Glaucoma is a disease of the eye that causes pressure to increase within the eye. There are several types of glaucoma, including Angle-closure glaucoma, Normal-tension glaucoma, and Secondary glaucoma. There are also several different types of treatments, including medications to reduce the pressure.
Normal-tension glaucoma
Normal-tension glaucoma, or NTG, is a progressive form of glaucoma that usually begins with optic disc excavation and progressive loss of visual field. Treatment is similar to that of primary open-angle glaucoma, with the only proven therapy being lowering eye pressure. This therapy was originally thought to be ineffective, but the Collaborative Normal-Tension Glaucoma Study has shown that eye pressure reduction can significantly slow the progression of the disease and prevent visual field loss in half of patients.
Following up visits for normal-tension glaucoma are important to monitor the progression of the disease and side effects of treatment. Generally, medical professionals schedule follow-up visits every three to six months, or as needed. However, if the disease is under control, they may space further apart.
A gonioscopy test, used to check the angle of the eye, which is the region between the peripheral iris and cornea. The gonioscopy helps detect if the trabecular meshwork is blocked, which would result in eye pressure. A special contact lens called a gonio prism can use to evaluate the angle.
Imaging is also an important diagnostic tool. Optic disc photographs can reveal focal superotemporal thinning, dropout of the retinal nerve fiber layer, and visual field defects. In addition, measurements of central corneal thickness (CCT) are essential for the diagnosis of normal-tension glaucoma. In eyes with low CCT, the measured IOP may be low. Therefore, the measurements should be correct for the CCT to produce an IOP that is more consistent with POAG.
The best way to detect early damage is to undergo routine glaucoma screenings. This should include a close examination of the optic nerve. Age is an important factor in the diagnosis of glaucoma, as is a family history of the disease. Other risk factors include age and higher eye pressure. Additionally, a complete physical examination is important, as cardiovascular disease and diabetes can both impair the nerve.
Angle-closure glaucoma
The trabeculectomy procedure has been the mainstay of glaucoma management for decades, and it provides a high success rate in controlling IOP over the long term. One study following a group of patients for 20 years reported a 79 percent success rate in controlling IOP. However, this surgery also carries several risks, including filtration failure, shallowing of the anterior chamber, and choroidal detachment. In addition, trabeculectomy in patients with chronic angle-closure glaucoma, associate with an increased risk of endophthalmitis and hyphema.
Angle-closure glaucoma is a condition in which the iris bows forward and blocks fluid drainage from the eye. Because of this, pressure builds up inside the eye. Acute angle-closure glaucoma can occur suddenly, or it can progress slowly. If left untreated, angle-closure glaucoma can damage vision.
If you suspect you have angle-closure glaucoma, you should seek treatment immediately. The procedure involves the removal of a small part of the iris, and it is a temporary fixation. If the condition persists, you should consult your eye doctor to have it corrected. Angle-closure glaucoma can lead to irreversible vision loss.
In the meantime, you can take steps to prevent acute angle-closure glaucoma from worsening. Regular eye examinations are crucial for patients with the condition, as these visits allow your eye doctor to monitor pressure levels and drainage channels. In addition, laser treatment may also recommend in some cases.
Treatment options for angle-closure glaucoma include laser iridotomy, phacoemulsification, and surgery for cataracts.
Developmental glaucoma
Developmental glaucoma affects the developing eye and it associates with vision loss. It often associates with myopia and inherits from parents. Developmental glaucoma, characterized by enlargement of the eye and high fluid content, usually detected in children younger than 5 years of age.
It is rare in newborns and affects approximately one in every ten thousand live births. Developmental glaucoma is usually bilateral in nature but can be asymmetrical. It is sporadic, but about 10 to 27% of cases are hereditary. Inheritance is autosomal recessive in some cases and polygenic in others. Penetrance is variable and can be as low as 0% or as high as 91%.
There are several types of developmental glaucoma, but the two most common are primary congenital glaucoma and secondary congenital glaucoma. Primary congenital glaucoma causes by a defect in the trabecular meshwork. Secondary glaucoma occurs after trauma or inflammation of the eye. In both cases, the iris and cornea undergo secondary changes that are related to elevated IOP.
Currently, it is difficult to determine the exact cause of this condition, but there are certain factors that associate with the disease. Approximately 3% of adult primary open-angle glaucoma patients manifest a mutation in the TIGR gene, also known as myocilin or glaucoma.
There are a variety of complications associated with primary congenital glaucoma, including complications during surgery and anesthesia. Untreated primary congenital glaucoma can cause significant visual impairment. Surgical or medical treatments can correct the problem, but untreated cases can lead to lens dislocation or retinal damage.
Secondary glaucoma
Secondary glaucoma is a condition characterized by elevated intraocular pressure and visual field defects. In a recent study, 12 cases of secondary glaucoma were found in the same group of patients. Of these, two mutations were found in the gene ATTR, one of which is a mutation of the Val30Met gene, and the other is an attenuated variant of the ATTR called Val30Met+Arg104His.
Secondary glaucoma is not always accompanied by symptoms, but the disease can be detected at an early stage through a routine eye exam. In addition to vision loss, patients may also experience redness or pain in the eye, halos, and blind spots. While there are no known cures for glaucoma, treatments can help lower the pressure and slow the loss of vision. In some cases, laser surgery is recommended to restore normal vision.
Secondary glaucoma occurs when the eye’s drainage system is not functioning properly, which causes a buildup of fluid in the eye. This fluid damages the optic nerve because it reduces blood flow through tiny blood vessels. Secondary glaucoma can be treated with glaucoma eye drops, laser treatment, or conventional surgery. In some cases, a combination of these treatments is used to restore vision to a normal range.
Secondary glaucoma often associates with intraocular tumors. Patients with trabecular meshwork iris melanoma are at an increased risk for developing this disease. Another contributing factor is angle invasion, which also associates with the condition. In addition to medications, other conditions can lead to an increased pressure in the eye.
There are two types of secondary glaucoma. The most common is exfoliative, which results in flakes of the outer layer of the eye clogging the drainage system. In contrast, pigmentary glaucoma results in iris pigments breaking off and entering the eye’s clear fluid. In both cases, annual eye exams are essential for those with diabetes and other risk factors.
Treatments
There are many different treatments for glaucoma, and the best ones focus on reducing the patient’s IOP. Lowering the IOP helps prevent glaucoma and its progression, which can lead to visual impairment and eventually, blindness. Many glaucoma treatments involve medication or surgery, and all aim at lowering IOP.
One of the most common types of glaucoma eye drops is prostaglandins, prescribed by an ophthalmologist. They reduce pressure in the eye and should use according to the instructions. However, you should be aware that these eye drops can have unpleasant side effects and aren’t suitable for everyone.
Another common treatment is laser surgery. While laser surgery isn’t permanent, it can reduce the pressure inside the eye and improve vision. However, it can cause side effects, including eye redness, itching, burning, and fatigue. Some people may also experience breathing problems or an increased heart rate.
Glaucoma treatment options include medications, surgery, and laser therapy. These treatments vary based on the cause and severity of the disease. If left untreated, glaucoma can eventually lead to blindness. However, most cases are possible to control. Treatments for glaucoma focus on reducing the pressure in the eye and slowing its progression.
Other treatments include herbal medications, dietary changes, and vitamin/mineral supplements. Several alternative treatments suggest, but research still needs to determine whether they are effective. Some lifestyle modifications, such as quitting smoking, exercise, and meditation, may reduce the risk of developing glaucoma. Also, sleeping on the back limits nighttime increases in IOP.
Glaucoma is a chronic eye disease that affects the optic nerve, caused by blocked drainage channels, increased pressure in the eye, or a combination of these conditions. In addition, glaucoma can cause by a variety of factors, including trauma to the eye or infection.
