Mrs Ghosh, a 40 year old housewife in Kolkata, complained regularly of seeing things blurry. Later the blurred vision was accompanied with frequent headaches. She realised it was serious when she started seeing halos around light. She thought she had a cataract. But when she went to an ophthalmologist she was in for a shock. After a couple of tests, he told her she was suffering from Glaucoma. She’d not even heard of the disease. Mrs Ghosh isn’t alone. There are many who don’t know about this silent blinding disease.
Over here we give you a brief overview of Glaucoma, different types of the disease and the signs (though there aren’t many).
What is Glaucoma?
Glaucoma refers to an eye condition that damages the optic nerves. The optic nerve sends images to the brain, thus helping you see everything properly. This condition develops as a result of fluid or pressure build-up just behind your eyes. This pressure, called Intraocular pressure, increases with time and eventually damages your optic nerves. If not treated in a timely manner, Glaucoma can also result in permanent loss of vision.
According to the statistics released by the National Rural Health Mission under their programme called National Programme for Control of Blindness (NPCB) launched in 1976, Glaucoma is the third leading cause of blindness in India. According to their statistics, there are at least 12 million people in India who suffer from Glaucoma and about 1.5 million people who have turned blind due to this condition.
According to the World Health Organisation, Glaucoma is the reason behind 15% of the total blindness all across the globe. This means, on an average, about 5.2 million people all over the world turned blind due to Glaucoma.
Glaucoma mostly affects people who are above 40 years of age. However, children, even infants can also suffer from this condition.
These factors can increase your chances of developing Glaucoma:
People of African-American descent are likely to suffer from Glaucoma more than any other race, and their degree of vision loss is also greater compared to others. People of Asian and Alaskan descent are at an increased risk of developing Angle-closure Glaucoma. On the other hand, Japanese people are vulnerable to Low-tension Glaucoma.
Medical conditions such as high blood pressure, diabetes, and heart conditions can also make you vulnerable to the risks of developing Glaucoma.
If you have a family history of Glaucoma, then you are most likely to develop this condition.
Extreme trauma in the eye, such as a blow in your eye, instantly increased the eye pressure. Any kind of internal damage can also cause pressure build-up, thus exposing you to the risk of developing Glaucoma.
Use of Corticosteroid
Prolonged exposure to corticosteroids such as hydrocortisone, cortisone, and prednisone also leads to developing symptoms of Glaucoma.
Other eye-related factors
There are many factors such as optic nerve sensitivity, thinner corneas, to name a few, that increase your risk of developing Glaucoma. Conditions such as eye tumours, retinal detachment, and eye inflammation can also trigger Glaucoma.
What are different types of Glaucoma?
There are mainly four types of Glaucoma:
Primary Open- Angle Glaucoma
This is the most prevalent form of Glaucoma. Doctors often refer to it as Wide-Angle Glaucoma. This is mainly caused when the drainage system of your eye known as Trabecular Meshwork stops working. Apparently, it might look normal, but the fluid that flows through it stops. This ultimately causes fluid build-up inside the eye, increasing the eye pressure. Another theory suggests that Primary Open-Angle Glaucoma is caused by poor blood flow to the optic nerve.
This type of Glaucoma is also known as Closed-angle or Narrow-Angle Glaucoma. This is not a very common form of Glaucoma. In this condition, the fluid (called aqueous humour) is blocked and can’t drain in the right way due to a narrow-angle between the Iris and the Cornea. In other words, the drainage angle in your eye formed by the Iris and the Cornea is blocked, thus, increasing fluid build-up and eye pressure. As you age, the lens of your eyes become large, thus pushing the Iris forward and eventually narrowing down the space between the Iris and the Cornea. With the narrow-angle, the fluid inside your eyes cannot find a way to pass, thus increasing the eye pressure.
Any external injury or eye disease can cause secondary Glaucoma. Many medical conditions, physical injuries, eye abnormalities, and medication can result in secondary Glaucoma. Frequent eye surgeries can also cause this condition.
Also known as Normal-Tension Glaucoma, this is a form of Glaucoma where the eye pressure is normal, but your optic nerve is damaged. The reason behind this particular condition is still unknown. Many theories suggest that people having an overtly sensitive optical nerve can develop this condition. Due to a reduced blood supply to the optic nerve as a result of a condition called Atherosclerosis (hardening of the arteries), even a normal pressure on the optic nerve can cause severe damage to it.
Symptoms of Glaucoma
The primary sign of Glaucoma is peripheral vision loss. This often goes unnoticed until the disease reaches an advanced stage. Often people suffering from the eye disease don’t notice any symptoms; which is Glaucoma is often referred as “sneak thief of vision.”
As you age, get your eyes checked every 1 or 2 years. Occasionally the pressure inside your eyes can increase to a significant level resulting in headache, eye pain, and blurry vision.
Visit an eye specialist immediately if you experience the following symptoms:
– Loss of vision
– Seeing halos around light
– Nausea or vomiting
– Narrowed vision or tunnel vision
– Hazy looking eyes (especially in infants)
– Redness of the eye
– Eye pain
Diagnosis of Glaucoma
The eye specialist usually reviews your medical history and conducts a couple of eye examinations.
The tests for Glaucoma include:
Visual Acuity Measurement
This test is conducted to measure whether the vision of the patient is affected or not.
This test is for measuring the eye pressure to determine the risk of developing Glaucoma.
This test measures the corneal thickness. People who have a thin Cornea are at a greater risk of developing Glaucoma.
Visual Field Testing or Perimetry
This test is for checking whether the field of vision has been affected by Glaucoma or not. With Visual Field Testing, the eye specialist measures your peripheral vision and the central vision by either determining the faintest amount of light that can be detected in various locations of the vision or by determining the sensitivity to targets.
Evaluating the Retina
The eye specialist might take photographs or scans of your optic nerves in order to monitor any changes over the time.
Doctors also conduct Serial Tonometry. Under this, several pressure measurements are taken to look for any changes in the eye pressure throughout the day. Apart from that, a number of devices can also be used to measure the thickness of the nerve fibre. This is done to look for tissue loss on specific areas of the layers of the nerve fibre.
Treatment of Glaucoma
The damage caused by Glaucoma cannot be reversed; however, with proper treatment and regular checkups, the condition can be kept under control, preventing vision loss. The goal of treatment for Glaucoma is to lower the eye pressure or Intraocular Pressure. Depending on the severity of your condition, the eye specialist can undertake several treatment options which include:
1.Using Eye drops
The treatment of Glaucoma often starts with prescribing eye drops. These drops help in decreasing the eye pressure by improving the fluid drainage in your eye. Prescription eye drops include:
Prostaglandins: This helps in increasing the outflow of fluid in your eye, thus reducing eye pressure. However, this drop might result in side effects such as redness of eye, stinging sensation and changes in the pigments of the eyelids.
Beta Blockers: This helps in reducing the production of eye fluid, thus lowering the eye pressure.
Alpha-Adrenergic Agonists: This drop reduces the production of aqueous humour and improves the fluid drainage. This drop also has a few side effects such as fatigue, swollen eyes, high blood pressure, and redness of eyes.
Miotic or Cholinergic Agents: This eye drop increases the fluid drainage from the eye. The side effects include dim vision, smaller pupils, and nearsightedness.
Carbonic Anhydrase Inhibitors: This drop is seldom used for Glaucoma but this medication reduces the fluid production in the eye. The possible side effects of the drop include frequent urination, metallic taste, tingling sensation in fingers and toes.
The doctor might also prescribe oral medication if eye drops do not work. They often prescribe carbonic anhydrase inhibitor. Possible side effects include tingling in the fingers and toes, frequent urination, kidney stones depression, https://holisticdental.org/xanax-treat-anxiety/ and stomach upset.
3.Surgery and other therapies
Other treatment options for Glaucoma include laser therapy and various surgical procedures. However, these treatment options can result in complications such as pain, infection, inflammation, redness, bleeding, loss of vision, and abnormally high or low eye pressure. The doctor might also suggest eye surgery and therapies. The following procedures are followed to treat Glaucoma:
Laser therapy: Laser trabeculoplasty is for people suffering from open-angle glaucoma. The doctor uses a laser beam to open the blocked channels in the trabecular meshwork. It takes several weeks before the full effect of this therapy becomes apparent.
Drainage tubes: In this process, the eye surgeon inserts a small tube in your eye.
Filtering surgery: In this procedure, the surgeon does a surgical procedure called a trabeculectomy. He or she creates an opening in the white area of the eye or sclera and then removes some part of the trabecular meshwork.
Electrocautery: The eye doctor may suggest a minimally invasive process for removing tissues from the trabecular meshwork. The doctor uses a small electrocautery device called a Trabecutome to perform this procedure.
4.Treatment for acute angle-closure glaucoma
This condition is a medical emergency, and if you have been diagnosed with this condition, urgent treatment is required for reducing the eye pressure. This requires both medication and laser or other surgical processes.
The doctor can also perform a procedure called laser peripheral iridotomy in which the doctor makes a small hole in the iris with a laser. This allows the flow of aqueous humour, thus decreasing eye pressure.
5.Other emerging therapies
Researchers across the globe are also evaluating the effectiveness of new drugs, surgical processes and devices (such as iStent, others) for treating Glaucoma.
Glaucoma cannot be prevented, but an early diagnosis can help you in controlling the disease.
We hope that this article has helped you gain some useful insights on Glaucoma and its treatment.