Glaucoma

Glaucoma advances in Greensboro, NC

Glaucoma is a degenerative disease of the optic nerve that if left untreated can cause permanent damage to the optic nerve resulting in gradual vision loss and eventual blindness. Damage to the optic nerve, due to glaucoma, is frequently associated with an elevated pressure (IOP) inside the eye. Clear fluid, called aqueous humor circulates through the eye providing nourishment to the tissues. Aqueous humor flows out of the eye through the Trabecular Meshwork (TM), near the edge of the iris. If the TM is blocked, or damaged the pressure inside the eye increases. This elevated pressure results in damage to the optic nerve and vision loss occurs.
Open Angle Glaucoma (OAG), occurs when there is an increase in fluid production or a decrease in fluid drainage. Over time, as the optic nerve fibers are damaged and peripheral (side) vision is lost. Without proper treatment, central vision is lost as well.
Glaucoma can occur in people of all races at any age. However, the likelihood of developing glaucoma increases if you:

are African American or Hispanic
have a relative with glaucoma
are diabetic
are very nearsighted
are over 35 years of age
are on steroids
have had an injury or surgery to the eyes

Types of Glaucoma

PRIMARY OPEN ANGLE GLAUCOMA

It is the most common type of glaucoma that affects many millions worldwide. This form of glaucoma is a result of the natural draining mechanism of the eye becomes clogged causing an increase in pressure within the eye. This draining mechanism or pipes become clogged which does not allow the free flow of fluids from inside the eye to exit the eye.
Unfortunately, this clogging does not have any symptoms and only early diagnosis can detect this condition. This type of glaucoma results in a gradual loss of vision that can lead to blindness. Fortunately, medical treatments are available to slow or maintain the progression of this disease.

ANGLE CLOSURE GLAUCOMA

Is a less common form of glaucoma that results when the draining mechanism of the eye is blocked because the angle of the eye is too small. This means there is a much smaller anterior chamber of the eye with little space between the iris and Schlemm’s Canal, the actual drain of the eye. As the angle becomes blocked, fluid will continue to be made at a normal rate but will be unable to exit the eye, allowing the pressure in the eye to quickly build up to harmful levels. The normal treatment protocol is usually surgery where a small amount of Iris is removed allowing for better movement. This better movement helps prevent or reduce the increase of pressure within the eye. Typical symptoms may include eye pain, halos, distorted vision, nausea or headaches. You may also experience a combination of symptoms.

SECONDARY GLAUCOMA

This form of glaucoma may result from some type of trauma to the eye, a disease of the eye that results in inflammation, tumor or individuals with cataracts or diabetes. This type of glaucoma can also be a result of certain medications or medications containing steroids. Treatment of secondary glaucoma will be dependent upon the angle of eye.

NORMAL TENSION GLAUCOMA (NTG)

This form of glaucoma results in damage to the optic nerve without an increase in the pressure of the eye. At present there is no clear understanding why this occurs even though there is normal intraocular pressure. A family history of normal tension glaucoma or systemic heart disease are possible risk factors of this disease. Early detection and diagnosis is the best course of action to reducing the harmfulness of this disease. A combination of laser therapy, medications and surgery may be used to deter the progression of
this disease.

PIGMENTARY GLAUCOMA

This is similar to secondary glaucoma. Some of the pigmentary granules in the back of the Iris separate from the Iris and move into the drainage area of the eye. These tiny granules eventually clog the drainage pipes of the eye. This eventually leads to an increase in intraocular pressure. Treatment options may include laser surgery, medications or surgery.

CATARACTS AND GLAUCOMA

Over time, many individuals, typically over the age of 60 are diagnosed with cataracts. Having glaucoma does not necessarily mean you will get cataracts and getting cataracts does not mean you will get Glaucoma. Glaucoma and cataracts are more prevalent as we get older. Although cataracts do not cause glaucoma, trauma to the eye or certain medications may lead to glaucoma and cataracts. Be well informed of the possible side effects of medications. As discussed, cataracts and glaucoma may lead to blindness but modern surgical techniques can reverse the effects of cataracts yet glaucoma is permanent, therefore routine eye exams and proper medical treatment may reduce possible vision loss.

TREATMENTS FOR OPEN-ANGLE GLAUCOMA

To control glaucoma, your doctor will use one of three basic types of treatment: medicines, laser surgery, or filtration surgery. The goal of treatment is to lower the pressure in the eye.

Glaucoma medication comes in many forms

Medicines come in pill and eye drop form. They work by either slowing the production of fluid within the eye or by improving the flow through the drainage meshwork. To be effective, most glaucoma medications must be taken between one to four times every day, without fail. Some of these medications have some undesirable side effects, so your doctor will work with you to find a medication that controls your pressure with the least amount of side effects. Medicines should never be stopped without consulting your doctor, and you should notify all of your other doctors about the medications you are taking.


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