"I want to be blind", said no one ever!

Sadly, blindness is a major consequence of glaucoma. And glaucoma has affected about 70 million people worldwide.

In this article, we will discuss the symptoms, causes, risk factors, types and treatment of glaucoma.

Definition 

It is a progressive eye condition that results from damage to the optic nerve. It usually occurs due to build-up of pressure inside the eye. This pressure is known as  Intraocular pressure(IOP). An increased IOP can damage the optic nerves that send impulses from the eye to the brain. If left untreated, the damage will escalate and such a person can lose their vision permanently. 

Symptoms 

Glaucoma symptoms are based on the types. However, some of the general symptoms include: 

  • Red eye
  • Pains in the eye
  • Headache
  • Tenderness of the eye 
  • Blurred vision
  • Seeing rainbow-coloured circles around bright light.

More on symptoms as we advance.

Causes 

Your eye continuously secrets a fluid called aqueous humour. It migrates from the back to the front of the eye then it leaves through the channels in your eye (cornea and Iris). If for any reason, these channels get blocked, the natural pressure in your eye will increase (IOP). As IOP goes up, your optic nerve begins to get damaged and you gradually begin to lose vision. Although the increase in IOP is the only known major cause, glaucoma can still develop without increased IOP.

Common causes of increase in Intraocular pressure (IOP):

  • Poor blood flow to your optic nerve.
  • High blood pressure
  • Dilating eye drops
  • Certain medications like corticosteroids 
  • Blocked or restricted drainage in your eye.
  • Severe eye infection 

Risk Factors 

The following people run a high risk of being diagnosed with glaucoma:

  • Adults over the age of 40
  • People with a family history of glaucoma
  • Diabetic patients 
  • People with poor vision
  • African-Americans and generally people of African descent
  • People of Asian descent 
  • People who constantly consume certain steroid medications.
  • People who have a history of eye injuries.
  • People whose corneas are thinner than usual.

If you fall under any of these categories, it's best to get an annual eye check-up.

Types Of Glaucoma 

1. Open-angle glaucoma

Also known as wide-angle glaucoma, it is the most common type of glaucoma. It is caused by gradual blockage of the drainage channels in the eye. The trabecular meshwork, the drain structure in your eye looks fine but fluid doesn't flow out as it should. Open-angle glaucoma remains asymptomatic until its bearer begins to lose a significant amount of vision. 

The first prominent sign of open-angle glaucoma is loss of peripheral vision

2. Acute Closed / Narrow-Angle Glaucoma 

Unlike the former, symptoms manifest rather quickly. Once the flow of aqueous humour to a person's eye is suddenly blocked, rapid accumulation of fluid will lead to a quick, severe, painful increase in pressure. 

If you begin to experience symptoms like: 

  • Redness of the eye 
  • Headaches 
  • Blurred vision 
  • Severe eye pain
  • Halos around lights,

please contact a health professional as soon as possible! 

PS: This is an emergency case that can lead to permanent vision loss if not treated on time. 

3. Congenital Glaucoma 

It is a very rare type of glaucoma affecting 1 in 10,000 infants. The increase in IOP occurs as a result of genetic abnormalities in the trabecular meshwork. Such children have a defect in the anterior chamber angle of their eye which slows or prevents normal fluid drainage. 

Some common symptoms are:

  • Cloudy eyes 
  • Sensitivity to light 
  • Excessive tearing 
  • Habitual rubbing of eyes
  • Squinting and keeping the eyes closed more often than usual. 
  • Unusual increase in the size of one or both eyes

4. Secondary Glaucoma 

Secondary glaucoma refers to any form of glaucoma that occurs as a result of an already-existing condition. The existing condition could be an eye injury or conditions like cataracts and eye tumours. These conditions alter the intraocular pressure It is a common side effect of using steroids. Though it rarely happens, surgeries can also cause it. Depending on the cause, it can be sudden or gradual.

There are usually no symptoms at the early stage but symptoms like loss of field vision, light sensitivity, eye ache, blurred vision, and headache may develop with time.

Some types of Secondary glaucoma are: 

  • Neuromuscular glaucoma
  • Exfoliative glaucoma 
  • Traumatic glaucoma
  • Pigmentary glaucoma
  • Childhood glaucoma
  • Uveitic glaucoma

5. Normal-Tension Glaucoma 

Unlike the others, this type of glaucoma occurs without increased eye pressure but by damage to the optic nerve. The cause is typically unknown. Lack of blood flow to the optic nerve is a suspected cause but hasn't been confirmed. It is usually asymptomatic but symptoms like blurred vision and loss of side vision develop with time.

How Do I Know I Have Glaucoma?

For a disease so intense, detecting its symptoms early is extremely important. 

So if you experience any of the symptoms listed above, please see a doctor as soon as possible. Even if you experience mild symptoms, it's best to still do a check-up to be on the safe side. 

Once you get to the hospital, your doctor can't automatically tell if you have glaucoma or not -he's no magician! They'll have to conduct a series of tests to determine the cause of your symptoms. Some of them are:

i. Tonometry test: To measure your eye's internal pressure

ii. Pachymetry test: To determine how thin your cornea is 

iii. Perimeter test: To measure your peripheral or side vision and Central vision

They'll also conduct a medical history check. This will help them determine if your problem is a generic one.

Treatment 

Treatment aims to control IOP and deter any additional vision loss. 

Doctors may recommend medications like Betaxolol, levobunolol, carteolol, etc.

Surgeries may be required for intense cases. The surgery will aim at creating a path for the fluid or destroying the tissue causing the blockage. 

For Angle-closure glaucoma, treatment is quite different.  Medicines may be prescribed at first but if they don't work, Laser Peripheral Iridotomy may be performed. It aims at creating holes in your Iris to increase fluid movement.

Bottom line 

Glaucoma is one of the diseases that does permanent damage to its sufferer. But if detected on time, it could do less or no damage at all. So if you experience any of the aforementioned symptoms, don't overlook them. Instead, get a health professional to check you out as soon as possible. You'd be saving yourself from a lifetime of blindness!

Written By:
Shalom Ngbala-Okpab
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Further Reading