When we hear about Glaucoma. Do we know what it is? Read to find out more

Half of people with glaucoma don’t know they have it. Get a healthy start this year by learning about glaucoma and taking steps to reduce your risk of vision loss!

WHAT IS GLAUCOMA?

Glaucoma is a group of eye conditions which is usually associated with high eye pressure that causes damage to your eye’s optic nerve and gets worse over time. It usually damages the optic nerve, which transmits images from your eyes to your brain for interpretation. If  the damage continues, without treatment,it can lead to permanent vision loss. Infact, glaucoma is one of the leading causes of irreversible blindness globally.

Glaucoma has been labelled the “sneak thief of sight” because many people remain undiagnosed until irreversible vision loss occurs.

It usually affects the peripheral vision (what you can see on the side of your head when looking ahead) first. Later, it will affect central vision, which is needed for seeing objects clearly and for common daily tasks like reading and driving, and this is why the patient experiences tunnel vision at the late stage.

In the human eye, there’s a fluid known as aqueous humour, it’s production and outflow affects the intraocular pressure. When AH is produced at the back of the eye, it passes through a sieve-like structure to the front of the eyes. If this drainage pathway is partially blocked, pressure builds within the eye, thereby pressing against the optic nerve, and causing optic nerve death that leads to gradual vision loss.

Even though glaucoma is usually considered a result of increase pressure in the eye, it can also occur even if a person has normal eye pressure.

Everyone is at risk for glaucoma. People older than 60 years are at a higher risk. Glaucoma could be hereditary (inherited). Glaucoma may not have any signs or symptoms.

The best way to watch for glaucoma is to have your eyes examined timely and regularly. There are a variety of tests to check for glaucoma, including measuring pressure within the eye, testing for optic nerve damage, and a visual field test.

Since open-angle glaucoma is the most common type and its symptoms don’t generally show up until the damage has been done, this is a time when an ounce of prevention is worth a pound of cure. While vision damage cannot be reversed, the progression of glaucoma can be slowed with medication.

There are various types of Glaucoma listed below:

TYPES OF GLAUCOMA

1. Primary Open Angle Glaucoma (POAG)- Most common type

2. Primary Angle Closure Glaucoma (PACG)-Less common type

3. Congenital Glaucoma

4. Secondary Glaucoma

1. PRIMARY OPEN ANGLE GLAUCOMA:

This is  the most common type of glaucoma. It comes on so slowly and painlessly that you can go years without knowing you have it. And by the time you do, it’s likely already done a lot of damage. It usually affects individuals 40 years and above, it affects Both genders and it is more common in blacks than whites. POAG is frequently inherited and 1st degree relatives .ie. your children are at an increased risk. Presently there’s no known obvious cause of POAG, but it is said that an  imbalance between the production and outflow of aqueous humour, leads to Raised IOP which damages the optic nerve that connects the eye to the brain. Vision loss is irreversible in POAG, because the damaged optic nerve cells do not regenerate.

This vision loss starts peripherally, and that is why tunnel vision is observed by the individual. It is without symptoms  until greater percentage of vision is lost by the individual.

Some risk factors include:

a. High Myopia

b. Increased IOP

c. Hypertension

d. Diabetes

SIGNS

a. Reduced vision

b. Tunnel vision

c. Optic disc changes with suspicious optic disc and pathological cupping

d. Increased IntraOcular Pressure

e. Characteristic Visual field changes

2. PRIMARY ANGLE CLOSURE GLAUCOMA:

This type of glaucoma also called “narrow-angle glaucoma” is a less common form of glaucoma. It is a “Medical Emergency” that can cause sudden blindness within a day of it’s onset.

PACG is a type of glaucoma that is not common among blacks, it occurs usually in one eye and it is found more in women than men, it is a common cause of irreversible blindness.

In PACG,the fluid in the eye called the aqueous humour is produced at a normal rate, but it cannot be distributed to the outer part of the eye as usual because the drainage angle in the eye (formed by the cornea and Iris) is blocked. The continuous production of aqueous humour with little or no outflow causes Raised IOP leading to damage of the optic nerve.

SIGNS AND SYMPTOMS

1. Marked reduced vision

2. Blurry vision

3. Nausea and vomiting

4. Colored halos around light

5. Severe headache

6. Eye Pain

7. Sudden loss of vision

8. Generalized redness of the eye

9. Optic disc changes with pathological cupping

10. Very shallow) closed anterior chamber angle

11. Raised IOP

12. Characteristic Visual field changes

13. Hazy cornea

14. Mid-dilated pupil.

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3. CONGENITAL GLAUCOMA:

Also Childhood, pediatric, or infantile glaucoma — occurs in babies and young children. It is usually present at birth; however, its manifestations may not be recognized until infancy or early childhood. It is usually diagnosed within the first year of life. This is a rare condition that may be inherited, caused by inadequate development of the eye’s drainage system before birth, leading to increased Intraocular Pressure that will in turn affect the optic nerve and leading to to an irreversible visual loss of the child.

SIGNS AND SYMPTOMS

a. Excessive tearing (called epiphora)

b. Sensitivity to light (called photophobia)

c. Spasms or squeezing of the eyelid (called blepharospasm)

d. Cloudy cornea (the front layer of your eye that’s normally clear)

e. Unusual large eyes

f. Redness of the eye

4. SECONDARY GLAUCOMA:

Secondary glaucoma can be as a result of  another eye disease or medical disorder, refers to any form of glaucoma in which there is an identifiable cause of increased eye pressure, resulting in optic nerve damage and vision loss. As with primary glaucoma, secondary glaucoma can be of the open-angle or angle-closure type and it can occur in one or both eyes.Signs and symptoms vary with the underlying disease. It can be caused by:

• Uveitis (inflammation of the inner eye)

• Eye injury (trauma)

• Bleeding inside the eye

• Eye tumor (extremely rare)

• Diabetes (neovascular glaucoma)

• Congenital problems

• An extremely mature cataract

• Steroid medications

MANAGEMENT OF GLAUCOMA

a. Anti Glaucoma medications.

b. Surgery

c. Combination of Prescription medications and surgery

d. Counselling

Having regular eye exams can help catch glaucoma early and save your sight, any signs or symptoms are apparent, be aware of these risk factors;

RISK FACTORS

• Increased eye Pressure

• Family History of glaucoma

• African Americans 40 years and above

• Hispanics 60 years and above

• High myopia (very severe nearsightedness)

• Diabetes.

• Eye surgery

• Sickle Cell anaemia

• Eye injury

• High blood pressure.

• Use of corticosteroids (for example, eye drops, pills, inhalers, and creams)

TAKE NOTE!

These self-care steps can help you detect glaucoma in its early stages, which is important in preventing vision loss or slowing its progress. Remember early detection is key to Prevention!!!

1. Get regular dilated eye examinations.

2. Know your family eye health history

3. Exercise healthy and safely

4. Use Prescription EYEDROPS regularly

5. Wear eye protection because some eye injuries can lead to glaucoma

6. Eat healthy

Written by Dr. Chioma Innocent, Optometrist

Image credit: Godaddy stock photos

Format by Dr. Onuoha

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