Understanding Glaucoma and Its Impact on the Human Eye

Glaucoma is a serious eye condition that can lead to vision loss and blindness if left untreated. It affects millions of people worldwide and is one of the leading causes of blindness for people over 60 years old. But what exactly is glaucoma and how does it affect your vision?

What is glaucoma?

Glaucoma is a group of eye diseases that damage the optic nerve, which is the cable that connects the eye to the brain and carries visual information. The optic nerve is made up of more than a million tiny nerve fibers that can die when they are damaged by glaucoma.

The most common cause of glaucoma is high pressure inside the eye, also known as intraocular pressure (IOP). This pressure is created by the fluid that fills the front part of the eye, called aqueous humor. Normally, this fluid drains out through a tissue located at the angle where the iris (the colored part of the eye) meets the cornea (the clear window of the eye). This tissue is called the trabecular meshwork. When the drainage system is not working properly, the fluid builds up and increases the pressure inside the eye.

However, glaucoma can also occur with normal or low eye pressure. Some people have optic nerves that are more sensitive to pressure or other factors, such as blood flow or inflammation. This means that their risk of getting glaucoma is higher than normal, even if their eye pressure is within the normal range.

What are the types of glaucoma?

There are two major types of glaucoma: open-angle glaucoma and angle-closure glaucoma. They differ in how they affect the drainage angle and the eye pressure.

Open-angle glaucoma

This is the most common type of glaucoma, accounting for about 90% of all cases. It happens gradually, where the drainage angle is open but not functioning well. As a result, the eye pressure builds up slowly and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first. It usually affects side vision (peripheral vision) first, and then central vision as it progresses. Many people with open-angle glaucoma do not notice any symptoms until they have significant vision loss.

Angle-closure glaucoma

This type of glaucoma occurs when the drainage angle is closed or narrowed by the iris. This can block the outflow of fluid from the eye and cause a sudden or gradual rise in eye pressure. This type of glaucoma can be acute or chronic.

Acute angle-closure glaucoma is a medical emergency that requires immediate treatment. It happens when the iris completely blocks the drainage angle, causing a rapid spike in eye pressure. This can cause severe eye pain, headache, nausea, vomiting, blurred vision, halos around lights, and redness in the eye.

Chronic angle-closure glaucoma is more common than acute angle-closure glaucoma. It happens when the iris partially blocks the drainage angle, causing a slow or intermittent increase in eye pressure. This type of glaucoma may not cause any symptoms until it causes significant damage to the optic nerve.

How is glaucoma diagnosed?

The only way to diagnose glaucoma is to have a comprehensive eye exam by an ophthalmologist (a medical doctor who specializes in eye care). The exam may include several tests, such as:

– Measuring your eye pressure with a device called a tonometer

– Examining your optic nerve with a special lens after dilating your pupils

– Checking your peripheral vision with a test called perimetry

– Measuring your corneal thickness with a test called pachymetry

– Inspecting your drainage angle with a test called gonioscopy

These tests help your ophthalmologist determine if you have glaucoma, what type of glaucoma you have, how severe it is, and what treatment options are best for you.

How is glaucoma treated?

The goal of glaucoma treatment is to lower your eye pressure and prevent further damage to your optic nerve. Unfortunately, there is no cure for glaucoma and any vision loss caused by it cannot be reversed. However, with early detection and proper treatment, you can slow down or stop the progression of glaucoma and preserve your vision.

The main treatment options for glaucoma are:

– Eye drops: These are medications that you apply to your eyes once or twice a day. They work by either reducing the production of fluid in your eye or increasing its outflow. There are different types of eye drops for glaucomas, such as beta-blockers, prostaglandin analogues, alpha-adrenergic agonists, carbonic anhydrase inhibitors, and parasympathomimetic agents. Your ophthalmologist will prescribe the best eye drops for you based on your type of glaucoma, your eye pressure, and your overall health. You need to use your eye drops as directed and follow up with your ophthalmologist regularly to monitor your eye pressure and optic nerve health.

– Laser surgery: This is a procedure that uses a beam of light to modify the tissues in your eye. There are different types of laser surgery for glaucoma, such as laser trabeculoplasty, laser peripheral iridotomy, and laser cyclophotocoagulation. These procedures aim to improve the drainage of fluid from your eye or reduce its production. Laser surgery is usually done as an outpatient procedure in your ophthalmologist’s office. It may lower your eye pressure for several years, but you may still need to use eye drops or have another surgery in the future.

– Conventional surgery: This is a procedure that creates a new opening for the fluid to leave your eye. The most common type of conventional surgery for glaucoma is trabeculectomy, where a small flap is made in the sclera (the white part of the eye) and a bubble of tissue called a bleb is created under the conjunctiva (the transparent membrane that covers the eye). The fluid drains through the flap and collects in the bleb, where it is absorbed by the blood vessels. Another type of conventional surgery for glaucoma is glaucoma drainage implant surgery, where a small tube is inserted into the eye and connected to a plate that is placed under the conjunctiva. The fluid flows through the line and collects around the plate, where it is absorbed by the blood vessels. Conventional surgery is usually done in a hospital or an ambulatory surgery centre under local or general anaesthesia. It may lower your eye pressure for many years, but you may still need to use eye drops or have another surgery in the future.

How can you prevent glaucoma?

There is no sure way to prevent glaucoma from developing in the first place, but there are some steps you can take to reduce your risk of vision loss from glaucoma:

– Get regular eye exams: If you are at risk for glaucoma, you should see your ophthalmologist regularly for eye exams. Your ophthalmologist can detect glaucoma in its early stages and start treatment before it causes significant vision loss. The frequency of your eye exams depends on your age, your family history, your medical history, and other risk factors. In general, you should have a comprehensive eye exam every two to four years before age 40, every one to three years from age 40 to 54, every one to two years from age 55 to 64, and every six to 12 months after age 65.

– Know your family history: Glaucoma can run in families, so if you have a parent or sibling with glaucoma, you are at higher risk of developing it yourself. You should inform your ophthalmologist about your family history of glaucoma and get screened more often.

– Protect your eyes from injury: Eye injuries can lead to traumatic glaucoma or secondary glaucoma, so you should always wear protective eyewear when playing sports or doing home improvement projects. If you experience any eye trauma, you should seek medical attention immediately.

– Eat well and exercise moderately: A healthy diet and lifestyle can benefit your overall health and your eyes. You should eat plenty of leafy green vegetables and colourful fruits that contain antioxidants and vitamins that protect your eyes. You should also exercise moderately regularly, as this can lower your blood pressure and improve your blood flow. However, you should avoid intense exercise that raises your heart rate too much, as this can also raise your eye pressure. You should also avoid head-down positions such as headstands or inversion tables, as these can increase your eye pressure.

– Avoid smoking and excessive alcohol: Smoking and drinking too much alcohol can harm your health and your eyes. Smoking can increase oxidative stress and inflammation in your body, which can damage your optic nerve. Alcohol can dehydrate your body and affect the fluid balance in your eyes. You should quit smoking and limit your alcohol intake to no more than one drink per day for women and two drinks per day for men.

Conclusion

Glaucoma poses a significant threat to vision if untreated, with various types affecting eye pressure differently. Detectable only through comprehensive eye exams, treatment involves options like drops, laser, and surgery to lower eye pressure and halt further damage, though it can’t restore lost vision. Therefore, proactive glaucoma management and overall eye health care are crucial. For a holistic approach, myCare+ offers personalized support, connecting you with expert ophthalmologists, monitoring eye pressure, and medication adherence, and providing educational resources. Elevate your glaucoma care and quality of life with myCare+. Join our community and take control of your eye health. Learn more and sign up today. Don’t miss this chance to prioritize your vision with myCare+.