Glaucoma

Glaucoma is a very common eye disease where the fluid pressure in the eye rises causing damage to the optic nerve (this connects the eye to the brain). Glaucoma is more common in older adults (70s or 80s) even though it can affect people of any age. If it is left untreated, it can lead to loss of vision. Glaucoma normally affects both eyes but can be more severe in just one. It is still unknown what the exact cause of glaucoma is but you do have Primary Glaucoma and Secondary Glaucoma. If it is primary glaucoma, it means that the reason for it is unknown and if it is secondary glaucoma, there is a known reason for it, such as, a tumour, diabetes or inflammation. There are four types of glaucoma which include, Acute angle-closure glaucoma (comes on very suddenly) chronic glaucoma (progresses very slowly), low-tension glaucoma (rare form of glaucoma where there is normal pressure but damage to the optic nerve) and pigmentary glaucoma (type of angle glaucoma).

SYMPTOMS OF GLAUCOMA

Glaucoma is known as the ‘thief of sight,’ and depending on the type of glaucoma, it can often be symptomless at the beginning (especially in chronic). The most common symptom of glaucoma though is eye pain and blurred vision as well as sudden vision problems (narrowed vision) and red eyes. The eye pain can also incur sickness and vomiting.

Treatments

The aim for glaucoma treatment is to avoid the patient from losing their eyesight. This can be achieved by eyedrops, pills and/or surgery. Glaucoma can be managed if found early on and most people won’t lose their eyesight.

Eyedrops

In order to control your eye pressure your doctor will prescribe eyedrops which will have to be taking regularly. These eyedrops are absorbed into the blood stream and it’s important to tell your doctor any other medication you might be taking. You will have to close your eyes for one or two minutes after administering the drops to maximize the amount of drugs taken into the eye. It will be uncomfortable for a few seconds, but burning or stinging sensation should not last longer than that.

Prostaglandins — these are only required once a day and work by allowing the eye muscles to relax and have better flow of fluids to reduce eye pressure.
Beta-blockers — these work by decreasing the fluid production in the eye and include Timoptic XE (Mreck), Istalol (ISTA) and Betoptic S (Alcon).
Carbonic anhydrase inhibitors — these decrease the rate of aqueous humor production and include Trusopt (Merck) and Azopt (Alcon).
Parasympathomimetics — these increase the outflow of aqueous humor from the eye and are used to control IOP in narrow-angle glaucoma.
Others include epinephrine drops and hyper-osmotic agents as well.

Surgery

You might be recommended for surgery if other medication don’t work or have bad side effects.

Trabeculoplasty — this procedure can take ten to fifteen minutes. It consists of a high energy light beam being focus on the eye’s drain. It allows the aqueous fluid to be able to pass more easily.
Argon Laser Trabeculoplasty — this increases the drainage outflow and lower IOP and treats the trabecular meshwork of the eye.
Selective Laser Trabeculiplasty — this is a low energy laser treatment and leaves part of the trabecular meshwork intact.
Laser Perhipheral Iridotomy — this produces makes an opening in the iris which lets aqueous fluid to flow behind the iris into the anterior chamber of the eye.
Cycloablation — this is used when other treatments or procedures have no worked. It uses lasers to direct energy through the outer sclera of the eye to destroy parts of the ciliary processes.
Drainage implant surgery — this uses a device to drain the aqueous humor out of the anterior chamber and decrease IOP.
Nonpenetrating surgery — this is a procedure where the surgery does not enter the anterior chamber of the eye and minimizes post-op complication and lowers risks of infection.

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