Eyes | Ophthalmology | Glaucoma (Disease)


Glaucoma generally develops gradually over a number of years and often goes undetected in the early stages. A person with glaucoma may not experience symptoms until vision loss has already begun. It also runs in families and the risk increases with age.

Glaucoma can be roughly divided into two main categories, open angle and closed angle (or angle closure) glaucoma. The angle refers to the area between the iris and cornea, through which fluid must flow to escape via the trabecular meshwork. Closed angle glaucoma can appear suddenly and is often painful; visual loss can progress quickly, but the discomfort often leads patients to seek medical attention before permanent damage occurs. Open angle, chronic glaucoma tends to progress at a slower rate and patients may not notice they have lost vision until the disease has progressed significantly.

Patients with open-angle glaucoma and chronic angle-closure glaucoma in general have no symptoms early in the course of the disease. Visual field loss (side vision loss) is not a symptom until late in the course of the disease. Rarely patients with fluctuating levels of intra-ocular pressure may have haziness of vision and see haloes around lights, especially in the morning.

Causes and Risk factors

Glaucoma is the name for a number of conditions that damage the optic nerve, usually as a result of increased pressure within the eye that results when the naturally occurring fluid (aqueous humor) in the eye does not drain properly out of the eye. Slow drainage may occur with normal eye anatomy (open-angle glaucoma) or with structural problems in the drainage mechanism (angle-closure glaucoma). The optic nerve damage of glaucoma usually affects the peripheral vision first, leading to tunnel vision, and moves progressively to involve the central vision.

Diagnosis and Treatment

Glaucoma treatments reduce intraocular pressure by improving aqueous outflow, reducing the production of aqueous, or both. Glaucoma cant be totally cured, and damage caused by the disease cant be reversed, but treatment and regular checkups can prevent visual loss in people with very early glaucoma. If visual loss has already occurred, treatment can slow or prevent further vision loss. ...