Glaucoma Treatment and Management
What is glaucoma?
Glaucoma is a category of eye diseases that causes damage to the eye’s optic nerve, the structure that transmits visual information from the eye to the brain. It is one of the leading causes of blindness in individuals over the age of 60. Glaucoma is often referred to as the "silent thief of sight," because most types typically cause no pain and produce no symptoms. Since peripheral vision is usually first to be affected, a great deal of vision can be lost before you are aware of it.
Risk factors
The following factors can increase the risk for developing glaucoma:
What causes it?
While there are many theories about the causes of glaucoma, the exact cause is actually unknown. The following are the different types of glaucoma and their potential causes:
Recommended tests for Glaucoma and Glaucoma Suspect patients
How do you treat it?
The main goal of glaucoma is to reduce intra-ocular pressure in the eye, thus preventing further damage to the optic nerve. The following are possible treatment options:
What is glaucoma?
Glaucoma is a category of eye diseases that causes damage to the eye’s optic nerve, the structure that transmits visual information from the eye to the brain. It is one of the leading causes of blindness in individuals over the age of 60. Glaucoma is often referred to as the "silent thief of sight," because most types typically cause no pain and produce no symptoms. Since peripheral vision is usually first to be affected, a great deal of vision can be lost before you are aware of it.
Risk factors
The following factors can increase the risk for developing glaucoma:
- Age: People over age 60 are at increased risk
- Race: African American and Japanese are more at risk
- Family history
- Underlying medical conditions such as diabetes, high blood pressure and heart disease
- Physical injuries to the eye
- Corticosteroid use
What causes it?
While there are many theories about the causes of glaucoma, the exact cause is actually unknown. The following are the different types of glaucoma and their potential causes:
- Primary Open Angle Glaucoma (POAG): The most common form, POAG causes slow and painless damage to the optic nerve. This is likely due to the eye’s drainage system becoming inefficient over time, leading to a buildup of pressure within the eye. It can also be caused of poor blood flow to the optic nerve.
- Angle Closure Glaucoma: This type of glaucoma is far less common but considered a medical emergency that can quickly cause vision loss if not treated. It occurs when the drainage angle of the eye becomes blocked, thus causing a sudden increase in eye pressure.
- Secondary Glaucoma: This type of glaucoma results from an injury or other eye disease. It may be caused by a variety of medical conditions, medications, physical injuries and eye abnormalities.
- Normal Tension/Low Tension Glaucoma: In this type of glaucoma, eye pressure remains within normal ranges, but the optic nerve is damaged nonetheless. The cause of this is unknown.
Recommended tests for Glaucoma and Glaucoma Suspect patients
- Tonometry: This test measures the pressure inside the eye to detect increased risk factors for glaucoma.
- Visual field testing: This test measures one’s peripheral vision to check for progression of vision loss.
- Optical coherence Tomography: This measures nerve fiber thickness and looks for tissue loss on specific areas of the nerve fiber layer.
- Pachymetry: This test measures the thickness of the cornea, the front surface of the eye. The thickness of the cornea relates directly to the accuracy of the intraocular pressure measurement.
- Optic Nerve Head evaluation: This may include photographs or scans of the optic nerve, to monitor changes over time.
- Gonioscopy: This procedure offers a view of the angle anatomy, which is where eye fluid drainage occurs.
How do you treat it?
The main goal of glaucoma is to reduce intra-ocular pressure in the eye, thus preventing further damage to the optic nerve. The following are possible treatment options:
- Medication: The main goal of topical medications is to reduce the elevated pressure in the eye. There are various types of medications that have different mechanisms of action and a single or combination of medications may be prescribed.
- Surgery: Procedures include laser treatment, making a drainage flap in the eye, inserting a drainage valve, or destroying the tissue that creates the fluid in the eye. All procedures aim to reduce the pressure in the eye when medication is not sufficient.