There are many forms of glaucoma. The most common form is called primary open angle glaucoma. With increasing age the drainage canals of the eye become narrowed creating a relative resistance to fluid outflow from the eye leading to increased intraocular pressure and functional loss of the peripheral vision. It is currently unclear why this happens.
Glaucoma can also be secondary to inflammation, steroid use, hypermature cataracts, trauma, and hemorrhage.
A rare form of glaucoma is called angle closure glaucoma. As with all forms of glaucoma, this form can only be diagnosed by your eye doctor. Warning labels on medications such as cold medicines and incontinence drugs, to name a few, refer to this very rare form of glaucoma that is found more commonly in farsighted females.
How frequent is glaucoma?
Open Angle Glaucoma occurs in approximately 1/10th of 1 % of people in their 40’s. This risk increases to almost 15% in those people in their 80’s. Blacks are affected more than whites and Hispanics.
What are the symptoms of glaucoma?
As mentioned above, there are no warning signs that primary open angle glaucoma is present until it has caused serious damage to the optic nerve and irreversible loss of peripheral vision. Secondary forms of glaucoma can be associated with light sensitivity, blurred vision, a history of trauma, and pain. Angle closure glaucoma is accompanied by severe pain associated with nausea and vomiting, blurry vision, and rainbows around lights.
Your eye doctor can determine the risk for or the extent of glaucoma damage by performing sophisticated tests such Visual Fields, Fundus Photography, OCT(), Gonioscopy, and Intraocular Pressure measurements.
What are the treatments for glaucoma?
Treatment for glaucoma primarily involves topical eye drops. The mechanism of action involves blocking the production of intraocular fluid, or enhancing its out flow. These drops are taken once or twice a day generally for the life of the patient. If taken responsibly, most glaucoma can be controlled with eye drops alone.
Noncompliance with eye drops is a frequent and serious problem. Many patients avoid taking their glaucoma drops because of the cost, inconvenience, or potential side effects.
ALT and SLT (Selective Laser Trabeculoplasty) are laser treatments of the drain of the eye to reduce the pressure. Their effect of pressure lowering is excellent but may last for only 2-3 years. Laser iridotomy is a laser procedure used to prevent angle closure glaucoma.
Surgical management of glaucoma is generally reserved for those cases that cannot be controlled by glaucoma drops and laser therapy. Procedures such as Trabeculectomy, Trabeculotomy, Goniotomy, Tube Shunts, viscocanalostomy, and microshunts work by creating a shunt to enhance fluid out flow there by lowering intraocular pressure.
One of the most common methods for lowering eye pressure is cataract surgery. While this does not work in all cases, studies have shown that cataract surgery alone lowers intraocular pressure by as much 30 %.