Glaucoma is basically a group of eye conditions which eventually damage the optic nerve which is essential to good vision. Damage to optic nerve is typically caused by abnormally high pressure within the eye. Leading cause of blindness among people in United States, Glaucoma can occur in any age group but is most common among older adults. Common forms of glaucoma show no warning signs. Effects are so slow & gradual that patients are unable to notice changes in vision until this condition manifests in advanced stages. However, since vision loss due to glaucoma is irreversible, it is important to undergo regular eye examination which includes measurements of eye pressure. Vision loss can be effectively slowed or prevented in cases where glaucoma is recognized in early stages. Patients having this condition generally require treatment for the rest of their lives.
Signs & Symptoms of Glaucoma
Signs & symptoms of glaucoma however vary, generally depending upon the type & stage of eye condition.
- Open Angle Glaucoma Symptoms
- Patchy blind spots in peripheral, side or central vision which is frequently in both eyes.
- Advanced stages of tunnel vision.
- Acute Angle-Closure Glaucoma Symptoms
- Eye Pain
- Severe Headache
- Blurred Vision
- Nausea & Vomiting
- Eye Redness
- Halos around Lights
Glaucoma will eventually cause blindness if it is left untreated. Even after treatment, about 15% of people with glaucoma turn blind in at least one eye within the following 20 years.
Causes for Glaucoma
Resulting from damage to optic nerve which gradually deteriorates, blind spots develop within visual field of patients suffering from glaucoma. This damage to optic nerve is usually related to increased pressure in eye which doctors do not still fully understand. Elevation in eye pressure is usually due to buildup of fluid called aqueous humor which floats throughout the eye. Aqueous humor normally drains into anterior chamber located in front of eye through trabecular meshwork of tissue at the angle where cornea & iris meet. This fluid cannot flow out at normal rate & therefore builds pressure when it is either overproduced or when the drainage system does not work properly. Moreover, glaucoma tends to run in families. Researchers have identified specific genes related to high eye pressure & optic nerve damage in some people suffering from glaucoma.
Types of Glaucoma
- Open-Angle Glaucoma – This is the most common form of glaucoma. While drainage angle formed by iris & cornea remain open, trabecular meshwork is partially blocked in open-angle glaucoma. This eventually results building pressure in eye which is gradually increased & causes damage to optic nerve. Moreover, it happens so slowly that patients often lose vision even before they are aware of this problem.
- Angle-Closure Glaucoma – Also known as Closed-Angle Glaucoma, this usually occurs when iris bulges forward so as to block or narrow drainage angle formed by iris & cornea. Fluid therefore cannot circulate through the eye & increases pressure as a result. Moreover, some people also have narrow drainage angles, which put them at increased risk of developing angle-closure glaucoma. This type of glaucoma when occurs suddenly is known as Acute Angle-Closure Glaucoma, & in cases where it gradually develops is called Chronic Angle-Closure Glaucoma. Acute angle-closure glaucoma is largely a medical emergency as it can be triggered by sudden dilation of pupils.
- Normal-Tension Glaucoma – Optic nerve gets damaged even when eye pressure is in normal range for normal-tension glaucoma patients. Exact reason for this type of glaucoma is however unknown. Having a sensitive optic nerve or lesser blood being supplied to optic nerve is suspected to be the reason behind this condition. This limited flow of blood may be causing atherosclerosis, which is buildup of plaques or fatty deposits within arteries or eye or other conditions impairing circulation.
- Glaucoma in Children – Infants & children are also found to develop glaucoma. This condition may either be present from birth or developed within the first few years of life following birth. Optic nerve damage among children may be caused by blockage in drainage or another underlying medical condition.
- Pigmentary Glaucoma – Pigment granules from iris buildup within drainage channels in pigmentary glaucoma patients. This will subsequently block or slow fluid exiting eyes. Physical activities like jogging are sometimes found to stir up pigment granules which deposit on trabecular meshwork as a result & cause elevations in intermittent pressure.
Initial Appointment for Glaucoma Treatment
Generally, glaucoma does not cause any noticeable signs & symptoms until it has caused permanent damage to optic nerve. It would therefore be sensible to consult an ophthalmologist for comprehensive eye examination & follow-up schedule. So make an appointment with the eye doctor as soon as you notice vision problems or any new eye symptoms.
Information to Help during Initial Appointment
Create a List of –
- Symptoms noticed including duration of time.
- Vitamins, supplements & medications you are taking including doses.
- Past eye problems like eye discomfort or vision changes.
List of Questions to Ask Ophthalmologists
- Do my signs & symptoms relate with glaucoma?
- What tests should I undergo so as to confirm diagnosis?
- Which treatment approach will you recommend?
- Are there any alternatives to primary approach suggested by you?
- Will I need to follow any restrictions in activity?
- Which other self-care measures can help me?
- What is the long-term outlook in my case of glaucoma?
- What schedule of follow-up visits can I expect?
- Will I need to see any additional specialists?
- How can I best manage my glaucoma with my other health conditions?
Some Questions Ophthalmologists May Prefer to Ask
- Have you ever had any eye discomfort including vision problems?
- What other signs & symptoms concern you?
- Are you having any family history of eye problems including glaucoma?
- Which eye screening tests have you undergone in the past & when?
- Which other medical conditions are you diagnosed for?
- Have you been using any eye-drops?
- What vitamins & supplements are you using?
Tests & Diagnosis for Glaucoma
Ophthalmologists or eye specialist doctors will review patients’ medical history & conduct a comprehensive eye examination. They may perform several tests which can include the following.
- Tonometry – Measuring intraocular pressure.
- Tests to evaluate optic nerve damage.
- Pachymetry – Measuring thickness of cornea.
- Gonioscopy – Drainage angle inspection.
Seeking Immediate Medical Care for Glaucoma
It would be ideal to seek immediate medical care from an ophthalmologist in case patients experience any symptoms of acute angle-closure glaucoma. This can include eye pain, severe headache & blurred vision.
Schedule the Following Eye Examinations
Since open-angle glaucoma hardly gives few warning signs until permanent damage to eye has occurred, regular examination of eyes is the key to detecting glaucoma in early stages which can successfully slow down or prevent loss of vision. Screening tests for glaucoma are recommended to be performed every 4 years starting at age 40 for people who have no risk factors for glaucoma. Eye screening tests for glaucoma should be scheduled every 2 years for high risk glaucoma patients or people over 65 years of age.
Treatments for Glaucoma
Damage caused by glaucoma to vision & optic nerve cannot be reversed, but regular checkups & treatment can slow down or prevent vision loss especially when disease is caught in early stages. Goal of glaucoma treatments is to lower intraocular pressure & several options including eye-drops, laser treatment or eye surgery are available.
- Eyedrops – Normally, treatment for glaucoma often begins with prescription eye-drops. These generally help decrease pressure in eye by improving fluid drains or by decreasing amount of fluid production in eye. Common prescription eye-drops include the following.
- Prostaglandins increase the outflow of fluid in eye & reduce pressure. Possible side effects include mild reddening, stinging of eyes, darkening of iris, changes in pigment of eyelid skin or eyelashes & blurred vision.
- Beta Blockers reduce production of fluid in eye & eventually lower intraocular pressure. Possible side effects include difficulty in breathing, impotence, lower blood pressure, slow heart rate & fatigue.
- Alpha Adrenergic Agonists also reduce production of aqueous humor & increase outflow in eye. Possible side effects of alpha adrenergic agonists include high blood pressure, irregular heartbeat, fatigue, itchy & red or swollen eyes & dry mouth.
- Carbonic Anhydrase Inhibitors are rarely used for glaucoma. However, these reduce production of fluid in eyes. Possible side effects include tingling in fingers & toes, frequent urination & metallic taste in mouth.
- Miotic or Cholinergic Agents increase outflow of fluid from eye. Possible side effects of miotic agents include nearsightedness, smaller pupils & dim or blurred vision.
- Oral Medications – When eye-drops alone cannot bring eye pressure down to desired levels, eye specialists may prescribe oral medications as well. These are usually carbonic anhydrase inhibitors with possible side effects including depression, frequent urination, kidney stones, stomach upset, along with tingling in fingers & toes.
- Surgeries & Other Therapies – Other treatment options for glaucoma include Different vision correction procedures & laser therapy. Possible complications from these procedures include redness, pain, infection, bleeding, inflammation & abnormally low or high eye pressure along with loss of vision. Moreover, some types of eye surgery for glaucoma may also speed development of cataracts. Glaucoma patients seeking this option will need to see eye doctors for follow-up examinations & may need to undergo additional procedures as well in case eye pressure begins to rise or other changes occur within eyes. Researchers are also engaged in evaluating effectiveness of newer drugs, drug delivery methods, devices & surgical procedures in the emerging technologies as treatment for glaucoma. Following 4 surgical techniques are intended to lower pressure & improve drainage of fluid within eye.
- Laser Therapy – Laser Trabeculoplasty option is for people with open-angle glaucoma. Eye surgeons in this procedure use laser beam to open clogged channels within trabecular meshwork. It may however take a few weeks until full effects of this procedure becomes apparent.
- Filtering Surgery – This surgical procedure is called Trabeculectomy. Eye surgeons create an opening in the white sclera of the eye & remove part of damaged trabecular meshwork.
- Drainage Tubes – Eye surgeon in this procedure will insert a small tube in eye for drainage.
- Electrocautery – Eye doctors in certain cases may suggest this minimally invasive procedure so as to remove damaged tissue from trabecular meshwork by using a small electrocautery device known as Trabecutome.
Treating Acute Angle-Closure Glaucoma
It is a medical emergency for treating acute angle-closure glaucoma patients. Patients with this condition will need urgent treatment so as to reduce pressure in eye & for which, both medication, & laser or other surgical procedures are required. Eye surgeons may in this condition opt for a procedure called Laser Peripheral Iridotomy in which they create a small hole in iris using laser. This will allow aqueous humor fluid to flow through it & thereby relieve pressure in eye.
Risk Factors for Glaucoma
Since chronic types of glaucoma destroy vision even before signs & symptoms are apparent, it would be sensible to be aware of the following risk factors.
- Having high intraocular or internal eye pressure.
- People above 60 years of age.
- Black or Hispanic populations.
- People with family history of glaucoma.
- Having medical conditions like heart disease, diabetes, high blood pressure & sickle cell disease.
- People with certain eye conditions like nearsightedness.
- People with eye injuries or having undergone certain types of eye surgery.
- Women with early estrogen deficiency caused after removal of both ovaries before age 43.
- People who have been taking corticosteroid medications, especially eye-drops for long periods of time.
Coping & Support for Glaucoma Patients
When people are diagnosed for glaucoma, they are facing a lifetime of treatment including regular checkups along with possibility of progressive vision loss. Meeting & talking with other people in similar situations, including support groups, can be very helpful. So check with eye care centers & support staff in order to find local groups & their times for meeting. One can also find several online resources & support groups for coping with suffering with glaucoma.
Preventive Measures for Glaucoma
Most often, people may not be able to prevent glaucoma. However, there are a number of self-care steps which can help early detection of glaucoma & so limit loss of vision or slow down progress.
- Regular Comprehensive Eye Examinations – Eye exams can help detect glaucoma in early stages prior to occurrence of irreversible damage. Undergo comprehensive eye examinations every 4 years as a general rule starting from age 40 & every 2 years after age 65. Some people who are at high risk of glaucoma may however need more frequent screening. Check with eye specialists who can recommend the right screening schedule in your case.
- Knowing Family History of Eye Conditions – Generally, glaucoma tends to run in the family. People who are at increased risk will therefore need more frequent screening tests.
- Regular Exercise for Eye Safety – Regular & moderate exercise regimen will help prevent glaucoma by reducing internal eye pressure. Consulting an ophthalmologist about an appropriate exercise program will be ideal.
- Administer Prescribed Eye Drops – Eye-drops for glaucoma can significantly reduce risk of eye pressure which can progress to glaucoma. Eye-drops prescribed by eye specialists are required to be regularly used to be effective even when you experience no symptoms.
- Wearing Eye Protection Gear – Serious eye injuries can also eventually lead to glaucoma. Therefore, protecting eyes with glasses & masks while using power tools or when playing high-speed racket sports on enclosed courts will be sensible.
Affordable Treatment for Glaucoma in India
There are many subtypes of glaucoma which can all be considered as some form of optic neuropathy. Optic nerve damage generally involves loss of retinal ganglion cells occurring in a characteristic pattern. Eye treatments & Eye surgery in India is at par with the best available in other parts of the world coming along with the additional low-cost factor. Eye hospitals in India are technologically advanced & offer a wide spectrum of surgical solutions for eye-care. IndianMedTrip is a one-stop online-shop offering numerous affordable healthcare solutions including eye treatments like glaucoma for international patients. Associated with the best accredited eye care facilities, IndianMedTrip Consultants would be glad to combine an exotic recuperative holiday at reasonable costs to go alongside your treatment for glaucoma in the subcontinent.