Treatment of glaucoma
Dr. Faozat Aragbaye
Glaucoma is a group of diseases that damage the eye’s optic nerve and can result in vision loss and blindness. However with early detection and treatment the eyes can be protected from serious vision loss.
Risk Factors of Glaucoma
- High internal eye pressure (intraocular pressure)
- Age above 60years
- Black, Asian or Hispanic
- Family history of glaucoma
- Certain medical conditions such as diabetes, heart diseases, high blood pressure and sickle cell anaemia.
- Corneas that are thin in the centre.
- Extreme nearsightedness or farsightedness
- Previous eye injury or certain type of eye surgery.
- Long term application of corticosteroids medications especially eye drops.
Types of Glaucoma
- Open –angle glaucoma- most common form of the disease.
- Angle- closure glaucoma
- Normal tension glaucoma
- Pigmentary glaucoma
- Congenital glaucoma
- Secondary glaucoma
Symptoms of Glaucoma
The signs and symptoms of glaucoma vary depending on the type and stage of the condition.
Open –angle glaucoma- Initially, open-angle glaucoma has no symptoms. Later, it presents with patchy blind spots in the side or central vision, frequently in both eyes. Tunnel vision in advanced stages.
Acute-angle glaucoma presents with the followings;
Severe headache; Eye pain; Nausea and Vomiting; Blurred vision; Halos around light and eye redness.
Causes of Glaucoma
Experts are unsure of the precise causes of glaucoma, but causes are divided into categories;
Primary glaucoma- the cause is unknown
Secondary glaucoma- the condition has a known cause, such as tumour, diabetes, an advanced cataract or inflammation of the eyes.
Diagnosis of Glaucoma
- Medical history
- Measuring intraocular pressure
- Evaluate optic nerve damage with dilated eye examination and imaging tests
- Checking for areas of vision loss. (visual field test.
- Measuring corneal thickness.
- Inspection of the drainage angle.
Treatment of Glaucoma
The damage caused by glaucoma can’t be reversed . But treatment and regular checkups can help slow or prevent vision loss especially if the disease is detected at its early stages.
Glaucoma is treated by lowering the eye pressure ( intraocular pressure )
Depending on the situation, treatment may include prescription eye drops, oral medication, laser treatment, surgery or combination of any of these.
Eye drops – Glaucoma treatment often starts with prescription eye drops. These include; prostaglandins; Betablockers; Alpha-adrenergic agonists; carbonic anhydrase inhibitors ; Rho-kinase inhibitor and Motic or Cholinergic agents.
Oral medications- If eye drops alone don’t bring the eye pressure down to the desired level, oral medication can be prescribed along with the eye drops.
Surgery and other therapies- Other treatment options include: Laser therapy and various surgical procedures. The following techniques are intended to improve the drainage of fluid within the eye, thereby lowering the eye pressure
These procedures include ; Laser therapy; Filtering surgery; Drainage tubes and Minimally invasive glaucoma surgery.
Acute Angle -closure glaucoma- This a medical emergency. This generally will require both medication and laser or other surgical procedures.
These self care steps can help one detect glaucoma in its early stage, which is important in preventing vision lossor slowing down its progress.
- Get regular dilated eye examinations- It is recommended that comprehensive eye examination should be done every five to ten years, if one is under 40 years old; every two to four years for 40-54years old; every one to three years for 55-64years and one to two years for people above 65years.
- Know your family ey health history since glaucoma tends to run in families. If one is at risk there is need to do frequent screening.
- Exercise safely- Regular, moderate exercise may help prevent glaucoma by reducing eye pressure.
- Regular use of prescribed eyes drops- Glaucoma eyes drops can significantly reduce the risk that high eye pressure will progress to glaucoma. Foe effectiveness, eye drops need to be used regularly even if there is no symptoms.
Wearing of eye protection- Serious eye injuries can lead to glaucoma. Wearing of eye protection when handling power toolsor playing high speed racket sports in enclosed courts.-