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
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Impaired outflow of aqueous humor leading to accumulation and increased intraocular pressure.
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Optic nerve damage related to vascular or structural factors.
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Some patients develop glaucoma even with normal eye pressure (normal-tension glaucoma).
Main Types of Glaucoma
1. Open-angle glaucoma (chronic)
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Progresses slowly and painlessly.
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Patients often do not notice symptoms until significant vision loss occurs.
2. Angle-closure glaucoma (acute attack)
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Sudden rise in intraocular pressure.
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Eye pain, redness, blurred vision, and nausea.
3. Congenital glaucoma
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Occurs in infants due to structural abnormalities of the eye.
4. Secondary glaucoma
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Caused by trauma, uveitis, long-term corticosteroid use, or other eye diseases.
Symptoms
Open-angle glaucoma
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Blurred vision.
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Loss of peripheral vision (tunnel vision).
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Poor vision in low light.
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No eye pain.
Acute angle-closure glaucoma
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Severe eye pain.
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Red eye.
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Blurred vision with halos around lights.
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Headache, nausea, or vomiting.
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Markedly elevated intraocular pressure.
Risk Factors
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Age over 40.
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Family history of glaucoma.
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High myopia or hyperopia.
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Diabetes or hypertension.
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Long-term corticosteroid use.
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Eye injury.
Diagnosis
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Measurement of intraocular pressure.
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Optic nerve examination.
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Visual field testing.
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OCT imaging of the retinal nerve fiber layer.
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Gonioscopy to evaluate the anterior chamber angle.
Treatment
Medications (eye drops)
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Prostaglandin analogs.
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Beta-blockers.
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Alpha-agonists.
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Carbonic anhydrase inhibitors.
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Combination therapies if needed.
Laser
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Laser peripheral iridotomy (for angle closure).
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Laser trabeculoplasty (for open-angle glaucoma).
Surgery
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Trabeculectomy.
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Drainage implants.
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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.
