Types of Glaucoma and Treatment Options | Ophthalmology

Glaucoma

What is glaucoma?

A glaucoma is a group of eye diseases that damage the optic nerve, and its health is vital to good vision. This damage is most often caused by abnormally high pressure in your eye.

It is one of the main sources of blindness for individuals beyond 60 years old. It can happen at any age yet is more normal in more seasoned grown-ups. Numerous types of this disease have no admonition signs. The impact is slow to the point that you may not see an adjustment in vision until the condition has arrived at a serious stage.

Because vision loss due to glaucoma cannot be reversed, it is important to have regular eye examinations that include measurements of your eye pressure so that the diagnosis can be made in its early stages and treated appropriately. If it is seen early, a vision mishap can be moved back or hindered. On the off chance that you have this condition, you will for the most part need treatment for an incredible remainder.

What are the types of glaucoma?

There are five main types of glaucoma. and this is:

Open-Angle (Chronic) 

Open or chronic angle glaucoma has no signs or symptoms except for progressive vision loss. This loss could be so slow that your vision could be damaged beyond repair before any other signs appear. According to the NEI, this is the most popular type of glaucoma.

Angle-Closure (Acute) 

If the flow of the aqueous humour is suddenly blocked, the rapid build-up of fluid may cause a sharp, rapid, and painful increase in pressure. Angle-closure glaucoma is an emergency condition. You should contact your doctor immediately if you start experiencing symptoms, such as severe pain, nausea, and blurred vision.

Congenital 

Babies born with congenital glaucoma have a defect in the corner of the eye, which slows or prevents the normal drainage of fluids. Symptoms of congenital glaucoma usually appear, such as cloudy eyes, excessive tears, or sensitivity to light. Congenital glaucoma can run in families.

Secondary 

Secondary glaucoma is often a side effect of an injury or other eye condition, such as cataracts or eye tumors. Prescriptions, for example, corticosteroids, may likewise cause this kind of glaucoma. In rare cases, eye surgery can cause secondary glaucoma.

Normal-Tension 

In some cases, people without high eye pressure develop optic nerve damage. The reason for this is unknown. However, severe allergies or decreased blood flow to the optic nerve may be a factor in this type of glaucoma.

Glaucoma causes

The fluid in your eye, called aqueous humor, usually flows out of your eye through a canal that resembles a retinal canal. If this channel is blocked, fluid builds up. Sometimes experts don’t know what causes this blockage. But it can be inherited, meaning that it is passed from parents to children.

More uncommon reasons for this disease incorporate an intense or compound physical issue to your eye, serious eye contamination, blockage of veins inside your eye, and fiery conditions. It’s rare, but eye surgery to correct another condition can sometimes trigger it. It usually affects both eyes, but it may be worse in one of the other.

What are the symptoms of glaucoma?

Initially, symptoms of glaucoma do not usually appear. This is why half of the people with this disease do not even know they have it. Over time, you may slowly lose vision, and it usually begins with side (peripheral) vision – especially the part of the vision that is closest to your nose. Since it occurs so slowly, many people cannot know that their vision is changing, especially at first.

But as the disease worsens, you may start to notice that you can’t see things aside anymore. Without treatment, it can eventually cause blindness.

Diagnosis of glaucoma

  • Characteristic changes in the optic nerve
  • Characteristic visual field defects
  • Exclusion of other causes
  • Intraocular pressure (IOP) usually> 21 mm Hg (but not required for diagnosis)
  • A patient’s disease should be suspected of any of the following:
  • The abnormal optic nerve in ophthalmoscopy
  • High IOP
  • Typical visual field defects
  • Family history

These patients (and those with any risk factors) should be referred to an ophthalmologist for a comprehensive examination that includes a comprehensive history, family history, optical disc examination (microscopy technique is preferred), formal visual field examination, tonometry, IOP measurement), central corneal thickness measurement, and / Or optic nerve and/or retinal nerve fibre layer imaging (using optical tomography), and gastroscopy (visualizing the angle of the anterior chamber with a special mirrored adhesive lens prism).

It is diagnosed when there are characteristic findings of optic nerve damage and other causes (such as multiple sclerosis) are excluded. High intraocular pressure increases the likelihood of a diagnosis, but intraocular elevation can occur in the absence of this disease and is not necessary to make a diagnosis.

Screening

Glaucoma screening can be performed by primary physicians by examining the visual fields with frequency doubling technique (FDT) and endoscopic assessment of the eye contour of the optic nerve. FDT perimeter measurement involves the use of a desktop machine that can check for visual field abnormalities that indicate the presence of glaucoma within 2 to 3 minutes per eye.

Although IOP should be measured, an assay that relies only on IOP has low sensitivity, low specificity, and low positive predictive value. Patients over 40 years of age and those with risk factors for open-angle glaucoma or angle-closure glaucoma should have a comprehensive eye exam every one to two years.

Risk factors for glaucoma

It is regularly called the “sneak thief of sight.” This is because, as referenced prior, by and large, eye weight can develop and devastate visual perception without causing evident side effects. Thus, awareness and early detection of this disease are very important because this disease can usually be treated successfully upon early diagnosis. While everybody is in danger of creating glaucoma, a few people are in a lot more danger and should be checked all the more regularly by an ophthalmologist.

The main risk factors for this disease include the following:

  • Age over 45 years old
  • Family history
  • Black ethnicity
  • Diabetic
  • History of high eye pressure
  • The decrease in corneal thickness and stiffness
  • Myopia (high myopia), which is the inability to see distant objects clearly
  • History of eye injury
  • Use of corticosteroids (steroids), either in the eye or systemically (by mouth or by injection)
  • Farsightedness (hyperopia), which is seeing distant objects better than close ones (farsighted people may have narrow drainage angles, exposing them to severe attacks [sudden] from angle-closure glaucoma.)

How is glaucoma treated?

The goal of treating glaucoma is to prevent further vision loss by controlling the pressure in the eye – such as controlling blood pressure to prevent a stroke. There are a few manners by which glaucoma can be dealt with effectively:

  • Medicines, in the form of eye drops or pills, lower pressure by reducing the amount of fluid produced in the eye, and by increasing drainage. At least one drug might be utilized simultaneously.
  • Laser therapy, which is performed on an outpatient basis, is used to reduce pressure in the eye. A system called laser trabeculoplasty improves fluid drainage in patients with open-angle glaucoma. People with closed-angle glaucoma usually need to be treated with a procedure called laser iridotomy, which creates a small opening in the iris (the coloured part of the eye), allowing the drainage angle to open.
  • Surgery may be needed to create a second drainage channel in the eye to support the natural channel. The medical procedure is generally performed on an outpatient premise with neighbourhood sedation and may permit the patient to diminish or dispose of glaucoma drugs.
  • For more advanced cases, an artificial glaucoma drainage implant may help reduce pressure. The implant helps drain excess fluid, which is then absorbed into the body.

Will a person with glaucoma go blind?

If the increased IOP can be stopped and the pressure returns to normal, vision loss may slow down or even stop. However, since there is no cure for this disease, you will likely need treatment for the rest of your life to regulate your internal eye pressure. Unfortunately, vision lost from glaucoma cannot be restored.

Prevention

There is no known way to prevent this disease, but detecting it early means it can be treated more effectively and reducing vision loss. Since there are often no symptoms, it is important to have your eyes checked regularly; Especially for people at higher risk.

Therefore, older adults, people of African or Hispanic descent, and individuals with diabetes should be tested every year or two after the age of 35. Ask your doctor how often you should be screened.

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