always treated with an operation as the surgery is performed to open the outflow channels of the angle. This is done while the patient is asleep and feels no pain (with anesthesia).
Glaucoma; types, causes , symptoms and treatment Reviewed by Tpdsm on August 09, 2017 Rating: 5

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