Glaucoma

Glaucoma is a common eye disorder characterized by damage to the optic nerve that links the eye to the brain. This damage is typically due to the accumulation of fluid in the front section of the eye, resulting in increased intraocular pressure. If not identified and treated promptly, glaucoma can result in vision loss. While it can impact individuals of any age, it is most prevalent among adults in their 70s and 80s.

Symptoms of Glaucoma

In the early stages, glaucoma typically does not cause any noticeable symptoms. It generally progresses gradually over several years, initially impacting peripheral vision. Because of this slow development, many individuals are unaware that they have glaucoma, and it is often detected during a routine eye examination.

If symptoms do appear, they may include blurred vision. Both eyes are usually affected, though one eye may experience more severe symptoms.

In some cases, glaucoma can manifest suddenly, leading to:

Severe eye pain
Nausea and vomiting
A red eye
Headaches
Seeing halos around lights
Blurred vision

Such symptoms are due to acute angle closure glaucoma. This is a medical emergency and requires urgent treatment by an Ophthalmologist to prevent blindness.

Types

There are several types of glaucoma:

Primary open-angle glaucoma: This is the most prevalent type. It typically progresses slowly over many years, initially without noticeable symptoms. It occurs when the drainage channels in the eye gradually become obstructed.
Acute angle-closure glaucoma: This type arises when the drainage system in the eye suddenly becomes blocked, leading to a rapid increase in eye pressure and the acute symptoms mentioned above.
Secondary glaucoma: This type is caused by an existing eye condition, such as eye inflammation (uveitis) or following eye trauma.
Normal tension glaucoma: This type occurs despite the eye pressure being within the normal range. The reasons why some individuals develop optic nerve damage despite having normal eye pressure are not fully understood. It is believed that certain individuals may have a weaker optic nerve or a more delicate blood supply to the optic nerve, which may render them unable to cope with eye pressure even if it is within the normal range.
Childhood glaucoma (congenital glaucoma): A rare form that occurs in very young children due to an abnormality in the eye. It can present with excessive tearing, sensitivity to the light and eye rubbing.

Predisposing factors

Certain factors can increase the risk of developing glaucoma. These include the following:

Age: The likelihood of developing glaucoma increases as one gets older.
Ethnicity: Individuals of African, Caribbean, or Asian descent are at a higher risk.
Family history: Having a parent or sibling with glaucoma raises your chances of developing the condition.
Other medical conditions: Conditions like myopia, hyperopia, eye trauma, certain eye conditions and diabetes may contribute to the risk.
Use of certain medication e.g. corticosteroids

Tests for Glaucoma

Glaucoma can typically be identified during a routine eye examination, often before symptoms become noticeable. It is therefore recommended to have a routine eye test at least every two years.

Several quick and painless tests can be performed to detect glaucoma, including vision assessments, measurements of intraocular pressure, slit lamp examination of the eye to include optic nerve assessment and visual field tests and optical coherence tomography (OCT) scan.

Treatments for Glaucoma

While it is not possible to restore any vision lost prior to a glaucoma diagnosis, treatment can help prevent further vision deterioration.

The treatment recommended will vary based on the type of glaucoma, but typically includes:

Eye drops: To lower eye pressure.
Laser treatment: To open blocked drainage paths or decrease fluid production.
Surgery: To enhance fluid drainage.

Patients diagnosed with glaucoma need regular follow-up appointments to monitor the condition and assess the effectiveness of the treatment, making sure the eye pressure remains under control.

Further Support for Glaucoma

For more information and support regarding glaucoma, organizations such as the Royal National Institute of Blind People (RNIB) and Glaucoma UK provide additional resources.