Glaucoma - Medical specialists

Glaucoma is an eye disease that causes damage to the optic nerve, which carries information from your eye to your brain. If not detected and treated at an early stage, glaucoma can cause a loss of vision.
Experts believe the condition generally occurs when the watery fluid in the eye is unable to drain away properly. This can cause pressure to build up inside your eye, which then in turn exerts further pressure on the optic nerve itself.
Glaucoma is a commonly occurring eye disease. However, because it doesn't always cause symptoms early on, many people may not be aware they have the condition.
Though glaucoma can afflict people of any age – including infants and young children – it most often affects older adults, during their 70s and 80s.

Overview

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Glaucoma - Further information

Glaucoma symptoms

At the outset, glaucoma is often painless and may not have any obvious symptoms, other than optic nerve changes. That means it’s often likely to be detected during routine eye check-ups.
Glaucoma progresses very slowly over a period of years, so many people are unaware they have the condition. Loss of vision generally starts from the edge of your visual field (peripheral vision).
Symptoms commonly affect both eyes, but one eye may be more affected than the other. Left untreated, this disease can cause blindness.
On rare occasions, glaucoma can occur suddenly and result in:

• intense eye pain
• red eye
headache
• tenderness around the eye region
• seeing haloes around lights
• blurred vision

Acute Angle Closure-glaucoma

Glaucoma

Causes of glaucoma

It’s not always clear what causes many glaucomas, but the most common reason is the development of an eye blockage, which prevents the proper drainage of eye fluid. In many instances, this then results in ocular hypertension – an increase of internal pressure inside the eye.
Those of African, Asian or Caribbean descent have a greater risk of developing this disease. Likewise, a family history of glaucoma is another risk factor. Around 10% of all adults over 75 are likely to develop glaucoma symptoms.

Diagnosis of glaucoma

Most often, glaucoma is spotted during screening as part of your regular eye check-up, and well before you notice any symptoms. Further diagnostic testing and monitoring of the disease may involve:

  • A physical examination and discussion of your medical history
  • Tonometry – which measures internal eye pressure
  • Gonioscopy – a close examination of your eye structure and drainage system
  • Perimetry – which checks your visual field
  • Assessment of your optic nerve – checking for signs of damage
  • Scanning the fibrous layer of your optic nerve

Glaucoma treatment

Most current glaucoma treatments aim to reduce the build-up of pressure within the eye – known as IOP (intra-ocular pressure) – to manage and minimize optic nerve damage. Though this will help preserve your eyesight, the treatment won’t be able to reverse any existing damage. However, in the case of children with congenital glaucoma, it is sometimes possible to repair damage and restore some of the eyesight that has been lost.

The most common treatments are various medications and surgical procedures, including laser treatments. Careful monitoring and diagnosis is required to accurately determine the type of glaucoma present and thus choose the most appropriate treatment approach in each case.
Here are some practical examples:

  • primary open-angle glaucoma is sometimes improved with eye drops, but laser treatment or surgery may be considered if drops prove ineffective
  • primary angle closure glaucoma may need urgent hospital treatment, using medication to lower the pressure inside the eye – perhaps then requiring laser surgery as a follow-up treatment
  • secondary glaucoma may respond best to eye drops, laser treatment or surgical procedures, and the choice will depend on a diagnosis of the underlying cause
  • childhood glaucoma quite often needs corrective surgery to address the specific eye problem that resulted in the build-up of internal fluid pressure

Chances of recovery from glaucoma

Usually affecting side vision at first, untreated glaucoma can lead to blindness within 25 to 70 years. When diagnosed and treated early, there is usually an expectation that good vision can be retained.

Glaucoma prevention

It is likely that glaucoma treatment will be ongoing and perhaps lifelong. Regular eye examinations will be essential to monitor the condition. Your eye specialist will probably fix a target pressure level for each eye, and should this be exceeded may then advise medication or other treatments to ease the problem.
If your glaucoma result in any significant vision loss, your eye doctor can refer you to specialist advisors who can help people to adapt to living with reduced vision.

More information can be found on the website of the International Glaucoma Association.

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