What is glaucoma and what are the most common treatments for glaucoma - A layman's explanation
What is Glaucoma..?
Glaucoma is a group of eye conditions that lead to optic nerve damage within the eye and is often associated with high pressure building up inside of the eye referred to as intraocular pressure or IOP. Glaucoma is the second most common cause of blindness with cataracts being the first. Glaucoma damages the optic nerve at the back of the eye which is the part of the eye that sends visual information as tiny electrical impulses to the brain, which are then processed into what we see as our vision.
Open angle glaucoma
Open angle, or chronic, glaucoma is by far the most common and it means that these channels are still open and not blocked. In this type of glaucoma, a build up of pressure in the eye usually occurs over the period of several years and is painless so it can often go completely unnoticed until it is picked up during an eye examination. This is one reason why it is so important to have regular eye examinations so that conditions like this can be diagnosed as early on as possible and before any real damage is done. Open angle glaucoma often runs in families so you are far greater at risk if either of your parents or grand parents suffered with glaucoma. People of African, Asian and Hispanic descent also have a much higher risk of contracting this disease. Most people have no noticeable symptoms until they begin to lose their vision through a gradual loss of their peripheral (side) vision which is also known as tunnel vision.
Closed angle glaucoma
Conversely, closed angle, or acute glaucoma is far more serious and it means that these channels are either very severely restricted or completely blocked. It usually happens very quickly causing a severe and painful rise in intraocular pressure within the eye and thus is treated as an ocular emergency case. If the pressure isn't reduced very quickly, permanent damage and loss of vision will ensue very quickly. If you have previously suffered from closed angle glaucoma in one eye you are then at high risk for another attack in the other eye and so your eye specialist or ophthalmologist will usually recommend a course of preventative treatment to greatly reduce the risks of it happening. Some medications and eye dilating drops can trigger an acute glaucoma attack. Initially symptoms may come and go or steadily worsen. These symptoms include; a sudden and severe pain in one eye, a reddening of one eye, one eye feeling swollen, rainbow-like halos appearing around lights, decreased or clouded vision, nausea and vomiting. If any or all of these symptoms are noticed immediate medical treatment must be sought as quickly as possible.
Congenital means that the condition is present at birth and is usually hereditary which means that it is passed down from older generations so often runs in families. It is a result of the abnormal development of the fluid outflow channels in the eye referred to as the angle. Symptoms are usually noticed early on, when the baby is just a few months old and include; an enlargement of one or both eyes, a reddening of one or both eyes, a cloudiness of the front of one or both eyes, a sensitivity to light or extra tearing.
This type of glaucoma is caused by eye diseases such as uveitis, drugs such as corticosteroids, and systemic diseases which affect the whole body.
Different types of glaucoma eye tests
Regular and thorough eye tests are highly important, especially for the early diagnosis of glaucoma. The eye specialist or ophthalmologist may examine the inside of your eyes by looking through the pupil, usually after first dilating your pupils using dilating eye drops and will usually carry out a complete eye examination. Merely checking for elevated intraocular pressure levels within the eye using tonometry isn't enough to diagnose glaucoma accurately as eye pressures change. In around twenty-five percent of people with glaucoma their eye pressure is still normal and is referred to as normal tension glaucoma and in these cases there are other problems that cause optic nerve damage. Usual tests for glaucoma include; a tonometry test to test intraocular pressure, gonioscopy which uses a special lens to inspect the outflow channels of the angle, optic nerve imaging to take photographs of the inside of the eye, a retinal examination, a pupillary reflex response test, a slit lamp examination, a visual field measurement test and a visual acuity test.
The treatment of glaucoma
The main objective of glaucoma treatments are to reduce the elevated intraocular pressure within affected eyes. This can be done by either using different glaucoma drugs or medications or by surgery, depending on the type and severity of the condition.
Open angle glaucoma treatment
In most cases, people suffering from open angled glaucoma can be treated successfully with a series of glaucoma eye drops. Thankfully, the newer generation of glaucoma eye drops have far fewer adverse side-effects than their predecessors. Commonly patients are prescribed more than one drop as they have different mechanisms of action so combining two together can give better results than using just one type on its own. Some manufacturers are now selling combined medications which utilise two different glaucoma drugs inside the same eye drops. There are also some oral pills available which are also designed to lower intraocular pressure and some patients may also be prescribed these as well. Researchers are also working on new drugs that might actually be able to protect the optic nerve against damage from glaucoma. In some cases, patients may need surgery or laser treatment to either help to open up the outflow channels at the angle or to open up a completely new outflow channel. Provided good care is given, most patients with open angle glaucoma will be able to successfully manage their condition without losing their vision. It is very important to follow the instructions of your eye specialist or ophthalmologist and to follow their advised regime of treatment precisely.
Closed angle glaucoma treatment
As already stated, acute closed angle glaucoma is an optical emergency and if left untreated blindness will usually occur in just a few days. The usual treatment is to administer pills, drops and medication intravenously (injected into a vein) to very quickly lower the elevated intraocular pressure within the affected eye. In some cases an emergency operation called an iridotomy is required which uses a laser to cut a new channel in the iris to very quickly release the pressure build up and to stop another attack from happening. Rapid diagnosis and speedy treatment after an attack are of paramount importance to saving your eye sight. If you have any of the symptoms described above of an acute closed angle glaucoma attack you must seek emergency medical care immediately. People who are at high risk, or those who have already had an acute attack in the past, may opt for an iridotomy operation.
Congenital glaucoma treatment
This type of glaucoma is nearly always treated by surgery while the patient is asleep under anesthetic and opens up a new outflow channels in the angle. Diagnosing the condition as early as possible and getting treatment should ensure that most patients will have no further problems in the future.
Prevention is better than cure
With glaucoma, early diagnosis and treatment compliance are major factors to help prevent vision loss. Most people who have open angle glaucoma have no noticeable symptoms at all. Everybody who is forty years of age or older should have a regular eye examination carried out at least every five years. People in higher risk groups should have them carried out much more regularly. If you are a high risk and have never been screed for the condition phone and make an appointment at your earliest possible convenience. If you suffer any form of severe eye pain or notice a sudden loss of vision, especially peripheral field vision, make an ocular emergency call immediately.
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Michael Wildman, who was the gentleman featured on the Richard & Judy Show trials with me, got his wife to try our Glaucoma Eye Drops as he got such great results with our other drops for cataracts as she suffered with glaucoma. Prior to using Bright Eyes Drops for Glaucoma, she had used two different prescribed medications; Xalatan and one other, for over 2 years, with no signs of any improvements whatsoever. She was having six-monthly checkups and on her next checkup, after using Bright Eyes Drops for Glaucoma, her ophthalmologist was amazed to report that her intraocular pressure had dropped from 28 mm/hg to 14 mm/hg which is back within the normal range. Her eye specialist was so amazed at such great improvements since her last checkup that he then sent her for further test with a specialist and those subsequent tests confirmed that her periphery vision had also improved as well which is virtually unheard of with glaucoma sufferers.
Everyone is at risk from glaucoma; from new born babies to the elderly alike. Even with standard prescribed medications and treatments, intraocular pressure within the eyes may continue to escalate and glaucoma can continue to advance until ultimately the progression leads to complete blindness.