Glaucoma is a group of eye conditions that affect the optic nerve function and is often caused by high pressure in the eye.
It is one of the leading causes of irreversible blindness and can occur at any age but most commonly affects adults over 40 years of age.
Glaucoma often gives no warning signs so that many patients get diagnosed at the advanced stages. It is important to undergo regular eye exams so that any signs of glaucoma can be picked up at an early stage and any further vision loss can be prevented.
Glaucoma causes significant vision loss and restriction of the visual field leading to tunnel-vision or blindness. It is shown to have significant genetic predisposition but there are several other risk factors that are proven to be associated with it, such as advanced age, origin, other eye conditions, steroid use etc. The devastating effect of glaucoma on the eyesight and visual field are related to loss of nerve fibers of the optic nerve due to elevated pressure in the eye.
There are several types of glaucoma. The most common form is the open-angle glaucoma, where the anterior chamber is open but the drainage of the aqueous fluid is impaired causing the intraocular pressure to rise. Angle-closure glaucoma occurs in patients with small eyes and narrow anterior chamber causing sudden rise in the intraocular pressure that presents with severe pain, redness and vision loss. Normal-tension glaucoma is a subtype of glaucoma with optic nerve damage but intraocular pressure within normal limits. Rare types of glaucoma include pediatric glaucoma that usually has a rapid progression, pigmentary glaucoma, glaucoma associated with uveitis and finally glaucoma related to previous eye injuries.
Glaucoma is diagnosed clinically with fundoscopy, measurement of the intraocular pressures, visual field testing and optic nerve tomography.
Treatment varies and depends on severity of the damage that has affected the optic nerve. Intraocular pressure lowering eye drops are prescribed in order to control progression of the disease. Drops can be combined with laser treatment to further decrease the intraocular pressure. Minimally Invasive Glaucoma Surgery (MIGS) includes a variety of minimally invasive methods such as the implantation of stents, to control the intraocular pressure. MIGS are often combined with cataract surgery in glaucoma patients. Finally surgical treatment with trabeculectomy is indicated in refractory cases with advanced glaucomatous damage to the optic nerve.