Glaucoma

Glaucoma is the leading cause of blindness in older adults in the United States. Blindness from glaucoma can be prevented if treatment is started early enough. Glaucoma is a disease of the optic nerve (which carries the images we see to the brain). Most people know that there is a relationship between glaucoma and intraocular pressure. In fact, the higher the eye pressure, the greater the possibility of damage to the optic nerve from the optic nerve, such as the power cable, which contains a huge amount of fine wires, as the optic nerve contains a very large number of nerve fibers, which are damaged by the effect of glaucoma, which leads to the formation of blind spots inside the eye.

Many people do not notice these blind spots until after a large part of the optic nerve is damaged, and in the case of complete damage to the optic nerve, this leads to complete blindness. Therefore, early diagnosis and treatment of glaucoma are the main factors in preventing blindness as a result of this disease.

What is the cause of glaucoma?

There is a fluid called “aqueous fluid” secreted inside the eye and drained outside it. This fluid is not part of the tears that are secreted outside the eye above its surface, and the movement of the watery fluid inside the eye can be imagined like a basin with an open tap that pours water continuously. When the drain channel is clogged, water collects in the basin, which increases pressure on its walls. Also, if the drainage area inside the eye becomes blocked, which is called the “drainage angle”, the amount of aqueous fluid inside the eye increases, and thus the pressure inside the eye increases, which leads to damage to the optic nerve.

What are the types of glaucoma?

(1) Chronic open angle glaucoma

It is the most common type of glaucoma and appears as a result of age, where the efficiency of the drainage angle inside the eye decreases, which leads to a gradual increase in intraocular pressure. If the increase in intraocular pressure leads to damage to the optic nerve, this type is called “chronic open angle glaucoma.” About 90% of glaucoma patients have this type of glaucoma, and this type of glaucoma can gradually affect the optic nerve in a painless manner until the patient is surprised after a period of clear damage in the optic nerve.

(2) Acute closed angle glaucoma

Sometimes a complete blockage may occur in the drainage angle inside the eye, and you can imagine what happens as a piece of paper falling on the drainage hole in the water basin. This is what happens when the iris sticks to the drainage angle, causing it to become clogged, and the pressure in the eye rises. This condition is called acute closed angle glaucoma.

Symptoms of this type of glaucoma:

Blurred vision

Severe eye pain.

headache.

Nausea and vomiting.

Seeing rainbow colors around light sources.

When these symptoms appear, the patient should visit an ophthalmologist immediately because this type of glaucoma may lead to vision loss.

(3) Chronic closed angle glaucoma

This type of glaucoma appears in people of African or Asian origin.

How can glaucoma be diagnosed?

A regular check-up with an eye doctor is the best way to detect glaucoma in its early stages. With a complete, painless examination, an ophthalmologist can do the following:

Intraocular pressure measurement.

Exploring the drainage angle inside the eye.

Evaluate the presence of any damage to the optic nerve.

Visual field measurement for both eyes.

After these checks are not necessary for everyone. Regular re-examinations may be necessary to see the progression of damage to the optic nerve caused by glaucoma over time.

Who are at risk of developing glaucoma?

An increase in eye pressure alone does not necessarily mean the presence of glaucoma, as the ophthalmologist puts a lot of information together to determine the chances of the appearance of this disease. These factors are:

Age

African origin.

Nearsightedness.

Previous eye injuries.

The presence of previous cases of glaucoma in the family.

Previous severe anaemia.

The doctor evaluates all of these factors in order to determine the patient’s need for treatment of glaucoma or to observe it only as a person at risk of developing it. This means that this patient is at greater risk of developing glaucoma than the normal person, and therefore needs regular checkups to detect early symptoms of optic nerve damage.

How do you treat glaucoma?

As a rule, damage caused by glaucoma to the optic nerve cannot be cured, and eye drops, tablets, lasers and surgeries only work to prevent further damage. In any type of glaucoma, regular examination is important to prevent vision loss.

Treatment with medication

Glaucoma can be controlled by using eye drops several times a day and sometimes with some types of tablets. These medicines help lower eye pressure either by reducing the secretion of aqueous fluid inside the eye or by improving the performance of the drainage angle.

The patient must use these medicines regularly and continuously until the desired result is given. He must also inform any doctor who treats him other than the ophthalmologist about the treatments he uses, and there may be some side effects of medications that the patient must notify the doctor about as soon as they appear.

Some eye drops may cause the following side effects:

tingling sensation

eye redness;

blurred vision

headache.

Change in pulse, heart rate, or breathing rate.

Some tablets may cause the following side effects:

Tingling of the fingers and toes.

vertigo.

Anorexia.

Kidney stones.

Diarrhea or constipation.

Anemia and easy bleeding.

Laser therapy

– Lasers may be effective in different types of glaucoma, and the laser is used in one of two ways:

Open angle glaucoma: where laser beams treat the insufficiency of drainage itself. The laser is used to widen the drainage angle to maintain intraocular pressure within the normal limits.
Open angle glaucoma: The laser creates an opening in the iris to improve the flow of aqueous fluid into the drainage angle

Surgical treatment

– When surgery is needed to control glaucoma, the ophthalmologist uses precise instruments to make a new drainage channel so that the fluid can flow out.