Glaucoma: the Underhand Disease

Glaucoma has been a leading cause of blindness worldwide for many years. This ocular disease is said to be underhand since it shows no symptoms until the advanced stage of glaucoma, no pain or loss of sight.

What is glaucoma?

Glaucoma is a chronic pathology of the eye. It is also referred to as an optic neuropathy since it is characterized by optic nerve damage. Several risk factors may explain it. Generally, an excess of pressure inside the eye - the intraocular pressure - is an important risk factor. Glaucoma is a slowly progressive disease. Optic nerve damage results in a progressive loss of vision that starts from peripheral vision (vision on the sides) to central vision, at a more advanced stage of the disease.

Glaucoma can not be cured, but can be controlled, such as diabetes or high blood pressure. Untreated glaucoma can result in total vision loss. It is therefore very important to start treatment as soon as possible to slow it down or simply stop it.

There are different types of glaucoma, grouped into two main forms.

Open angle glaucoma

The angle in question is the one formed by the iris and the cornea, it is more commonly called the "iridocorneal angle". It is where the tissue called "trabecular meshwork" is located. It is a drain responsible for maintaining the intraocular pressure by evacuating the aqueous humor.

Open-angle glaucoma is characterized by a normal opening of the iridocorneal angle, in contrast to narrow-angle glaucoma. The beginnings of this form of glaucoma are asymptomatic. A person who is affected can not perceive the signs before an advanced stage, hence the importance of an early diagnosis. The goal of treating this type of glaucoma is to lower the intraocular pressure and stabilize it, by using drugs, laser or surgery.

Angle-closure glaucoma

Angle-closure glaucoma is the rarer form of this pathology, but it is also more serious. It is distinguished by an iridocorneal angle smaller than normal, which increases the risk of a closure. The reduced angle may result in partial or complete blockage of the trabecular meshwork. When full, the obstruction can cause an acute attack of angle-closure glaucoma. The latter is manifested by a very strong and painful increase in intraocular pressure. This is a medical emergency. In the absence of rapid treatment, blindness occurs quickly.

Risk factors

The genes and mechanisms responsible for the onset of glaucoma are not all known. It is therefore impossible to associate this disease with one or more specific causes. On the other hand, certain risk factors can favor its emergence:

• The increase in intraocular pressure
• Age
• Family history
• Prolonged use of corticosteroids
• The pseudoexfoliative syndrome
• Pigment dispersion syndrome
• Eye trauma
• Ethnicity
• Myopia
• Farsightedness
• Some medicines
• Venous occlusion of the retina
• The anatomy of the eye
• Eye surgeries
• Sickle cell anemia
• Iridocorneal endothelial syndrome (ICE)
• Intraocular tumors
• Inflammatory reactions
• Development anomalies
• Vascular risk factors
• Diabetes
• The presence of other diseases (such as hypothyroidism, sleep apnea and migraines)
• Smoking

Diagnosis

The diagnosis of glaucoma is based on the detection of several signs associated with the disease, such as elevated intraocular pressure, optic nerve damage or loss of peripheral vision. An early diagnosis of the disease is very important since glaucoma, at its beginning, is not manifested by any symptoms. To prevent a visual impairment and to make a diagnosis, several examinations are necessary, whether in a clinic or in a hospital.

Prevention and treatments

Although there is no way to prevent glaucoma, early diagnosis is the best way to ensure good eye health. It is therefore recommended to have regular eye exams, especially if one is subject to the risk factors listed above, such as family history.

You can not cure glaucoma, but you can treat it effectively. The damage already done at the time of diagnosis is irreversible. It is possible to control the disease to prevent an even further decrease in vision. The main goal of the treatments is to lower the intraocular pressure. Depending on the case, the ophthalmologist will determine the level of pressure to be reached depending on several elements, such as the pressure level before treatment, the glaucoma stage and the visual field impairment.

The treatments fall into three main categories: drug treatments, laser treatments and surgical treatments. The choice of treatment will be made according to the type of glaucoma and the advancement of the disease. A combination of treatments can also be used.

Living with glaucoma

Glaucoma is recognized as one of the leading causes of blindness around the world, but most sufferers can still live a normal life if they are diagnosed early and are treated appropriately. The quality of life of a person with glaucoma differs little from that of a healthy person, except in cases where greater damage has already affected the optic nerve. In any case, following the advice of an ophthalmologist will certainly help the patient live a life without hassle.

Book an appointment with your ophthalmologist

If you have a consultation request, you can make an appointment online at the Bellevue Clinic.