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Glaucoma: A Silent Thief of Sight

Glaucoma is an eye condition that directly damages the optic nerve (the bundle of nerve fibers that carries information from the eye to the brain). This damage is often caused by an increased pressure in the eye, known as intraocular pressure (IOP). The optic nerve is crucial for vision, and if it becomes damaged, it can lead to vision loss and blindness.
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  • Open-angle glaucoma :– This is the most common form. The drainage angle where the iris meets the cornea is open, but the trabecular meshwork (the drainage system within the eye) becomes less efficient over time, leading to an increase in intraocular pressure
  • Angle-closure glaucoma :– In this type, the drainage angle between the iris and cornea is closed or blocked, causing a sudden increase in intraocular pressure. This is considered a medical emergency
  • Normal-Tension Glaucoma (NTG) :- In Normal Tension Glaucoma, optic nerve damage and vision loss occur despite normal intraocular pressure. The exact cause of this type is not fully understood, but factors such as reduced blood flow to the optic nerve may play a major role.
  • Secondary Glaucoma :- Secondary glaucoma can be caused by eye injuries, inflammation, tumors, or other conditions that affect fluid drainage from the eye.
  • Pigmentary Glaucoma :- Pigmentary Glaucoma occurs when pigment granules from the iris build up in the drainage channels of the eye, which leads to increased intraocular pressure and optic nerve damage.
  • Exfoliative Glaucoma :- This type is associated with the shedding of material from the outer layer of the lens. The material can block the drainage angle, leading to increased intraocular pressure.
  • Congenital Glaucoma :- This rare form of glaucoma is present at birth and is usually caused by an abnormal development of the eye’s drainage system. It requires prompt medical attention.

Glaucoma is known as the “silent thief of sight” because it progresses slowly and without noticeable symptoms in its early stages. However, as the condition advances, symptoms may become more apparent. It’s important to notice symptoms on time, otherwise significant vision loss may happen.

  • Loss of peripheral vision
  • Tunnel vision (narrowed vision)
  • Blurred vision
  • Halos around lights
  • Headache and eye pain
  • Changes in eye color
  • Red eyes

Glaucoma is generally associated with increased intraocular pressure (IOP), which can damage the optic nerve over time. However, the exact cause of increased intraocular pressure and subsequent optic nerve damage is not always clear. There are several factors and types of glaucoma, each with its potential causes. 


Here are some contributing factors:

  • Increased Intraocular Pressure (IOP):  the most common risk factor for glaucoma, eyes continuously produce and drain a fluid called aqueous humor. If this drainage system is compromised or the eye produces too much fluid, the intraocular pressure can increase.
  • Age: The risk of glaucoma increases with age. Primary open-angle glaucoma, the most common form, is often associated with aging.
  • Family History: Individuals with a family history of glaucoma are at a higher risk of developing the condition. There may be a genetic predisposition for certain types of glaucoma.
  • Race and Ethnicity: Some ethnic groups, particularly individuals of African, Asian, and Hispanic descent, have a higher risk of developing certain types of glaucoma.
  • Medical Conditions: Certain medical conditions, such as diabetes and high blood pressure, can increase the risk of glaucoma. Conditions that affect blood flow to the optic nerve may contribute to the development of Glaucoma.
  • Eye Trauma: Injuries to the eye, especially those causing bleeding, can result in secondary glaucoma. This type of glaucoma may develop immediately after the injury or years later.
  • Use of Steroids: Long-term use of corticosteroid medications, whether in the form of eye drops, pills, or inhalers, can increase the risk of developing glaucoma.
  • Other Eye Conditions: Certain eye conditions, such as uveitis (inflammation of the eye), tumors, and conditions that block the drainage channels within the eye, can contribute to increased intraocular pressure and glaucoma.
  • Thin Corneas: People with thinner corneas may have an increased risk of developing glaucoma. The cornea is the clear front part of the eye.
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Treatments for Glaucoma

 

The treatment of glaucoma aims to lower intraocular pressure (IOP) to prevent or slow down further damage to the optic nerve. The specific treatment plan depends on the type and severity of glaucoma. Here are some common  glaucoma treatments:

Prescription Eye Drops: Eye drops increase the outflow of aqueous humor (fluid) from the eye, and reduce intraocular pressure or decrease the production of aqueous humor. 

Oral Medications: In some cases when eye drops are not effective oral medications may be prescribed, particularly for certain types of glaucoma.

Laser Therapy

  • Laser Peripheral Iridotomy (LPI): Used for angle-closure glaucoma, this procedure creates a small hole in the iris to improve drainage.
  • Laser Trabeculoplasty: This procedure is often used for open-angle glaucoma and involves applying laser energy to the trabecular meshwork to enhance drainage.

Surgery

  • Trabeculectomy: This surgical procedure creates a new drainage channel for the aqueous humor to reduce intraocular pressure.
  • Minimally Invasive Glaucoma Surgery (MIGS): New surgical techniques that involve less tissue disruption than traditional surgeries.

Drainage Implants: Sometimes a drainage tube shunt may be surgically implanted to help drain excess fluid from the eye.

Regular Monitoring: Regardless of the treatment method, regular monitoring and follow-up appointments with glaucoma eye specialists are essential to assess the effectiveness of the treatment and make adjustments as needed.

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