Glaucoma
Glaucoma is the main cause of blindness in the elderly. 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 for preventing blindness as a result of this disease.
What are the types of glaucoma?
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• open-angle: occur gradually; As the eye does not drain the fluid inside it as it should, and as a result, intraocular pressure increases, and optic nerve damage begins, usually in both eyes, and its prevalence increases with age. It’s also painless, doesn’t cause any changes in vision at first, and is most common. People with high blood pressure are also at greater risk.
• Closed angle (acute): usually affects people who have a narrow front corner of the eye, or people with farsightedness, and it is the main cause of severe visual impairment all over the world.
Closed-angle: This is a medical emergency. In this type of glaucoma, the outer edge of the iris (the colored part of the eye) prevents fluid from draining from the front of the eye; where fluid accumulates rapidly; This causes a sudden increase in intraocular pressure. If not treated, it can cause blindness within only a few days. Therefore, when feeling symptoms, you must go to the emergency immediately.
• Secondary glaucoma: caused by an eye problem such as: iritis (the colored middle layer of the eye), eye injuries, operations, or some medications.
• congenital glaucoma: affects newborns or children; due to a congenital defect in the development of the angle of the eye; As a result of poor eye development, meaning that eye fluid cannot flow out normally, children with congenital glaucoma have cloudy eyes, sensitivity to light, increased eye tears, and may have eyes that are larger than normal.
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 faucet 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.
Who are at risk of developing glaucoma?
The 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 emergence 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.
And the doctor evaluates all these factors in order to decide the patient’s need for treatment of glaucoma or only to note him as a person exposed to infection. 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, periodic 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 inform the doctor of them 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 deficiency of the drainage itself. The laser is used to expand 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 the need for surgery to control glaucoma arises, the ophthalmologist uses precise instruments to make a new drainage channel for the aqueous fluid to flow out of it, which helps reduce intraocular pressure. Although the complications of modern surgery to treat glaucoma are rare, they are as common as any surgery.
The doctor advises to perform surgery only when he sees that it is safer than leaving the optic nerve damage to continue.
What is the patient’s role in treatment?
– The treatment of glaucoma requires a team composed of the doctor and the patient, where the doctor prescribes the treatment and the patient must be consistent in its use. K