Glaucoma is a collection of eye disorders that cause damage to the optic nerve, which is essential for proper vision. This injury is frequently caused by extremely high ocular pressure.
For those over the age of 60, glaucoma is one of the major causes of blindness. It may happen at any age, although it is more frequent in elderly people.
Many types of glaucoma have no symptoms. Because the effect is so gradual, you may not detect a change in vision until the problem has advanced.
Because glaucoma vision loss cannot be restored, it is critical to have frequent eye exams that include measures of your eye pressure so that a diagnosis can be made and proper treatment may be provided. Vision loss can be delayed or avoided if glaucoma is detected early. If you have the illness, you will almost certainly require therapy for the rest of your life.
WHAT ARE THE SYMPTOMS OF GLAUCOMA?
Glaucoma signs and symptoms differ based on the kind and stage of your illness. For instance:
Open-angle glaucoma
- Patchy blind patches in your peripheral (side) or central vision, often in both eyes
- Tunnel vision in its latter phases
Acute angle-closure glaucoma
- Extensive headache
- Eye pain
- Vomiting and nausea
- Blurred vision
- Lights with halo effects
- Redness of the eyes
Glaucoma will eventually cause blindness if left untreated. Even with therapy, around 15% of patients with glaucoma lose sight in at least one eye after 20 years.
WHAT ARE THE CAUSES OF GLAUCOMA?
Glaucoma is caused by damage to the optic nerve. Blind patches appear in your vision field when this nerve deteriorates. This nerve injury is generally associated with increased ocular pressure for reasons that doctors do not completely understand.
Elevated eye pressure is caused by a buildup of a fluid (aqueous humor) that circulates inside your eye. This internal fluid generally drains via a tissue called the trabecular meshwork at the iris-cornea junction. When fluid is overproduced or the drainage mechanism fails, the fluid cannot flow out at its typical pace, causing ocular pressure to rise.
Glaucoma often runs in families. Scientists have discovered genes linked to excessive eye pressure and optic nerve injury in certain people.
Glaucoma comes in several forms, they include:
- Open-angle glaucoma: The most prevalent kind of glaucoma is open-angle glaucoma. Although the drainage angle produced by the cornea and iris is open, the trabecular meshwork is partially occluded. As a result, the pressure in the eye steadily rises. The optic nerve is damaged as a result of this pressure. It happens so slowly that you may lose sight before you realize there's an issue.
- Angle-closure glaucoma: Angle-closure glaucoma, also known as closed-angle glaucoma, is caused by the iris bulging forward, narrowing or blocking the drainage angle created by the cornea and iris. As a result, fluid is unable to flow within the eye, and pressure rises. Some people have limited drainage angles, which puts them at risk of angle-closure glaucoma.
Angle-closure glaucoma can develop quickly (acute angle-closure glaucoma) or gradually (progressive angle-closure glaucoma) (chronic angle-closure glaucoma). Acute angle-closure glaucoma is a life-threatening condition.
- Normal-tension glaucoma: Even if your eye pressure is within the usual range, your optic nerve is injured with normal-tension glaucoma. Nobody knows why this is happening. You may have a sensitive optic nerve, or your optic nerve may be receiving less blood. This restricted blood flow might be caused by atherosclerosis, which is the accumulation of fatty deposits (plaque) in the arteries, or by other disorders that affect circulation.
- Glaucoma in children: Glaucoma can develop in newborns and children. It might be present at birth or develop over the first few years of life. Drainage obstructions or an underlying medical issue may cause optic nerve injury.
- Pigmentary glaucoma: Pigment granules from your iris accumulate in the drainage canals of your eye, delaying or obstructing fluid outflow. Jogging, for example, can cause the pigment granules to be stirred up, depositing them on the trabecular meshwork and creating occasional pressure increases.
WHAT ARE THE RISK FACTORS FOR GLAUCOMA?
Because chronic glaucoma can ruin eyesight before any signs or symptoms appear, be aware of the following risk factors:
- Having high internal eye pressure (intraocular pressure)
- Being above the age of 60
- Being a black, Asian, or Hispanic person
- Being farsighted or highly nearsighted
- Having suffered an eye injury or undergone various forms of eye surgery
- Having a glaucoma-related family history
- Having diabetes, heart problems, high blood pressure, or sickle cell anemia
- Having thin corneas in the center
- Long-term use of corticosteroid medicines, particularly eyedrops
HOW IS GLAUCOMA DIAGNOSED?
Your doctor will go over your medical history and provide a thorough eye check. He or she may conduct a variety of tests, including:
- Intraocular pressure measurement (tonometry)
- Imaging tests and dilated eye examinations to check for optic nerve damage
- Examining regions of eyesight loss (visual field test)
- Corneal thickness measurement (pachymetry)
- Examining the drainage angle (gonioscopy)
WHAT ARE THE TREATMENTS FOR GLAUCOMA?
The effects of glaucoma cannot be reversed. However, medication and frequent exams can help decrease or prevent vision loss, especially if the illness is detected early.
Glaucoma is treated by reducing your intraocular pressure (intraocular pressure). Depending on your circumstances, you may be able to use prescription eyedrops, oral drugs, laser therapy, surgery, or a combination of these.
Eyedrops
Prescription eyedrops are frequently used to begin glaucoma therapy. These can help lower eye pressure by changing how fluid drains from your eye or by reducing the quantity of fluid produced by your eye. Depending on how low your eye pressure needs to be, you may require more than one of the eyedrops listed below.
Prescription eyedrop drugs include the following:
- Prostaglandins: These accelerate the flow of fluid out of your eye (aqueous humor), lowering your eye pressure. Latanoprost (Xalatan), travoprost (Travatan Z), tafluprost (Zioptan), bimatoprost (Lumigan), and latanoprostene bunod are examples of medications in this category (Vyzulta).
Mild reddening and stinging of the eyes, darkening of the iris, darkening of the pigment of the eyelashes or eyelid skin, and impaired vision are all possible adverse effects. This type of medication is just taken once a day.
- Rho kinase inhibitor: This medication reduces ocular pressure by inhibiting the rho kinase enzymes that cause fluid accumulation. It is marketed as netarsudil (Rhopressa) and is administered once daily. Eye redness, irritation, and deposits accumulating on the cornea are all possible adverse effects.
- Beta blockers: These relieve the pressure in your eye by reducing fluid production in your eye (intraocular pressure). Timolol (Betimol, Istalol, Timoptic) and betaxolol are two examples (Betoptic).
Breathing difficulties, decreased heart rate, reduced blood pressure, impotence, and weariness are all possible adverse effects. Depending on your situation, this kind of medication may be administered once or twice daily.
- Carbonic anhydrase inhibitors: These medications lessen the amount of fluid produced in your eye. Dorzolamide (Trusopt) and brinzolamide are two examples (Azopt). A metallic taste, frequent urination, and tingling in the fingers and toes are all possible adverse effects. This kind of medication is often administered twice daily, although it can also be prescribed three times each day.
- Alpha-adrenergic agonists: These decrease aqueous humor production and promote fluid outflow in your eye. Praclonidine (Iopidine) and brimonidine are two examples (Alphagan P, Qoliana).
An erratic heart rate, elevated blood pressure, weariness, red, itchy, or swollen eyes, and dry mouth are all possible adverse effects. This kind of medication is often administered twice daily, although it can also be prescribed three times each day.
- Miotic or cholinergic agents: These increase the amount of fluid that drains from your eye. Pilocarpine is one example (Isopto Carpine). Headache, eye discomfort, smaller pupils, potential hazy or dim vision, and nearsightedness are all possible side effects. This type of medication is typically administered up to four times per day. These drugs are no longer often recommended due to the risk of adverse effects and the requirement for regular administration.
Because part of the eyedrop medication is taken into your circulation, you may have some unrelated side effects. Close your eyes for one to two minutes after applying the drops to reduce absorption. You may also shut the tear duct by softly pressing the corner of your eyes near your nose for one or two minutes. Wipe any remaining droplets from your eyelid.
If you need to use artificial tears or have been prescribed numerous eyedrops, spread them out so that you wait at least five minutes between types of drops.
Oral medications
If eyedrops alone are ineffective in lowering your eye pressure, your doctor may prescribe an oral drug, commonly a carbonic anhydrase inhibitor. Frequent urination, tingling in the fingers and toes, sadness, stomach distress, and kidney stones are all possible adverse effects.
Surgery and other treatments
Laser therapy and several surgical techniques are also therapeutic possibilities. The following treatments are designed to increase fluid outflow within the eye and thereby decrease pressure:
- Laser therapy: If you have open-angle glaucoma, you may be able to benefit from laser trabeculoplasty. It is completed at your doctor's office. A tiny laser beam is used by your doctor to unblock congested passages in the trabecular meshwork. It may take a few weeks for the full impact of this surgery to be felt.
- Filtering surgery: A trabeculectomy is a surgical operation in which your surgeon makes a hole in the white of the eye (sclera) and removes part of the trabecular meshwork.
- Drainage tubes: Your eye surgeon inserts a thin tube shunt into your eye to drain extra fluid and reduce your eye pressure.
- Minimally invasive glaucoma surgery (MIGS): To reduce your eye pressure, your doctor may recommend a MIGS surgery. These treatments are less risky and need less immediate postoperative care than trabeculectomy or the installation of a drainage device. They are frequently used in conjunction with cataract surgery. There are several MIGS procedures available, and your doctor will explain which one is best for you.
You'll need to see your doctor for follow-up checks after your operation. Additionally, if your eye pressure continues to rise or other abnormalities occur in your eye, you may need to undergo additional operations.
Acute angle-closure glaucoma treatment
Acute angle-closure glaucoma is a life-threatening condition. If you have this problem, you will require immediate therapy to decrease the pressure in your eye. This will usually need both medicine and laser or other surgical techniques.
A laser peripheral iridotomy is a technique in which the doctor uses a laser to create a tiny hole in your iris. This permits fluid (aqueous humor) to pass through and relieves eye pressure.
HOME REMEDIES FOR GLAUCOMA
These suggestions may assist you in controlling high blood pressure or promoting eye health.
- Maintain a nutritious diet: A nutritious diet can help you stay healthy, but it won't keep your glaucoma from progressing. Several vitamins and minerals, including zinc, copper, selenium, and antioxidant vitamins C, E, and A, are essential for eye health.
- Exercise with caution: Regular exercise may help lower ocular pressure in people with open-angle glaucoma. Consult your doctor about a suitable workout routine.
- Drink plenty of fluids: Only drink modest amounts of fluids at any one moment of the day. A quart or more of any liquid consumed in a short period of time may temporarily elevate ocular pressure.
- Elevate your head when sleeping: Using a wedge cushion that elevates your head by around 20 degrees as you sleep has been demonstrated to minimize intraocular pressure.
- Take the medication as directed: Using your eyedrops or other drugs exactly as directed will help you obtain the greatest results from your therapy. Make certain you utilize the drops precisely as directed. Otherwise, the damage to your optic nerve may increase.
- Caffeine use should be limited: Caffeine-containing drinks may cause an increase in your ocular pressure.
Alternative medicine
Some complementary and alternative medicine options may benefit your general health, but none are effective glaucoma treatments. Discuss the potential advantages and hazards with your doctor.
- Herbal treatments: Some herbal products, such bilberry extract, have been promoted as glaucoma treatments. However, further research is required to demonstrate their usefulness. Do not substitute herbal supplements for established therapy.
- Relaxation techniques: Acute angle-closure glaucoma can be triggered by stress. Find healthy strategies to cope with stress if you are at risk for this illness. Meditation and other practices may be beneficial.
- Marijuana: According to research, marijuana reduces ocular pressure in persons with glaucoma, but only for three to four hours. Other, more conventional therapies are more successful. Marijuana is not recommended by the American Academy of Ophthalmology for the treatment of glaucoma.
HOW CAN GLAUCOMA BE PREVENTED?
These self-care measures can assist you in detecting glaucoma in its early stages, which is critical for avoiding vision loss or delaying its progression.
- Get dilated eye exams on a regular basis: Regular comprehensive eye exams can aid in the early detection of glaucoma, before major damage develops. The American Academy of Ophthalmology advises a complete eye exam every five to ten years if you're under 40, every two to four years if you're 40 to 54, every one to three years if you're 55 to 64, and every one to two years if you're over 65. If you are predisposed to glaucoma, you will require more regular screening. Inquire with your doctor about the best screening schedule for you.
- Understand your family's eye health history: Glaucoma often runs in families. If you are at a higher risk, you may require more regular screening.
- Exercise with caution: Regular, moderate exercise may aid in the prevention of glaucoma by lowering ocular pressure. Discuss a suitable exercise regimen with your doctor.
- Regularly apply recommended eyedrops: Glaucoma eyedrops can dramatically minimize the chance of developing glaucoma from excessive eye pressure. Eyedrops given by your doctor must be taken on a daily basis, even if you have no symptoms.
- Wear safety glasses: Glaucoma can be caused by serious eye damage. When utilizing power tools or playing high-speed racquet sports in enclosed courts, use eye protection.