Glaucoma

• 01 November 2016

WHAT DOES THE TERM: GLAUCOMA, MEAN?

Very often, glaucoma, is a condition in which the pressure inside the eye (intra-ocular pressure) becomes abnormally high leading to visual impairment. It’s one of the principal causes of blindness in North America. In fact, one person out of 30, over the age of 40, is at increased risk. Many people with glaucoma are unaware of it. Usually, there are no warning symptoms in the early stages of this sickness, there is no cure for glaucoma and the damage to the optic nerve can’t be reversed. There are good news: an early diagnosis offers the best chance of successful treatments and good tests. If the exams are done regularly the sickness will be detected in its early stages and prevent an important visual loss. As glaucoma may not come with any symptoms, initially, everyone over 18, should have a periodic detection, to protect their vision from this eye disease, according to their optometrist recommendations.

WHAT CAUSES GLAUCOMA?

Normally, intraocular pressure (I.O.P.) is regulated by the production and drainage of aqueous humour, a fluid naturally and continually produced in front of the eye. With glaucoma, if this fluid is not drained enough from the eye, then intraocular pressure increases. The pressure (I.O.P.) affects the optic nerve. This nerve connects the eye vision information to the brain. If the optic nerve is completely destructed, blindness occurs.

TYPES OF GLAUCOMA

There are many types of glaucoma. We will limit to the 4 main varieties.

1.       Chronic Open-Angle Glaucoma

Open-angle glaucoma is the most common form and occurs, when the eye fluids drain too slowly, causing a fluid backup and increased intraocular pressure: Damage to the optic nerve occurs slowly and is painless so visual loss may happen without symptoms. Open angle glaucoma typically occurs in both eyes and is a chronic, progressive condition that can lead to loss of vision. The drainage of aqueous humour is blocked. In that case, those changes are age related (people over 40). The first symptoms of chronic open-angle glaucoma could be a blurred vision, loss of peripheral vision, but already the optic nerve is irreparably affected.

2.       Acute Angle-Closure Glaucoma

This type of glaucoma occurs when the iris suddenly blocks the drain where the aqueous humour (fluid in the front chamber of the eye) evacuates itself. The fluid cannot drain away from the eye, leading to a rapid build-up pressure within the eye. The acute angle-closure, glaucoma symptoms include: blurred vision, severe throbbing eye pain, redness of the eyes, headache, and the presence of halos around lights. Often nausea and vomiting are present. Immediately consult your optometrist or ophthalmologist, it’s essential, and urgent you do so, because blindness can occur within few hours.

3.       Secondary Glaucoma

Secondary glaucoma occurs when the drainage of aqueous humour becomes blocked by infection, trauma to the eye, certain medications, hemorrhages or tumors. Secondary glaucoma symptoms can often resemble those of acute angle-closure glaucoma. It’s essential that you consult your vision specialist, quickly.

4.       Low Tension Glaucoma

The measure of intraocular pressure is an important sign of glaucoma in low-tension glaucoma; 1/3 of the cases have a normal I.O.P. This is why, a thorough eye exam of the optic nerve, done with dilated pupils is important. If needed this exam, may include a tonometry exam (measured pressure within the eyeball and visual test) (to see how your vision field is affected) these tests are done by your optometrist.

What a person, must keep in mind: “An early detection of the eye sickness, is the key of success.”

RISKS FACTORS

Risks factors include: people over 40, race, family history of glaucoma (genetic defects may be inherited), diabetes, myopia, injuries (trauma to the eye), eye tumors, or inflammatory eye disease, long term use of medications. Generally, high blood pressure is not related to glaucoma. However, you should know that glaucoma doesn’t present itself only in the conditions enumerated up above, but can occur in many other situations.

TREATMENT

If you get a glaucoma diagnosis, you will probably be treated with ophthalmic drops. The medication will reduce the fluid production in the eye or help evacuate this fluid outside of it. The eye drops will control the eye pressure, but will never cure the sickness. All your life: treatments and a follow-up of glaucoma will carry on.

In some cases, your medication can produce side effects as: a blurred vision, or occasional headaches, the drops may cause itchy and red eyes, and your nocturnal vision may decrease. Most of these side effects decrease with time; if you get more serious side effects, as sleepiness, a loss of appetite or a change in cardiac rhythm or respiratory, you should mention it to the specialist or professional that prescribed that medication, to you.

If the treatment with drops isn’t effective and can’t be pursued, different surgeries can be suggested, to you.

CONTROLLING GLAUCOMA IS YOUR RESPONSABILITY

If you were diagnosed with glaucoma, you must meticulously follow the given instructions. To be effective, the medication must become a part of your daily routine. Never stop, your medication without talking to your eye specialist. For any reason if you must see a doctor, it’s important to tell him, what eye medication you take, because these drops even administered in the eyes, circulate in your body and can affect other organs such as the heart, lungs etc.

Finally, because the effects of glaucoma may worsen or improve without you expecting it, you must follow the recommendations and the assigned controls to keep up with the evolution of the sickness. Because glaucoma is a disease which progresses, in time, your treatment against glaucoma can change in the course of the year.

TAKING SYSTEMIC MEDICATION

You must inform your specialist of systemic medications that you take, even those sold without prescription. Some of these medications can interact with those for glaucoma controlling particularly those controlling intraocular pressure.

TELL YOUR FAMILY ABOUT IT

As glaucoma is an hereditary sickness, encourage all the adults in your family even cousins, uncles, aunts to regularly have a visual exam.

Remember: Your role in the treatment of Glaucoma must not be underestimated. Because glaucoma is a chronic disease, its therapy lasts a lifetime. It requires perseverance. But, don’t forget, that all this perseverance will help to protect your precious vision.