Glaucoma and your eyes

Glaucoma week is being celebrated from 8th-16th March this year, so lets us know about it. Glaucoma is a group of eye diseases that causes damage to your eye's optic nerve. It  gets worse over time if proper treatment is not taken timely & can eventually lead to blindness. It's often associated with a build-up of pressure inside the eye. Glaucoma tends to be inherited and may not show up until later in life.

One of the major risk factors is increased pressure (inside the eyeball), called intra-ocular pressure, can damage the optic nerve, which transmits images to the brain. Without treatment, glaucoma can cause total permanent blindness within a few years, usually starting with peripheral, or side vision loss. There is a condition known as (NTG) Normal Tension Glaucoma, where glaucoma changes progress despite normal pressures.

Because most people with glaucoma have no early symptoms or pain from this increased pressure, it is important to see your eye doctor regularly so that glaucoma can be diagnosed and treated before long-term visual loss occurs.

If you are over the age of 40 and if you have a family history of glaucoma, you should have a complete eye exam with an eye doctor every one to two years. If you have health problems such as diabetes or a family history of glaucoma or are at risk for other eye diseases, you may need to visit your eye doctor more frequently.

Who is at risk?

Although anyone can get glaucoma, some people are at higher risk than others.

1. Age - One per cent of people over the age of 40 may be affected. 5 per cent of people over the age of 65 may be affected.
2. Race - If you are of African origin you are more at risk of chronic glaucoma and it may come on earlier and be more serious. Ensure you have regular eye checks.
3. Family History - If you have a mother, father, brother or sister who has glaucoma, then you should have an eye test regularly, especially if you are over 40.
4. Short Sighted - People who are short sighted are more prone to glaucoma.
5. Diabetes - Diabetes is believed to increase the risk of developing this condition

Glaucoma types & symptoms-

Open Angle Glaucoma (OAG)/Chronic Glaucoma – The most common, when the drainage channels become blocked slowly over many years. The eye pressure rises very slowly and there is no pain to show there is a problem. But the field of vision gradually becomes impaired. Once damage is done it cannot be repaired. However with early diagnoses and regular eye checkups and treatment, damage can be kept to minimum

Angle Closure Glaucoma/ Acute Glaucoma - This happens when there is a sudden and more complete blockage to the flow of the fluid to the eye. This is because the narrow angle closes to prevent fluid getting to the drainage channel. The eye becomes red, vision deteriorates .You may also experience nausea and vomiting. In the early stages you may see colored rings around white lights. This can be very painful and will cause permanent damage if not treated promptly. In some cases Acute Glaucoma does not always cause sudden pain. You can have a series of mild attacks, often in the evening. There may be some discomfort in the eye, colored lights around a white light, and hazy vision. If you experience either of these systems you should contact your Doctor.

Congenital glaucoma (Buphthalmos) – Over 80% of cases are diagnosed in the first three months of life. Due to an abnormality of the angle of the anterior chamber, blocking drainage.

Secondary Glaucoma - Two other main types of glaucoma occur when a rise in eye pressure is caused by another eye condition. This is known as secondary glaucoma. Secondary glaucoma can develop as a complication of other medical conditions. They are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumours, or uveitis (eye inflammation). Pigmentary Glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. Neovascular Glaucaoma is linked to diabetes.

How is glaucoma Diagnosed?
To diagnose glaucoma, an eye doctor will test your vision and examine your eyes through dilated pupils. The eye exam typically focuses on the optic nerve which has a particular appearance in glaucoma. In fact, photographs of the optic nerve can also be helpful to follow over time as the optic nerve appearance changes as glaucoma progresses. The doctor will also perform a procedure called tonometry to check for eye pressure,CCT(central corneal Thickness) and a visual field test, if necessary, to determine if there is loss of side vision. Glaucoma tests are painless and take very little time

How is glaucoma Treated ?

Glaucoma treatment may include prescription eye drops, laser surgery, or microsurgery.

Eye drops for glaucoma. These either reduce the formation of fluid in the front of the eye or increase its outflow. Side effects of glaucoma drops may include allergy, redness of the eyes, brief stinging, blurred vision, and irritated eyes. Some glaucoma drugs may affect the heart and lungs. Be sure to tell your doctor about any other medications you are currently taking or are allergic to.

Laser surgery for glaucoma. Laser surgery for glaucoma slightly increases the outflow of the fluid from the eye in open-angle glaucoma or eliminates fluid blockage in angle-closure glaucoma. Types of laser surgery for glaucoma include trabeculoplasty, in which a laser is used to pull open the trabecular meshwork drainage area; iridotomy, in which a tiny hole is made in the iris, allowing the fluid to flow more freely; and cyclophotocoagulation, in which a laser beam treats areas of the middle layer of the eye, reducing the production of fluid.

Microsurgery for glaucoma. In an operation called a trabeculectomy, a new channel is created to drain the fluid, thereby reducing intraocular pressure that causes glaucoma. Sometimes this form of glaucoma surgery fails and must be redone. For some patients, a glaucoma implant is the best option. Other complications of microsurgery for glaucoma include some temporary or permanent loss of vision, as well as bleeding or infection.

Open-angle glaucoma is most commonly treated with various combinations of eye drops, laser trabeculoplasty, and microsurgery. Traditionally in the U.S., medications are used first, but there is increasing evidence that some people with glaucoma may respond better with early laser surgery or microsurgery.

Infant or congenital glaucoma -- meaning you are born with it -- is primarily treated with surgery since the cause of the problem is a very distorted drainage system.

Talk to your eye doctor to find out which glaucoma treatment is right for you.

Preventing Glaucoma -

Take care of your eyes by all means. Eat good balanced and nutritious food. Increase the intake of food that will give you vitamin A, C, E and zinc. These things can reduce the risk of glaucoma. Apart from these things there is nothing that you can do to prevent glaucoma.

Would I Be Able To Drive?

If the loss of visual field is not advanced, most people can still drive. To assess damage to peripheral vision a field test will be carried out. You will be given a field test. You will be shown a sequence of spot lights on a screen and asked to say which you can see. This will enable the specialist to identify if you have any blind spots and see whether your sight meets the standard set out by the Driver and Vehicle Licensing Authority. Ask your specialist about this.

What Happens If My Sight Cannot Be Fully Restored?

Early detection and prompt treatment usually prevents or slows further damage by glaucoma. There are many aids and equipment to help you utilize your remaining vision. You should ask your specialist or optician about Low Vision Aids and whether you are eligible to register as partially sighted or blind. Registration enables you to get expert help and sometimes financial benefits.

What Is the Outlook for People With Glaucoma?

At this time, loss of vision caused by glaucoma is irreversible and cannot be restored. However, successfully lowering eye pressure can help prevent further visual loss from glaucoma. Most people with glaucoma do not go blind as long as they follow their treatment plan and have regular eye exams.