Understanding Glaucoma: Symptoms, Causes, and Treatments

Amisha Jain
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Understanding Glaucoma: Symptoms, Causes, and Treatments

Did you know that Glaucoma is the leading cause of irreversible blindness in the United States and the world?

It is expected that around 111.8 million people globally will suffer from Glaucoma by the year 2040.

But what is this condition, and how do you know if you have it?

This article discusses in detail the symptoms, causes, and treatment options available for this condition.

What is Glaucoma?

Glaucoma is a group of eye diseases that can damage the nerve in the back of your eye called the optic nerve.

The function of the optic nerve is to send information from your eyes to your brain about what you see.

This damage can lead to vision loss or blindness, if left untreated.

Glaucoma can develop slowly over time and often does not cause noticeable symptoms in the early stages.

We will learn about these signs and symptoms in the next section.

Types of Glaucoma and their symptoms

GlaucomaSource: Zarina_Lukash_from_Getty_Images
Glaucoma eye

The symptoms of Glaucoma are not apparent until after the condition has progressed.

Hence, it becomes important to catch on to the early signs to prevent further deterioration of eyesight and preserve it.

Warning
Regular eye exams are necessary for early detection and treatment of Glaucoma. If you have any concerns about your eye health, schedule an appointment with an ophthalmologist.

The signs of Glaucoma may depend upon the type of Glaucoma affecting you.

Hence, we will see the symptoms based on each type.

Open-Angle Glaucoma

Open-Angle Glaucoma, also called primary open-angle Glaucoma (POAG), is the most common type in the USA.

It causes a rise in intraocular pressure (IOC) due to insufficient fluid drainage from the eye.

Usually, people with Open-angle Glaucoma respond well to treatments, especially if caught in the earlier stage of the condition.

It, therefore, becomes important to understand and identify the condition at the earliest possible stage.

Open-angle Glaucoma develops without any early signs and gradually causes patchy blind spots in your peripheral vision.

The later stages affect the central vision.

Acute angle-closure Glaucoma

When the pupil enlarges too quickly or too much, the edges of the iris bunch up over the drainage canals causing them to block partially or completely.

Signs of Acute angle-closure Glaucoma, also known as closed-angle or narrow-angle Glaucoma, are very noticeable and develop quickly.

Hazy or blurred vision, accompanied by severe eye and head pain, is a common sign of this type of Glaucoma.

The following signs are also observable:

  • Rainbow-colored circles around bright lights
  • Nausea or vomiting
  • Sudden sight loss
  • Eye redness
Glaucoma can cause redness in the eyesSource: Bouillante_from_Getty_Images_Signature
Acute angle-closure Glaucoma can cause redness

Normal-tension Glaucoma

Normal-tension Glaucoma or normal-pressure Glaucoma is a form of POAG categorized by normal eye pressure but damaged optic nerve.

Patients with normal-tension Glaucoma typically do not exhibit any symptoms until a moderately advanced stage.

In the later stages, patients usually notice the following:

  • Loss of peripheral vision
  • Difficulty with low-contrast situations
  • Awareness of visual field defects

Childhood Glaucoma

One in every ten thousand births is affected by childhood Glaucoma.

It could be congenital (since birth), infantile (within 24 months after birth), or juvenile (after 3 years of age).

Signs of infantile or congenital Glaucoma include:

  • Dull/cloudy cornea
  • Excessive tearing
  • Increased blinking
  • Light sensitivity

But, juvenile Glaucoma develops like adult Glaucoma without any visible signs.

Blurred vision, headache, and worsened nearsightedness can be observed in this case.

A Glaucoma patient for checkupSource: Zoranm_from_Getty_Images_Singature
Glaucoma Checkup

Pigmentary Glaucoma

Pigmentary Glaucoma is a secondary open-angle Glaucoma with no visible early symptoms.

But as the condition progresses, patients may experience:

  • Blurred vision
  • Gradual loss of peripheral vision
  • Halos around light

Neovascular Glaucoma (NVG)

It is another type of secondary Glaucoma related to the restricted blood supply to the retina.

In this condition, new blood vessels form over the existing drainage channels and block the flow of aqueous humor.

Most of the NVG cases are attributed to

  • Ocular ischemic syndrome (OIS)
  • Proliferative diabetic retinopathy (PDR)
  • Ischemic central retinal vein occlusion (CRVO)

In addition to headache and nausea, patients might experience:

  • Decreased vision
  • Photophobia
  • Corneal edema
  • Conjunctival injection
  • Rubeosis
  • Inflammation
  • Hyphema
  • Vitreous hemorrhage

Uveitic Glaucoma

Uveitic Glaucoma is a very common complication that affects 20% of uveitis patients.

Uveitis can cause obstruction in the eye’s drainage canal, leading to a decreased outflow of aqueous humor and, thereby, increased IOP.

This increased eye pressure poses a risk of Glaucoma if left untreated.

Symptoms of acute Uveitic Glaucoma include the following:

  • Pain
  • Blurry vision
  • Headache
  • Photophobia
  • Colored haloes

Traumatic Glaucoma

All kinds of eye trauma, be it blunt or penetrating, have the potential to increase eye pressure.

This increased pressure can lead to Glaucoma in the affected eye.

People suffering from traumatic Glaucoma experience symptoms such as:

  • Pain in the eye
  • Blood collection and inflammation of the eye
  • Blurred vision
  • Light sensitivity

Exfoliative and Pseudoexfoliative Glaucoma

Exfoliative and Pseudoexfoliative Glaucoma are two subtypes of open-angle Glaucoma.

It involves the accumulation of protein material in the eye.

In exfoliative Glaucoma, this accumulation is only present on the surface of the drainage structure, while in Pseudoexfoliative Glaucoma, it is also present on the lens of the eye.

The accumulation of this material impacts the drainage system of the eye, causing an increase in eye pressure.

It can cause pain, blurred vision, and seeing haloes around lights while your eyesight deteriorates over time.

Causes

Glaucoma can cause eye painSource: fizkes_from_Getty_Images
Glaucoma can cause eye pain

In the majority of cases, Glaucoma is caused by increased eye pressure, known as intraocular pressure, which can damage the optic nerve over time.

However, not all cases of Glaucoma are related to elevated eye pressure, and some people with normal intraocular pressure may still develop Glaucoma.

Other contributing factors to the development of Glaucoma include

  • Genetics
  • Age
  • Ethnicity
  • Medical conditions like Diabetes and High Blood Pressure

Additionally, certain medications, eye injuries, and other eye diseases can increase the risk of Glaucoma.

Fact
Are you at risk of Glaucoma?

According to CDC, anyone can get Glaucoma, but the following groups are at a higher risk of getting it.

  • African Americans, Asians, and Hispanics in old age groups.
  • Steroid users
  • All people over age 60
  • People with a family history of Glaucoma
  • Diabetes patients

Treatment options

There are several treatment options available to inhibit Glaucoma from worsening.

They are discussed below.

Eye drops

Old man using eye dropsSource: RealPeopleGroup_from_Getty_Images_Signature
Old man using eye drops

Eye drops form the mainstay treatment for Glaucoma and work by reducing eye pressure with regular use.

The drops regulate the outflow of the aqueous humor, the fluid that nourishes the eyes.

There are various classes of eye drop medication that can be prescribed individually or in combination with one another for optimal results.

These classes include:

  • Prostaglandin analogs
  • Beta-adrenergic blockers
  • Alpha-adrenergic agonists
  • Carbonic anhydrase inhibitors
  • Miotic or Cholinergic agents
  • Rho kinase inhibitor
Medications for GlaucomaApprox. cost
Careprost Plus Eye Drop$25.38
Dorzox T 5 ml$12.05
9 PM Eye Drop$15.19
Bimat 3 ml$12.24
Dorzox Eye Drop 2%$8.90
Sometimes, using these medications can cause certain side effects, including
  • Dry mouth
  • Fatigue
  • High Blood Pressure
  • Irregular heart rate
  • Red, itchy, or swollen eyes

Consult a doctor if these symptoms persist or cause trouble.

Do not stop using the medication without talking to your doctor about it.

Laser treatment

Laser aurgery for GlaucomaSource: baranozdemir_from_Getty_Images_Signature
Laser treatment for Glaucoma

Laser treatment is another way to lower eye pressure effectively in people with a more progressive form of Glaucoma.

After a proper diagnosis, your doctor would suggest the most suitable laser option.

Laser Trabeculoplasty

Laser Trabeculoplasty is a brief and painless initial surgical option for open-angle Glaucoma.

This procedure involves aiming a high-intensity laser beam through the lens of the eye.

The beam causes a biological and chemical change that improves the fluid drainage in the eye and restores normal IOP.

Inflammation and pain are the most common side effects associated with this treatment.

Laser Peripheral Iridotomy

Laser Peripheral Iridotomy is a surgery suggested to treat and prevent angle-closure Glaucoma attacks.

In this process, a new channel is created to allow the flow of aqueous humor from the back of the eye to the front of it.

This new channel relieves eye pressure and helps in the treatment.

Patients usually do not experience any significant problems after the procedure except temporary blurred vision, inflammation, redness, and discomfort.

However, see a doctor if you experience persistent uneasiness.

Laser Cyclophotocoagulation

This procedure is usually recommended for people with end-stage open-angle and angle-closure Glaucoma.

It lowers the IOP by treating the part of the eye responsible for producing aqueous humor.

Generally, the side effects of this treatment are temporary and mild and include

  • Corneal edema
  • Inflammation
  • Pain
  • Temporarily increased eye pressure

Surgery

Glaucoma SurgerySource: Изображения_Пользователя_Дмитрий_Ткачук
Medical technologies for eye surgery

Surgeries are suggested to people for whom eye drops and laser treatment options prove ineffective.

They can help to create a new drainage passage for aqueous humor or to improve the current one and reduce intraocular pressure.

Your doctor may recommend one of a few different Glaucoma surgeries.

Micro-Invasive Glaucoma Surgery (MIGS)

Patients with primary open-angle Glaucoma or those who did not respond to eye drops or laser trabeculoplasty are advised this surgical procedure.

Due to its low-risk profile, MIGS may be a first-line surgical intervention for high-risk or monocular patients.

Trabeculectomy

Patients with chronic angle-closure or open-angle Glaucoma are typically treated surgically with trabeculectomy.

It involves creating a small blister of fluid (called a bleb) and a new drainage site for the aqueous humor.

Aqueous Shunt

Inserting an aqueous shunt is often done for patients for whom trabeculectomy can not be an option or those who have had multiple failed trabeculectomies.

Congenital Glaucoma, Neovascular Glaucoma, and Glaucoma caused as a result of an eye injury are often treated with a shunt.

This surgery involves implanting a shunt into the eye to help regulate fluid drainage.

Herbal medications

Ginkgo biloba, Bilberry, and medicinal marijuana are said to help patients with Glaucoma by lowering eye pressure.

Ginkgo biloba and Bilberry may delay or prevent the death of retinal ganglion cells. However, there is currently no proof that they can change how Glaucoma develops.

Additionally, medicinal marijuana has been rendered inappropriate because of:

  • Adverse side effects
  • Potential to cause addiction
  • Short duration of action

More extensive studies are still needed to establish the efficacy and effectiveness of herbal ingredients in preventing and treating Glaucoma.

Lifestyle

It has been studied that some lifestyle changes can lead to a modest impact on the risk of Glaucoma development.

A balanced diet rich in vitamins A and C and carotenoids might be associated with a lower risk of the likelihood of Glaucoma.

In addition, exercise, meditation, and quitting smoking also reduce the risk of Glaucoma.

Takeaway

Glaucoma is a serious eye condition that can lead to vision loss or blindness if not treated in time.

The disease is characterized by damage to the optic nerve, which can be caused by elevated intraocular pressure, genetics, age, ethnicity, certain medical conditions, and other factors.

Glaucoma symptoms can differ depending on the type and degree of advancement of the disease. But often, it includes blurry vision, seeing halos around lights, eye pain, and loss of peripheral vision.

Treatment options available for Glaucoma include medications, laser therapy, and surgery, all of which aim to lower intraocular pressure and slow or stop the progression of the disease.

Regular eye exams are required for early detection and management of the condition, especially for those at higher risk of developing it.

With proper management and treatment, many people with the disease are able to maintain their vision and quality of life.

Frequently Asked Questions

Is Glaucoma hereditary?

Yes, certain types of Glaucoma can be hereditary. A family history of the condition is a significant risk factor for developing Glaucoma. However, not every occurrence of Glaucoma has a genetic component, and other factors can also contribute to the development of the disease.

What does Glaucoma vision look like?

There may be no noticeable signs in the early stages of Glaucoma. The condition progresses gradually, where vision loss typically begins with the loss of peripheral vision. In some instances, Glaucoma patients may also experience blurry vision, seeing halos around lights, and difficulty adjusting to the darkness.

Is Glaucoma cancer?

No, Glaucoma is not a form of cancer. It is a condition that can potentially harm the optic nerve and lead to blindness if left untreated. Although there are rare forms of the disease that are unrelated to elevated pressure, Glaucoma is primarily brought on by increased intraocular pressure.

Is Glaucoma painful?

Glaucoma is typically not painful. The condition is frequently referred to as the “silent thief of sight” since it can advance gradually and with no initial signs. However, in some cases of acute angle-closure Glaucoma, there might be sudden eye pain, redness, and blurry vision, requiring immediate medical attention.

Citations:
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