Glaucoma: Symptoms, Causes, Treatment

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Glaucoma is one of the serious eye conditions and one of the leading causes of blindness around the world. Although early detection and treatment could prevent permanent loss of vision, most people are not aware of the symptoms before the disease has progressed too far. Hence, we will proceed to know the symptoms, causes, and the treatment given for glaucoma.

What is Glaucoma?

Glaucoma is the group of eye diseases leading to damage or injury to the optic nerve, that is, the transmission part of the eye which provides visual information from the retina to the brain. Elevated intraocular pressure has been a vital cause of many cases of glaucoma as it can cause irreversible vision loss if increased over time. The condition is sometimes termed the “silent thief of sight” since it develops slowly and painlessly until noticeable symptoms develop.

Common Symptoms of Glaucoma

Knowledge of the early warning signs of glaucoma would lead to diagnosis and treatment in good time. Among the most typical symptoms are  :

  • Gradual loss of peripheral vision: Usually unnoticed, this symptom can be advanced until the center of vision is affected.
  • Eye pain or soreness: This can be as a result of severe pain the patients with acute angle-closure glaucoma.
  • Headache: In acute cases, headaches may also occur due to the onset of pressure at the back of the eye.
  • Poor vision: Usually, with more and more damage to the optic nerve, there is less sign of fuzzy or blurry vision.
  • Seeing lights with halos surrounding them: This condition is very prevalent at night when lights appear to have an aura or halo around them.
  • Sudden loss of vision: This can occur in the advanced stages or in the acute form of glaucoma.

Any of the above symptoms require prompt presentation to an eye hospital in Lucknow as early treatment can prevent total blindness drastically.

What Triggers Glaucoma?

Glaucoma predominantly occurs because of increased intraocular pressure, however, there are many other reasons that lead to this condition:

  • Age: People who are over 60 years old are more at risk of getting glaucoma.
  • Genetics: A family history of glaucoma increases the risk of this disease.
  • Eye Injuries: Blunt eye trauma causes secondary glaucoma. The pressure can be due to the injury.
  • Diseases: Diabetic, hypertension, and ocular hypertension are some of the most common risk factors.
  • Long-term use of steroids: Corticosteroid medication raises IOP. Thus, more risk is added to glaucoma.

Symptoms of Glaucoma

One of the things that makes glaucoma so difficult to address is that early on, it may not have obvious symptoms. This is especially true of open-angle glaucoma, as it develops gradually over a period of years. Therefore, many people with glaucoma do not know they have the condition until irreversible loss of vision has taken place. The recognition of possible symptoms can lead to much earlier detection and treatment .

Common symptoms of glaucoma include :

  • Peripheral vision loss gradually: This is the first sign of open angle glaucoma
  • Blurred vision: This may indicate advanced stages of glaucoma or rapid onset of eye pressure.
  • Severe pain: Such people complain of severe eye pain. Acute angle-closure glaucoma can cause this
  • Lights appear to have halos: Some patients report that they can see lights having halos around them. People are more likely to observe such halos while looking in night and bright lights.
  • Redness of eyes: Redness and irritation can sometimes be symptoms of increased pressure within the eye.
  • Headaches: Headache, alongside eye pain or dim vision, is also the symptom in patients suffering from glaucoma.
  • Nausea and vomiting: More commonly seen in the acute form of glaucoma
  • Sudden loss of vision: In some rare and aggressive forms of glaucoma, it might lead to sudden loss of vision.

If you have any of these symptoms, especially intense eye pain or loss of vision, report immediately to an eye hospital in Lucknow. Timely diagnosis is the key to good management and the prevention of permanent damage.

Types of Glaucoma

here are different types of glaucoma; each type is managed with its own set of treatments. The different varieties can help in early detection and hence management.

Open-Angle Glaucoma

This is the most common type and usually starts slowly with little to no symptoms at all. It happens because the drainage system of the eye becomes less efficient with time resulting in a rise in pressure within the eye. The only sure way one can find out about this early is through regular examinations since loss of vision results to be without noticing anything happening.

Angle-Closure Glaucoma

This form is more severe; it occurs if the iris covers too close to the angle of drainage in the eye, thereby blocking fluid flow. The rate at which the pressure in the eye increases leads to sudden symptoms of pain, blurred vision, nausea, and vomiting. Emergency treatment is required to avoid permanent vision loss.

Normal-Tension Glaucoma

The optic nerve gets damaged in spite of the fact that normal intraocular pressure exists in this type of glaucoma. Researchers believe that bad circulation to the optic nerve, or an optic nerve that is more sensitive, may be the culprits. Visit an eye hospital in Lucknow regularly if you suspect it. 

Pediatric and Congenital Glaucoma

Glaucoma can also occur in children, either at birth or shortly thereafter. Pediatric glaucoma is a rare entity, though prompt detection and treatment could prevent vision loss. Congenital glaucoma occurs because the drainage canals of the eye develop improperly.

Pigmentary Glaucoma

In pigmentary glaucoma, pigment granules are released from the iris and migrate into drainage channels of the eye, subsequently blocking the flow of these channels due to the accumulation and increasing pressure.

The form occurs more often in younger adults and sometimes varies with physical activity.

Clinical Diagnosis of Glaucoma

Early detection of glaucoma may prevent loss of vision due to glaucoma. A comprehensive eye examination at Lucknow Eye Hospital performs a large number of tests to check whether the patient suffers from a disease or has the susceptibility to develop one. Some of these tests include;

  • Tonometry: The test measures the pressure on the inside of the eye. High pressure in the eye can trigger glaucoma.
  • Ophthalmoscopy: the ophthalmologist applies a specific device to observe for the presence of any damage to the optic nerve.
  • Visual Field Test: This test checks the outer periphery as it is where the manifestations occur early in cases of glaucoma.
  • Pachymetry: this is the test intended to determine the thickness of the cornea. It could influence intraocular pressure readings.
  • Gonioscopy: This involves the assessment of the drainage angle of the eye being either open or closed.

Even though glaucoma is not curable, there have been various treatment methods that have been provided to control the disease and further avoid damage.

Glaucoma Medications

The most common preliminary course is the medical treatment of glaucoma in the form of eye drops. The medications are either made up of drugs that reduce fluid production in the eyes or facilitate them to pass more promptly. 

These include:

  • Prostaglandin analogs: Increase the fluid drainage.
  • Beta-blockers: Reduce the rate of fluid produced by the eyes.
  • Alpha-adrenergic agonists: They have both functions; they assist in decreasing the production of the fluid as well as in promoting drainage.

Glaucoma Surgery

Glaucoma surgeries are opted for if medication alone is not successful. The surgical treatment can take up from laser treatment to fully invasive procedures:

Laser Trabeculoplasty: Laser Trabeculoplasty is one of the treatments for open-angle glaucoma and serves quite well by improving fluid drainage in the eyes.

Minimally Invasive Glaucoma Surgery (MIGS): These are the latest treatment modalities with minimal side effects and quicker recovery periods compared to others.

Glaucoma Drainage Implants: These are implants that are placed inside the eye to facilitate drainage of fluid from the eye, thereby reducing intraocular pressure.

Traditional Glaucoma Surgeries

In severe cases, trabeculectomy-a surgical procedure in which a new pathway for drainage is created- is necessary. The glaucoma drainage implant is another traditional method in which a glaucoma drainage implant is placed inside the eye to create an accessory drainage path for the fluid to be drained from the eye and consequently reduce intraocular pressure.

Surgical Glaucoma Surgery

Surgery would then be recommended when other drugs fail to reduce the intraocular pressure. There are two forms of glaucoma surgery based on how severe the case may be.

Laser Surgery

Laser surgery is a minimally invasive surgery as it improves the draining system in the eyes. There are several forms of laser surgery, and any of the following could be the one:

Laser Trabeculoplasty : Laser Trabeculoplasty It is for open-angle glaucoma in which laser light is used to open the drainage canals and hence fluid would be moving freely.

Laser Iridotomy: It is for the treatment of angle-closure glaucoma, whereby a small hole is created in the iris to permit freer fluid flow.

 Minimally Invasive Glaucoma Surgery (MIGS)

Increasingly popular is the MIGS procedure, as it poses fewer risks and shortens the period for recovery compared to the conventional surgery method. MIGS makes tiny incisions that have microscopic devices inserted to boost fluid outflow. MIGS is usually recommended for patients who have mild to moderate glaucoma cases.

Controlling Glaucoma Progression

Although glaucoma cannot be prevented entirely, the progress of glaucoma can be slowed with prompt intervention. Regular eye examinations are required, especially for patients at higher risk. Individuals with a family history of glaucoma or other diseases like diabetes should undergo annual screenings at an eye hospital in Lucknow. Overall, good eye care through diet and exercise should contribute to a minimized risk.

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