Glaucoma

What is Glaucoma?

Glaucoma is a disease that damages the eye’s optic nerve. It usually happens when fluid builds up in the front part of your eye, which leads to increased pressure in your eye, damaging the optic nerve. Glaucoma is a leading cause of blindness in Egypt and Worldwide for people over 60 years old. Blindness from glaucoma can often be prevented with early diagnosis and treatment.

Types of Glaucoma:

• Primary open-angle glaucoma:

This is the most common type of glaucoma. It is painless and causes no vision changes at first. It happens slowly, where the eye does not drain fluid as well as it should. As a result, eye pressure builds and starts to damage the optic nerve. Some people can have optic nerves that are sensitive and their risk of getting glaucoma is higher than normal. Regular eye exams are important to find early signs of damage to their optic nerve, especially if there is a family history.

• Angle-closure glaucoma or narrow-angle glaucoma:

This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle.  Eye pressure can rise very quickly and the drainage angle can get completely blocked. This is a true eye emergency, and you should see your ophthalmologist right away or you might go blind.

 

*Here are the signs of an acute angle-closure glaucoma attack:

• vision is suddenly blurry.
• Severe eye pain.
• Headache.
• You feel sick to your stomach (nausea) or vomiting.
• Seeing rainbow-colored rings or halos around lights.

Many people with angle-closure glaucoma develop it slowly. There are no symptoms at first, so they don’t know they have it until the damage is severe or they have an attack.

Angle-closure glaucoma can cause blindness if not treated right away.

Causes of glaucoma?

Your eye constantly makes aqueous humor. As new aqueous flows into your eye, the same amount should drain out through an area called the drainage angle. This process keeps pressure in the eye (called intraocular pressure or IOP) stable. If the drainage angle is not working properly, fluid builds up which increases the pressure inside the eye and damages the optic nerve.

The optic nerve is made of more than a million tiny nerve fibers.  As these nerve fibers die, you will develop blind spots in your vision. You may not notice these blind spots until most of your optic nerve fibers have died. If all of the fibers die, you will become blind.

Who is at Risk for Glaucoma?

Some people have a higher than normal risk of getting glaucoma. Talk with your ophthalmologist about the risk of getting glaucoma. If you have more than one of these risk factors then you have a higher risk of glaucoma.

This includes people who:

• are over age 40.
• have family history of glaucoma.
• are of African, Hispanic, or Asian heritage.
• have high eye pressure.
• are farsighted or nearsighted.
• have had an eye injury.
• use long-term steroid medications.
• have corneas that are thin in the center.
• have diabetes, migraines, high blood pressure or poor blood circulation.

How to Diagnose Glaucoma?

The only sure way to diagnose glaucoma is with a complete eye exam. A glaucoma screening that only checks eye pressure is not enough to find glaucoma.

-During a glaucoma exam, your ophthalmologist will:

• measure your eye pressure.
• inspect your eye’s drainage angle.
• examine your optic nerve for damage.
• test your peripheral (side) vision.
• take a picture or computer measurement of your optic nerve.
• measure the thickness of your cornea.

Glaucoma Treatment:

-Medical:

Eyedrop medicines are helpful in treating glaucoma.

It is extremely important to use your glaucoma eye drops exactly as your ophthalmologist tells you to. That includes taking every dose, every day. If you do not do this, you may lose vision.

Also, remember to tell your other doctors which medicines you take for glaucoma. As with any medication, glaucoma eye drops can cause side effects.

There are many types of glaucoma medications. Your eye doctor will chose the medication that is best for you.

*Laser Surgery:

There are two types of laser surgery to treat glaucoma. They help aqueous drain from the eye, and they are short procedures that are usually done in clinic.

-Operating room surgery:

Patients who have advanced disease that is not controlled with drops or laser might need glaucoma surgery, which is done in an operating room. It creates a new drainage channel for the aqueous humor to leave the eye.

Trabeculectomy or a Glaucoma drainage tube are the main glaucoma surgeries. The goal of each surgery is to lower the intraocular pressure.