Conditions

Glaucoma

Learn about this condition that can damage the optic nerve.

What is Glaucoma?

Glaucoma is a group of eye conditions that damage the optic nerve, often due to increased pressure within the eye. Assessment and treatment can limit risks such as vision loss.

Glaucoma is a build-up of pressure within the eye that can lead to serious vision loss and blindness. When pressure in the eye increases, it can begin to damage the optic nerve, irreversibly affecting vision.

Early detection of glaucoma allows it to be treated to prevent serious vision loss.

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Symptoms

There are two main ways in which pressure can build up in the eye and cause glaucoma:

The eye regulates pressure through something called a drainage angle. Open-angle glaucoma occurs when this becomes partially blocked leading to a build-up of pressure. Open-angle is the most common type of glaucoma, accounting for up to 90% of cases. It is also the most gradual, meaning it is easier to manage with treatments to control pressure in the eye.

There are initially no symptoms with open-angle glaucoma and it is usually identified during an eye exam. Eventually, reduced peripheral vision will become noticeable and eyesight will gradually deteriorate.

This type of glaucoma is rarer and more serious than open-angle glaucoma. When eye pressure builds up quickly, this can cause severe symptoms and permanent vision loss. Closed-angle glaucoma, also called acute-angle closure glaucoma, is considered a medical emergency.

Symptoms of closed-angle glaucoma will appear rapidly. They include severe eye pain, red eyes, headache, nausea, blurry vision and coloured halos around bright lights.

One rare type of glaucoma is congenital glaucoma in which the condition is present from birth or emerges in early childhood. Congenital glaucoma is divided into primary and secondary cases: the former occurs independently of any underlying causes while the latter may be the result of another condition or injury.

Regular eye examinations offer the best opportunity to catch the condition early on, allowing for more effective treatment. Optometrists can diagnose the condition by checking the pressure within the eye, carrying out a visual field test or examining the optic nerve using a slit lamp or advanced scanning technology. As with most eye conditions, it is better to diagnose glaucoma sooner rather than later.

The condition is much more common among older people, but there are other factors as well. For example, people of African descent are more likely to develop the condition as are those who have a close family member with glaucoma.

Causes

Glaucoma is a group of eye conditions that can damage the optic nerve and lead to vision loss. The exact cause of glaucoma is not always clear, but some common factors that can contribute to the development of glaucoma include:
Elevated pressure within the eye (intraocular pressure) is a major risk factor for glaucoma. This increased pressure can damage the optic nerve over time.
Glaucoma is more common in older adults, with the risk increasing with age.
Certain ethnic groups, such as African Americans and Hispanics, have a higher risk of developing glaucoma.
People with thinner corneas may be at an increased risk of developing glaucoma.
Certain eye conditions or anatomical features, such as a shallow anterior chamber or narrow angles, can increase the risk of glaucoma.
Conditions such as diabetes, high blood pressure, and cardiovascular disease may increase the risk of glaucoma.
Previous eye injuries or surgeries can sometimes lead to the development of glaucoma.
It is important to have regular eye examinations, especially if you have risk factors for glaucoma, to detect the condition early and prevent vision loss.

Treatments

While glaucoma cannot be cured, its symptoms can be managed and pressure in the eye can be controlled using medicated eye drops, laser surgery and other procedures.

Closed-angle glaucoma

Closed-angle glaucoma needs to be treated immediately. Medication is used to stabilise the pressure within the eye and then surgery is performed to create a longer-lasting solution. A laser peripheral iridotomy is often performed in which a tiny hole is created, allowing the eye to drain fluid and relieve pressure.

Open-angle glaucoma

For open-angle glaucoma, medicated eye drops are usually prescribed first. If these don’t succeed in limiting pressure build-up, surgery is often recommended. A laser treatment called Trabeculoplasty is often used in which the eye’s drainage angle is cleared to reduce eye pressure.
No one treatment is right for everyone and finding the right choice for you can take some expert help.

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