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Glaucoma is a disease of the major nerve of vision, called the optic nerve. The optic nerve receives light from the retina and transmits impulses to the brain that we perceive as vision. Glaucoma is characterized by a particular pattern of progressive damage to the optic nerve that generally begins with a subtle loss of side vision (peripheral vision). If glaucoma is not diagnosed and treated, it can progress to loss of central vision and blindness. Glaucoma is usually, but not always, associated with elevated pressure in the eye (intraocular pressure). Generally, it is this elevated eye pressure that leads to damage of the eye (optic) nerve. In some cases, glaucoma may occur in the presence of normal eye pressure. This form of glaucoma is believed to be caused by poor regulation of blood flow to the optic nerve.
Complications of Glaucoma
If left untreated, glaucoma will cause progressive vision loss, typically in these stages:
Causes of Glaucoma
Glaucoma is caused by an increase in pressure within your eye or a weakness in the optic nerve, or both. You're more likely to get glaucoma later in life. Not many people under 40 will develop the condition, but two in 100 people over the age of 40 and five in 100 people over the age of 70 will develop some type of glaucoma.
Other factors that can increase your chances of getting glaucoma include:
Signs & Symptoms of Glaucoma
The most common types of glaucoma — primary open-angle glaucoma and acute angle-closure glaucoma — have completely different symptoms.
Primary open-angle glaucoma signs and symptoms include:
Both open-angle and angle-closure glaucoma can be primary or secondary conditions. They're called primary when the cause is unknown and secondary when the condition can be traced to a known cause, such as eye injury, inflammation, tumor, or advanced cataract or diabetes. In secondary glaucoma, the signs and symptoms can include those of the primary condition as well as typical glaucoma symptoms.
Diagnosis of Glaucoma
These are some of the tests that can establish a diagnosis of glaucoma:
Treatments of Glaucoma
Treatment for glaucoma aims to lower the pressure inside your eye to reduce the risk of future sight loss if it hasn't already deteriorated, or prevent any further loss of sight. Treatment can't reverse any existing optic nerve damage, so it won't improve your sight if it has already deteriorated.
Options include medicines given as eye drops, laser treatment and surgery.
There are different types of eye drops available for treating glaucoma. These include:
Several other types of medicine are available in drop and tablet form, as alternatives or in addition to beta-blockers or prostaglandins. It's important that you use any prescribed eye drops every day as advised by your doctor to ensure consistent lowered pressure in the eye. If you don't, the pressure in your eye will rise again.
There are different side-effects for each type of medicine. Ask your doctor or pharmacist for more information. If you think your medicine is causing a side-effect, speak to your doctor as soon as possible. He or she can advise you and if necessary can prescribe a different drop or consider other treatments.
A laser can be used to open the holes in the draining system to help fluid drain out of your eye or stop your eye producing as much fluid.
The procedure is usually quick and causes little discomfort. It can be done under local anaesthesia and you will be able to go home the same day. The success of this type of treatment varies from person to person, and you may need to continue using eye drops after laser treatment.
You may be able to have surgery if medicines and/or laser treatment haven't lowered the pressure in your eye.
There are a range of operations and the most commonly performed is trabeculectomy. In this operation a tiny opening is created in your eye wall to allow fluid to escape under the thin lining of the white of your eye (the conjunctiva) and be absorbed back into your bloodstream. You may have the operation under local or general anaesthesia.
Prevention of Glaucoma
When to seek Medical Advice
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