Understanding Glaucoma: a Chronic Eye Condition
What is glaucoma?
Glaucoma is a disease affecting the optic nerve. The optic nerve is a structure located at the back of the eye. Its main function is to carry signals from your eyes to your brain, helping you see.2
The optic nerve is made of millions of tiny nerve fibers. If these fibers get damaged, it can lead to vision loss. Damage to a large number of fibers can result in blindness. Not surprisingly, glaucoma is a leading cause of blindness in people over 60 years old.2
What causes glaucoma?
The exact cause of glaucoma is not totally understood. The disease usually happens due to high pressure in the eye, but it can also affect those with typical eye pressure.2
The human eye produces fluid to help keep its pressure and shape. The clear liquid found in the front part of the eye is called aqueous humor.2
Typically, the amount of fluid entering the eye equals the amount that drains out. If it doesn’t drain properly, the fluid builds up, increasing pressure inside the eyes. As pressure rises, it damages the optic nerve, causing glaucoma.2
Types and symptoms of glaucoma
There are different types of glaucoma, each with its own symptoms. Some people call glaucoma a silent thief of sight, as you only realize you have it until it’s quite severe. Doing regular checkups can help you avoid future problems.2
Glaucoma can either happen on its own or be caused by another condition. The first type is called primary glaucoma, and the second is called secondary glaucoma. 2
Some common types of primary glaucoma include:
Open-angle glaucoma
This is the most common type of glaucoma in the U.S., affecting 9 out of 10 people with the condition.3
People with open-angle glaucoma usually don’t notice symptoms until they begin to lose their vision. This happens because pressure builds up in the eye, gradually damaging the optic nerve.3
Angle-closure glaucoma
Angle-closure glaucoma is a serious condition in which the outer edge of the iris (the colored part of the eye) blocks the fluid from draining out of the eye. This leads to a sudden increase in pressure, which, if not treated, can cause blindness.3
Angle-closure glaucoma has no warning signs. As the disease progresses, blind spots develop in the person’s peripheral vision.3
Normal tension glaucoma
Normal tension glaucoma is a type of glaucoma that occurs in people with normal eye pressure. People with this condition may notice blind spots in their field of vision.3
Congenital glaucoma
Congenital diseases are those that are present from birth. In congenital glaucoma, a problem in the baby’s eye prevents fluid from draining properly.3
A child born with congenital glaucoma may have:3
· Cloudy eyes
· Sensitivity to light
· Excessive tearing
· Larger-than-normal eyes
Examples of secondary glaucoma include:
Pigmentary glaucoma
Pigmentary glaucoma is a type of glaucoma that affects people with pigment dispersion syndrome. In this condition, pigment from the iris is released and gets stuck in the eye’s drainage system, blocking it. This can lead to an increase in eye pressure and optic nerve damage.3,4
People with this condition may notice halos around lights, blurred vision, and gradual vision loss.4
Neovascular glaucoma
Neovascular glaucoma is usually caused by other health problems, such as diabetes or high blood pressure. In these cases, the eye makes extra blood vessels that block the area where fluid drains.4
Neovascular glaucoma can cause pain and redness in the eyes. Eventually, it progresses with vision loss.4
Exfoliation glaucoma
It’s a type of open-angle glaucoma that occurs in people with exfoliation syndrome. This condition causes extra material to deposit on eye parts and prevents fluid from draining.4
This type of glaucoma can progress faster than others and cause higher eye pressure.4
Uveitic glaucoma
It’s a type of glaucoma affecting people with uveitis. Uveitis causes swelling and inflammation of the eye. This causes the tissue in the middle of the eye to scar, damaging or blocking the area where fluid drains out and increasing eye pressure.4
Symptoms of uveitic glaucoma include pain, blurred vision, sensitivity to light, and headaches.4
Who is at risk for glaucoma?
Some people have a higher risk of developing glaucoma. Risk factors include:5
· A family history of glaucoma.
· Age older than 40 years.
· African, Hispanic, or Asian heritage.
· Eye problems such as myopia.
· Certain conditions like high blood pressure, poor circulation, migraine, sleep apnea, and diabetes.
· Using long-term steroid medications.
Talk to your ophthalmologist about your risk of developing glaucoma.5
How to diagnose and treat glaucoma?
Glaucoma is usually identified on a routine eye exam. During this exam, the doctor will measure your eye pressure, inspect your eye’s drainage, test peripheral vision, measure the thickness of the córnea, and examine your optic nerve.6
Glaucoma damage is irreversible, but treatment can help stop it from getting worse. Treatment often involves:6
· Medication – eyedrop medicine can lower eye pressure by helping fluid flow better through the drainage system.
· Surgery – surgery can help the fluid drain from the eye. Your doctor may recommend laser surgery, done in the office, or a procedure performed in an operating room.
While medication to lower eye pressure remains the standard treatment, lifestyle changes can help mitigate glaucoma’s impact. Recommendations include:7
· Diet – include leafy greens, berries, and Omega-3 fatty acids in your diet. Try to avoid caffeinated beverages, foods high in sodium, and excessive alcohol consumption.
· Exercise – moderate exercise such as walking, jogging, or swimming can lower eye pressure.
· Stress management – stress can worsen glaucoma by increasing eye pressure. Incorporating stress-reduction techniques such as meditation, yoga, or deep breathing exercises can be helpful.
Key takeaways
Glaucoma is a serious condition. Talk to an eye doctor to check for signs of glaucoma. Regular checkups can help detect the disease early and stopping it from getting worse.
References
1- Tham, Yih-Chung, et al. "Global prevalence of glaucoma and projections of glaucoma burden through 2040: a systematic review and meta-analysis." Ophthalmology 121.11 (2014): 2081-2090. Availabe at: https://www.sciencedirect.com/science/article/abs/pii/S0161642014004333
2- Understanding Glaucoma: Symptoms, Causes, Diagnosis, Treatment. American Academy of Ophthalmology. Available at: https://www.aao.org/eye-health/diseases/what-is-glaucoma
3- Types of glaucoma. National Eye Institute. Available at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma/types-glaucoma
4- Pigmentary glaucoma. Glaucoma Research Foundation. Available at: https://glaucoma.org/types/pigmentary-glaucoma
5- Who Is at Risk for Glaucoma? American Academy of Ophthalmology. Available at: https://www.aao.org/eye-health/treatments/glaucoma-risk
6- Glaucoma. National Eye Institute. Available at: https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/glaucoma
7- Managing Glaucoma: Effective Lifestyle Changes. Glaucoma Research Foundation. Available at: https://glaucoma.org/articles/managing-glaucoma-effective-lifestyle-changes
