Glaucoma Eye Disease
Glaucoma is a disease characterized by an abnormally high fluid pressure within the eye, resulting in nerve damage and permanent loss of vision. The fluid, aqueous humor, produced within the eye escapes from the eye via a drainage system in the angle of the eye, as shown in the picture, which returns the aqueous humor to the blood stream. When production of aqueous humor is too high or the drainage system is insufficient, pressure within the eye rises.
Glaucoma Eye Medications
Glaucoma treatments are typically intended to lower intraocular pressure. The two primary means of accomplishing this are medication and surgery.
One way in which glaucoma medication works is to increase the rate at which fluid flows out of the eye. This is most often accomplished through the use of miotics. These medications, which usually come in eyedrop form, constrict the pupil and open the cornea-iris angle. They are often a primary treatment for a glaucoma attack, and are used regularly to treat pigmentary glaucoma as well.
There are also glaucoma medications that decrease the rate at which fluid flows into the eye. These types of medication can come in both eyedrop and pill form. Typically, the eyedrop is prescribed first because its effects are milder, but pills may be used if the patient’s symptoms are not relieved. One or both types are often administered in response to a glaucoma attack.
Glaucoma Eye Surgery
Surgery can also relieve intraocular pressure. The most common surgical approaches to glaucoma adjust the trabecular meshwork to increase the flow of aqueous humor out of the eye. This may be accomplished through laser surgery or conventional removal of tissue.
Laser surgery on the trabecular meshwork is usually an intermediate step between medication and traditional surgery. The most common laser procedure for glaucoma is called trabeculoplasty, and it is used to shrink the trabecular meshwork and allow a small amount of free drainage around it. Typically, the procedure is painless and recovery is quick and complication-free. However, the chances are slight that laser surgery will permanently cure a patient’s glaucoma; many trabeculoplasty patients eventually have to undergo another procedure.
Sooner or later, the surgeon may have to resort to traditional surgical methods. The most frequently performed procedure to decrease intraocular pressure is trabeculectomy. In trabeculectomy, the surgeon removes a small portion of the trabecular meshwork. This has been proven to effectively reduce pressure, and it very frequently results in the patient’s discontinuation of medication. However, there is one alarming possible side effect of trabeculectomy: the development of cataracts. About one out of every three trabeculectomy patients develop cataracts within 5 years of surgery.
One procedure that does not impact the trabecular meshwork at all is called laser iridotomy. In the procedure, a laser is used to produce a hole in the iris, allowing fluid to flow around the meshwork. Iridotomy is usually quick and painless. Even if only one eye is affected, the procedure is typically performed on both eyes as a preventative measure. Currently, laser iridotomy’s primary use is in response to glaucoma attacks. However, it is also being researched as cure from some chronic forms of glaucoma such as pigmentary glaucoma.
Who might have glaucoma?
1. Family history of glaucoma
2. Over 50 years of age
4. Severe myopia
5. Previous trauma to the eye
How will I know if I have glaucoma?
Glaucoma is called the "the thief of sight" because in most cases there are no symptoms. Glaucoma must be detected by an eye examination. There are four types of glaucoma. Open angle glaucoma is the most common type and hereditary in nature. The eye pressure builds gradually over a long period and the vision is impaired from the periphery toward the center. Acute glaucoma or closed angle glaucoma is associated with severe pain and sudden blurred vision. There may be nausea as well. These symptoms need medical attention right away.
Eye trauma, infection, tumors, inflammation or even eye medication such as steroid eye drops can cause secondary glaucoma. Congenital glaucoma is very rare. It is present since birth.
The key to prevent visual loss from glaucoma is early detection and proper treatment. Treatment consists of eye drops and pills. Regular use and proper technique of placing eye drops are very important in successfully managing glaucoma. Laser treatment may be another option in treating glaucoma. Laser treatment is painless and can be performed on an outpatient basis. Surgery to create a new drainage may be required if all other methods fail to control the glaucoma.
Corrective Eye Care
Surgery and Treatments Available