Glaucoma

Glaucoma is a disease of the optic nerve. If the aqueous humor does not drain properly, intraocular pressure builds, damaging the optic nerve and causing blind spots to develop. When the entire nerve is destroyed, blindness results. If glaucoma is detected and treated in the early stages, loss of vision can be averted. Glaucoma is the most common cause of blindness in the world.

Classification

  1. Open-angle (chronic) glaucoma

Angle-closure (acute) glaucoma

  1. Congenital glaucoma
  2. Secondary glaucoma

Causes

  1. Open-angle glaucoma
  • Hereditary
  • African race
  1. Angle-closure (acute) glaucoma

Dilating eye drops and certain medications

3. Congenital glaucoma

  • Hereditary
  • Abnormal development of the fluid outflow channels in the eye

4. Secondary glaucoma

  • Drugs( corticosteroids)
  • Eye diseases (uveitis)
  • Systemic diseases

Symptoms And Signs

  1. Open-angle glaucoma
  • Most people have no symptoms until they begin to lose vision
  • Gradual loss of peripheral vision (tunnel vision)
    1. 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
    1. 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

Investigations

  • 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

  1. Open-angle glaucoma
  • Eye drops
  • Pills to lower pressure in the eye
  • Laser treatment
  • Surgery to open a new outflow channel.

2. Angle-closure glaucoma

  • Drops, pills, and medicine IV( to lower pressure)
  • Emergency operation( iridotomy)

3. Congenital glaucoma

Surgery( to open the outflow channels of the angle)                                       

Prevention

  1. Early diagnosis
  2. Careful management are the keys to preventing vision loss.
  3. Everyone over age 40 should have an eye examination at least once every 5 years

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