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Open-angle glaucoma, by far the most common form,
has no symptoms at first. The pressure in the eye
builds up gradually. At some point, side vision
(peripheral vision) is lost and without treatment,
total blindness will occur.
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Closed-angle glaucoma may be acute or chronic.
Acute closed-angle glaucoma results when the normal
flow eye fluid (aqueous humor) between the iris
and the lens becomes suddenly blocked. Symptoms
may include severe pain, nausea, vomiting, blurred
vision, and seeing a rainbow halo around lights.
Acute closed-angle glaucoma is a medical emergency
and must be treated immediately or blindness could
result in one or two days. Chronic closed-angle
glaucoma progresses more slowly and can produce
damage without symptoms, similar to open-angle glaucoma.
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Normal-tension glaucoma (NTG) is an open-angle
form of the disease that is not well understood.
Damage occurs to the optic nerve even though eye
pressure is in the normal range.
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Congenital glaucoma is a condition where babies
are born with defects that prevent the normal drainage
of fluid from the eye.
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Juvenile glaucoma has conventionally been used
to describe open-angle glaucoma in children, adolescents
and young adults.
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Secondary glaucoma occurs as the result of some
other medical problem, such as inflammation, a tumor,
or eye injury.
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Pigmentary glaucoma is a rare form of the disease
where pigment granules from the iris flake off into
the aqueous humor (eye fluid) and then clog the
eye drainage system (trabecular meshwork).
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Pseudoexfoliation syndrome occurs when outer layers
of the lens flake off and block normal flow of the
aqueous humor.
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Irido-corneal-endothelial syndrome (ICE) consists
of a number of features, including the loss of cells
from the cornea, which break off and block the drainage
channels in the eye, resulting in increased eye
pressure. There also may be scarring that connects
the iris to the cornea.
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Neovascular glaucoma results from abnormal blood
vessel growth that blocks the fluid drainage channels
of the eye, resulting in increased eye pressure.
Low blood supply to the eye as a result of diabetes,
insufficient flow of blood to the head due to blocked
arteries in the neck, or blockage of blood vessels
in the back of the eye causes the abnormal blood
vessel growth.
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Immediate treatment can delay the progression
of the disease. Open-angle glaucoma treatment usually
begins with medications (pills, ointments or eyedrops)
that help the eye either drain fluid more effectively
or produce less fluid. Several forms of laser surgery
can also help fluid drain from the eye; these include
trabeculoplasty, cyclophotocoagulation, and SLT
(Selective Laser Trabeculoplasty). Incisional surgery
to create a new opening for fluid to drain is usually
performed after other treatment options have failed.
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Acute closed-angle glaucoma (a medical emergency)
is treated with medications and laser peripheral
iridotomy, a procedure that helps drain fluid from
the eye.
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Chronic closed-angle glaucoma is treated with
laser peripheral iridotomy and medications.
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Normal-tension glaucoma is currently treated in
the same fashion as open-angle glaucoma. When this
form of the disease is better understood, then treatment
strategies will be modified.
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Congenital glaucoma is usually treated with medications
and either goniotomy or trabeculotomy, two forms
of eye surgery.
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Juvenile glaucoma is treated using medications,
laser surgery and filtering surgery.
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Secondary glaucoma treatment depends on whether
the condition is acute or chronic. The underlying
condition causing the increase in eye pressure will
need to be addressed and this, of course, will vary
depending on the cause.
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Pigmentary glaucoma is treated using medications,
laser surgery and filtering surgery.
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Pseudoexfoliation syndrome is treated using medications,
laser surgery and filtering surgery. Surgical techniques
may be used earlier than in open-angle glaucoma.
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Irido-corneal-endothelial syndrome (ICE) is not
well understood and it is not known how to keep
the condition from progressing. Medications are
often used to help manage the glaucoma and corneal
transplants are sometimes needed to treat swelling
of the cornea.
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Neovascular glaucoma may be managed with medications
and if abnormal blood vessel growth is occurring
in the back of the eye (diabetic retinopathy, for
example), a laser procedure called scatter panretinal
photocoagulation can be helpful. When the abnormal
growth of blood vessels in the retina are treated,
the abnormal blood vessel growth that is blocking
fluid drainage near the front of the eye may begin
to improve also. Trabeculectomy and surgery to destroy
parts of the ciliary body (the part of the eye that
produces eye fluid - the aqueous humor) may also
be used in an effort to decrease eye pressure. |
What
is Glaucoma?
