What is Glaucoma, symptoms, treatment, causes and more

What is Glaucoma

Glaucoma is a set of different diseases that involve intraocular pressure associated with optic neuropathy. Because of this, it has very specific characteristics, in which there is damage to the optic nerve – part of the eye that carries visual information to the brain -, causing progressive (if not treated) and irreversible loss of vision.

According to the World Health Organization (WHO), glaucoma is the second largest cause of blindness in the world, behind cataracts . It is estimated that the prevalence of the disease in the world is approximately 1 to 2%; in Brazil, the estimate is that 900 thousand people are carriers of the disease.

What are the causes of Glaucoma

Most of the time, glaucoma is caused by an increase in the individual’s intraocular pressure (IOP). But how does it happen? The front of our eyes continuously produces a liquid called aqueous humor that fills the entire front of the organ. After that, it leaves the eye through channels located in the cornea and iris. When these channels are blocked or partially destroyed, IOP may increase. With this increase, the optic nerve can be damaged and as this damage can be progressive, the field of view can be affected gradually.

The causes of this increase in eye pressure are not yet known, but experts believe that one or more of the factors listed below may influence:

  • Dilating eye drops;
  • Restricted or blocked drainage in your eye;
  • Use of corticosteroids;
  • Poor circulation or blood reduction in the optic nerve;
  • High or high blood pressure.

Risk factors

Glaucoma has a hereditary character, where family members of those who have the disease are more likely to develop it as well. However, in addition to this risk factor, there are still others that can influence its appearance, according to the following list:

  • High intraocular pressure;
  • Age above 60 years or above 40 years (for cases of acute glaucoma);
  • People of African descent are more likely to develop the disease, especially over 40;
  • Family history presents a risk of up to 6 times more of the development of the disease;
  • Diseases such as diabetes, heart problems, hypertension and hyperthyroidism;
  • Eye diseases, such as tumors, retinal detachment and inflammation;
  • Prolonged use of corticosteroid-based medications.

Existing types

There are 4 main types of glaucoma. Check out the characteristics of each one:

Primary open-angle glaucoma or chronic glaucoma

Most common type of glaucoma, it accounts for about 90% of all cases. It is usually asymptomatic and takes years to cause some impairment in the person’s vision, as the development of damage to the optic nerve occurs slowly. One of its causes is the obstruction of the draining of the aqueous humor from the eye.

Closed-angle glaucoma or acute glaucoma

It occurs when the outflow of aqueous humor is suddenly blocked, causing a sudden, painful and severe increase in intraocular pressure. Cases of this type of the disease are emergency, as it can cause irreversible visual loss in a short time.

Congenital glaucoma

A rare genetic disease that affects babies as soon as they are born or in the first years of life, congenital glaucoma is inherited from the mother during the gestation process. It is characterized by enlarged eyeballs and blurred corneas.

Secondary glaucoma

Secondary glaucoma is developed by some complication of various medical conditions – such as surgery, cataracts and uveitis – and also by the overuse of corticosteroid medications.

Glaucoma Symptoms

The symptoms of the disease are quite variable and this happens because of the type of the disease. Some cases are completely asymptomatic, while others may have symptoms other than vision loss.

Open-angle glaucoma

  • Most people do not show symptoms until the onset of vision loss;
  • Over the years, the gradual loss of lateral peripheral vision occurs.

Closed-angle glaucoma

  • Severe and sudden pain in the eye;
  • Decreased or blurred vision;
  • Nausea and vomiting;
  • Reddish eyes;
  • Puffy-looking eyes.

Congenital glaucoma

Most of these symptoms are noticed when the child is only a few months old:

  • Cloudiness in the frontal part of the eye;
  • Enlargement of an eye or both;
  • Red eyes;
  • Sensitivity to light;
  • Excessive tearing.

Diagnosis

The occurrence of glaucoma can only be detected after eye exams performed by the ophthalmologist. So it is super important that you go to the doctor at least once a year, to perform the various tests that diagnose not only this disease, but several others as well. The sooner glaucoma is diagnosed, the better the chances of its treatment.

Among the tests that the doctor may perform are:

  • Visual acuity: detects changes in vision.
  • Pupil examination: detects damage to the optic pathways, including the optic nerve.
  • Slit lamp examination: evaluates the inside and outside of the eye.
  • Tonometry: checks the intraocular pressure.
  • Optic nerve photography: documents the appearance of the optic nerve, in addition to being very useful in monitoring it.
  • Optical nerve: measures the excavation and pallor.
  • Gonioscopy: evaluates the angle of the anterior chamber of the eye.
  • Visual field: checks the patient’s visual field loss.

Treatment for Glaucoma

As much as Glaucoma is not curable, there are several forms of treatment for the loss of vision to be controlled and also for the quality of life of the patient to be the best possible. In addition, treatment should be individualized, considering the following factors:

  • Severity of glaucoma;
  • Patient’s age;
  • Family history;
  • Corneal thickness.

Medicines

Immediately, specialists always recommend the use of eye drops, so that the intraocular pressure is reduced and remains so. When these are no longer able to perform this function, the doctor may also indicate the use of pills orally.

The drugs most used in the treatment of glaucoma are:

  • Bimatoprosta;
  • Brimonidina;
  • Dorzolamide Hydrochloride + Timolol Maleate ;
  • Diamox;
  • Dolantina ;
  • Meticorten .

Do not forget that the prescription of any medication must be carried out by a doctor who specializes in eye diseases and that the misuse can cause several complications.

Attention! 

NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Laser

When drug treatment does not yield effective results, specialists resort to the use of laser. This technique is applied to perform small burns on the trabecular network (the aqueous humor drainage system), encouraging it to work. It lasts about 15 to 20 minutes and is a painless procedure. It is necessary to know that, even with the use of the technique, the patient must continue with the drug treatment.

Surgeries

This form of treatment is always left to the last resort, as much as it is a highly sophisticated technique, both clinical and surgical, it is a more invasive treatment that can generate some complications. However, if it is strictly necessary – as in the case of closed-angle glaucoma and congenital glaucoma – delay is not advisable.

Surgery for glaucoma consists of creating a new drainage system for the eye, the most common being trabeluctomy. Surgical results are quite positive: more than 75% of patients have their IOP properly controlled. The indication for this treatment is more frequent in patients who, due to social, cultural or economic problems, are not faithful to other types.

Are there complications?

If not treated as soon as possible and in the right way, glaucoma can cause the patient to have some blind spots in the peripheral vision, later reaching the tunnel vision (normally used for reading) and, finally, it turns into total blindness.

Prevention

There are no effective ways to prevent glaucoma. However, as already said, frequent visits to an ophthalmologist can help you in the early diagnosis of glaucoma and other diseases. Exercising safely and regularly using eye drops prescribed by your doctor can also help control intraocular pressure and prevent glaucoma from being avoided.

Share this information with your friends and acquaintances! This can cause people prone to develop the disease to learn more and seek medical help early.

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