Glucoma

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Glucoma

• By Ashutosh

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• The leading cause of blindness
• all over the world.
• The Second-Leading Cause of Blindness in the
  U.S.

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Glucoma
Glaucoma affects an estimated 3 million
Americans, with 120,000 blind due to the
condition. Elsewhere in the world, glaucoma
treatment is less available, and glaucoma ranks
as a leading cause of blindness just about
everywhere. Even if people with glaucoma do not
become blind, vision can be severely impaired.
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Glucoma
The silent thief of sight Also known
as kala motia
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What is Glucoma (kala motia)

• Your eye has pressure just like your blood, and
  when this intraocular pressure (IOP) increases to
  dangerous levels, it damages the optic nerve.
  This can result in decreased peripheral vision
  and, eventually, blindness. Glaucoma is similar
  to ocular hypertension but with accompanying
  optic nerve damage and vision loss.

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Anatomy of Eye
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Types of Glucoma

• There are two major types of glaucoma
• Chronic or primary open-angle glaucoma (POAG)
• And
• Acute closed-angle glaucoma.
• Other variations include congenital glaucoma,
  pigmentary glaucoma and secondary glaucoma.

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Glaucoma Signs and Symptoms

• Chronic glaucoma (primary open-angle glaucoma or
  POAG) is often called "the silent thief of sight"
  because you have no warning sign, no hint that
  anything is wrong. Person with chronic glaucoma
  don't know they have it. Glaucoma gradually
  reduces your peripheral vision, but by the time
  you notice it, permanent damage has already
  occurred. If your IOP remains high, the
  destruction can progress until tunnel vision
  develops, and you will only be able to see
  objects that are straight ahead.

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Glaucoma Signs and Symptoms

• An acute attack of narrow-angle glaucoma, also
  termed acute angle-closure glaucoma or acute
  closed-angle glaucoma, produces sudden symptoms
  such as eye pain, headaches, haloes around
  lights, dilated pupils, vision loss, red eyes,
  nausea and vomiting. These signs may last for a
  few hours, then return again for another round.
  Each attack takes with it part of your field of
  vision.
• Other signs include headaches, blurred vision,
  difficulty adapting to darkness, or haloes around
  lights.
• Chronic glaucoma normally develops after age 35.

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Glaucoma Signs and Symptoms

• Like POAG, normal-tension glaucoma (also termed
  normal-pressure glaucoma, low-tension glaucoma or
  low-pressure glaucoma) is an open-angle type of
  glaucoma that can cause visual field loss due to
  optic nerve damage, but in normal-tension
  glaucoma, the eye's IOP remains in the normal
  range.
• Chronic narrow-angle glaucoma, like open-angle
  glaucoma, can be symptomless until vision loss
  occurs.

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• Congenital GlucomaIt's difficult to spot signs
  for congenital glaucoma because the children are
  too young to understand. If you notice a cloudy,
  white, hazy, enlarged or protruding eye, consult
  your eye doctor. Congenital glaucoma occurs more
  in boys than girls.
• Pigmentary glaucoma often exhibits no symptoms
  at all. You may notice some pain and blurry
  vision after exercise. Pigmentary glaucoma
  affects mostly white males in their mid-30s to
  mid-40s.
• Symptoms of chronic glaucoma following an eye
  injury could indicate secondary glaucoma.

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What Causes Glaucoma?

• An increased IOP reading indicates a problem with
  the amount of aqueous humor (fluid) in the eye
  either the eye is producing too much, or it's not
  draining properly. The drainage area is the angle
  formed between the cornea and the iris, which is
  why you see the word "angle" in the different
  glaucoma names.

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• In chronic glaucoma, the aqueous humor can't make
  it through meshwork in the eye to the drainage
  channel. Risk factors for this type of glaucoma
  include
• Certain medical disorders. Diabetes, extreme
  nearsightedness and previous eye surgery are risk
  factors for chronic open-angle glaucoma.
  Additionally, if you have a condition that
  requires the use of oral or inhaled steroids,
  particularly high doses for prolonged periods,
  that can increase your risk as well.(Glucosugar
  and omagrowth)
• Family history. Like so many diseases, glaucoma
  tends to run in families different genes,
  however, are involved in different families.

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The cause of normal-tension glaucoma is not
known, but many doctors believe it is related to
poor blood flow to the optic nerve.
Normal-tension glaucoma is more common in those
who have a history of vascular disease, are
Japanese or are female. Narrow-angle glaucoma
occurs in less than 10 of glaucoma patients. In
this form of the disease, aqueous humor cannot
drain out of the eye due to very narrow drainage
angles that are usually blocked by the iris. This
condition can occur slowly and progressively, or
very quickly.
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Again, rapid closing of the angles, or acute
angle-closure glaucoma, is a medical emergency.
Optic nerve damage and vision loss will occur
within hours if the angles are not opened to
drain fluid and lower IOP. Acute angle-closure
glaucoma may be triggered by anything dilating
the pupil, resulting in more of the iris blocking
the angles. Dim lighting, drops administered by
your eyecare practitioner during an eye
examination, or certain medications such as
antihistamine/decongestant drops or cold
medications may cause an acute angle-closure
attack.
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Congenital glaucoma is a rare form of the disease
affecting babies, with 80 of cases diagnosed by
age one. These children are born with narrow
angles or some other defect in the drainage
system of the eye. Pigmentary glaucoma, another
rare form of the disease, is caused by pigment
from the iris clogging the draining angles,
preventing aqueous humor from leaving the eye.
Over time, the inflammatory response to the
blocked angle damages the drainage
system.Secondary glaucoma develops after trauma
to the eye that affects the drainage system.
Injury, infection, inflammation, tumor or an
enlarged cataract can precipitate secondary
glaucoma.
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Glaucoma Treatment

• The best way to prevent vision loss from glaucoma
  is early diagnosis and treatment. See your
  eyecare practitioner at least every two years for
  a complete examination, including an IOP check.
  People at high risk for glaucoma due to high
  intraocular pressures, family history, ethnic
  background, age or optic nerve appearance may
  need more frequent visits to the eye doctor.

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A test called a visual field may be performed on
glaucoma suspects to detect peripheral vision
loss. It involves staring straight ahead into a
machine and clicking a button when you notice a
blinking light in your peripheral vision. The
visual field test may be repeated at regular
intervals for your doctor to determine the extent
of vision loss. Glaucoma treatment (for any
form) entails decreasing aqueous humor
production, increasing fluid drainage or a
combination of the two. These treatments will not
restore any vision already lost to glaucoma.
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Generally the first stage of glaucoma treatment
is beta-blocker eyedrops, which will lower fluid
production in the eye. These may not be used in
people with heart conditions, because they can
affect heart or lung function. There are other
pressure-lowering drops besides beta-blockers
that are known as alpha-2 agonists and
prostaglandin analogs. Many of the drugs used for
glaucoma interact with common medications.
Patients should discuss these issues with both
the family physician and the eyecare
practitioner.
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By Surgery During a type of glaucoma surgery
called trabeculoplasty, the doctor uses a laser
to create tiny holes where the cornea and iris
meet, to increase aqueous humor drainage.
Another procedure called trabeculectomy creates
an artificial drainage area it's used in cases
of advanced glaucoma where there is optic nerve
damage and the IOP continues to soar. A third
option is a drainage device, which the surgeon
implants in your eye to improve fluid drainage.
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Request You

• Please check your IOP once in two year followed
  by visual field.

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• Thank you!