Glaucoma 

Glaucoma is a group of eye diseases that cause damage to the optic nerve, usually related to increased intraocular pressure. Without timely treatment, it can lead to irreversible vision loss.

Causes

• Impaired outflow of aqueous humor leading to accumulation and increased intraocular pressure.

• Optic nerve damage related to vascular or structural factors.

• Some patients develop glaucoma even with normal eye pressure (normal-tension glaucoma).

Main Types of Glaucoma

1. Open-angle glaucoma (chronic)

• Progresses slowly and painlessly.

• Patients often do not notice symptoms until significant vision loss occurs.

2. Angle-closure glaucoma (acute attack)

• Sudden rise in intraocular pressure.

• Eye pain, redness, blurred vision, and nausea.

3. Congenital glaucoma

• Occurs in infants due to structural abnormalities of the eye.

4. Secondary glaucoma

• Caused by trauma, uveitis, long-term corticosteroid use, or other eye diseases.

Symptoms

Open-angle glaucoma

• Blurred vision.

• Loss of peripheral vision (tunnel vision).

• Poor vision in low light.

• No eye pain.

Acute angle-closure glaucoma

• Severe eye pain.

• Red eye.

• Blurred vision with halos around lights.

• Headache, nausea, or vomiting.

• Markedly elevated intraocular pressure.

Risk Factors

• Age over 40.

• Family history of glaucoma.

• High myopia or hyperopia.

• Diabetes or hypertension.

• Long-term corticosteroid use.

• Eye injury.

Diagnosis

• Measurement of intraocular pressure.

• Optic nerve examination.

• Visual field testing.

• OCT imaging of the retinal nerve fiber layer.

• Gonioscopy to evaluate the anterior chamber angle.

Treatment

Medications (eye drops)

• Prostaglandin analogs.

• Beta-blockers.

• Alpha-agonists.

• Carbonic anhydrase inhibitors.

• Combination therapies if needed.

Laser

• Laser peripheral iridotomy (for angle closure).

• Laser trabeculoplasty (for open-angle glaucoma).

Surgery

• Trabeculectomy.

• Drainage implants.

• Minimally invasive glaucoma surgery (MIGS).

Prognosis

Optic nerve damage from glaucoma is irreversible, but early detection and continuous treatment can slow or prevent further vision loss.