What is Glaucoma and its Risk Factors, Symptoms, Signs and Treatment?

Glaucoma is a common chronic and progressive eye condition caused by damage to the optic nerve. The optic nerve is a bundle of nerve fibres that connect the retina with the brain. Glaucoma often leads to vision loss, the main risk factor being eye pressure. Its main cause is an abnormality in the eye’s drainage system, causing fluid to build up, leading to excessive pressure on the optic nerve. This pressure leads to damage and can result in loss of eyesight.

Rather than a singular disease, glaucoma is a group of eye conditions whose symptoms start slowly and are sometimes unnoticeable. Usually, a comprehensive eye exam is administered to determine whether or not you have glaucoma. There’s no cure for glaucoma, but early detection and treatment can often stop the damage to maintain your vision.  

Different types of glaucoma

The two main types of glaucoma are chronic or open-angle glaucoma and acute or closed-angle glaucoma, but there are several more:

Open-angle (chronic) glaucoma

This is the most common form of glaucoma. In open-angle glaucoma, fluid in the eye drains too slowly and pressure builds up. Its typical risk factor is age, however, younger people can also develop this type of glaucoma.

Normal-Tension Glaucoma

This is a form of open-angle glaucoma, yet it is not related to high pressure within the optic nerve. Individuals with normal tension glaucoma are often particularly sensitive to normal levels of pressure. It is suggested that reduced blood supply to the optic nerve may also play a role in normal-tension glaucoma.

Pigmentary glaucoma (pigment dispersion syndrome)

This is another type of open-angle glaucoma that usually develops in early or middle adulthood. It occurs when the pigment cells that give colour to the iris are abnormally dispersed throughout the eye. These cells are thought to cause a blockage within the drainage channels in the eye. This affects the normal flow of fluid in the eye with the resistance leading to increased eye pressure.

Closed-angle (acute) glaucoma

Closed-angle glaucoma develops when the drainage system of the eye resists outflow of fluid. An attack occurs when there is a sudden rise in pressure, requiring emergency medical intervention. Unlike other types of glaucoma the signs are sudden and noticeable. These may include blurred vision, headaches, ocular pain, and vomiting. However the condition may be intermittent and brief resulting in a delay to seek medical attention.

Secondary Glaucoma

Secondary glaucoma is the result of another eye condition, such as inflammation, trauma, or a tumour often causing resistance to outflow mechanisms of the eye.

Childhood glaucoma (congenital glaucoma)

Congenital glaucoma is a rare type that occurs in very young children, caused by an abnormality in the eye. It occurs when there are incorrect or underdeveloped drainage channels in the eye during the prenatal period.

Risk factors

Age

Your risk for glaucoma increases with age, especially affecting those over the age of 60.

Poor eyesight

If you are particularly nearsighted or farsighted, this may also contribute to your risk of developing glaucoma.

Eye injury or surgery

Glaucoma can develop after an eye injury or eye surgery. Trauma can cause damage to the eye and increase the pressure at the time of trauma or in the future.

Comorbidities (related health conditions)

Certain health conditions and diseases contribute to the development of glaucoma. Diabetes, high blood pressure, and heart disease in particular increase your risk of glaucoma.

Long-term corticosteroid use

Using corticosteroids for an extended period of time may increase your risk of getting glaucoma.

Thin corneas

Thin corneas can lead to increased eye pressure, putting you at a higher risk of getting glaucoma.

Family history

Glaucoma is hereditary and runs in families so it’s important to know your medical history.

Signs and symptoms

Signs and symptoms vary depending on the type of glaucoma you have but when symptoms do develop, it is usually late in the disease. Early detection is almost impossible since symptoms such as an enlarged blind spot are barely noticeable. That being said, if you find that you have developed any of the following, get medical care right away:

• Vision loss

• Eye pain

• Severe headaches

• Seeing rainbows and halos around lights

• Eye redness

• Whitening/haziness of the cornea

• Patchy blind spots inside or central vision

• Nausea

• Vomiting

Vision loss begins around the edges of an individual’s visual field and slowly creeps into central vision. It can take months or even years after the nerve damage has occurred to notice the symptoms but once vision is lost, it can’t be recovered.

However, there are various lifestyle choices you can make to help prevent getting glaucoma:

• Find out your family’s medical, and specifically eye health history.

• Get regular comprehensive eye exams.

• Exercise regularly to help reduce eye pressure.
• Wear eye protection when necessary.

Treatment and prognosis

The cause of the increased pressure in the eye can help determine the type of glaucoma and the best treatment for it. Treatment, however, cannot reverse the damage that has already occurred but it can prevent it from worsening. 

Eye doctors can use medicines to treat glaucoma by lowering the pressure on the optic nerve. Individuals with glaucoma often find that they must take these medicines for life to control the pressure and reduce the risk of vision loss. They usually come in the form of drops, but there are also pills or topical ointments available that work to lower the amount of fluid produced in the eye or improve fluid drainage.

Some people may need eye surgery to control their condition, while laser treatment is also very useful for treating glaucoma as it avoids cutting parts of the eye.

Bottomline 

Glaucoma often has no symptoms in its early stages. Most individuals don’t even know that they have it. This is why regular eye exams are important and can help your ophthalmologist test for and detect the disease before vision loss. Unfortunately, glaucoma damage is permanent and cannot be reversed. However, medicine and surgery help prevent further damage. 

For more information please contact Dr L. Raman-Abdula, Ophthalmic Surgeon at Randfontein Private Hospital

Tell:  087 087 2653