One of the leading causes of blindness, affecting more than 450,000 Canadians, Glaucoma affects the optic nerve in the eye, resulting in irreversible vision loss.
By far, the most common type of glaucoma is primary open-angle glaucoma, also known as the silent theft of sight due to the absence of symptoms in its early stages.
**The following information has been adapted by the Canadian Association of Optometrists.
What are the symptoms of glaucoma?
It is common for people with early-stage glaucoma not to realize it until it has progressed to the later stages. The early stages of glaucoma can be detected during a routine eye exam. In order to prevent vision loss, early diagnosis and treatment are crucial. As the condition progresses, it leads to a loss of side vision or peripheral vision and ultimately tunnel vision, making driving more difficult. If not treated, permanent vision loss may result.
Other symptoms of glaucoma include:
blurry vision
eye redness
eye pain
light sensitivity
halos around lights
tearing
nausea
vomiting
headache
rapid progression to vision loss
How are glaucomas classified?
90% of all cases of glaucoma are caused by primary open-angle glaucoma, which generally develops painlessly and gradually without early warning signs. Primary open-angle glaucoma is associated with increased eye pressure. It is believed that increased pressure results in damage to the optic nerve due to mechanical stress on the back of the eye.
Acute angle-closure glaucoma occurs when the drainage system within the eye becomes blocked. Angle-closure glaucoma is a rare but serious condition. A buildup of fluid in the eye, increased eye pressure, and damage to the optic nerve results when the drainage system becomes blocked. Symptoms of angle-closure glaucoma include redness, pain, blurry vision, nausea, vomiting, and headaches. As vision loss can occur within a day, this is a medical emergency.
An injury, surgery, infection, or tumour in or around the eye can cause secondary glaucoma. Certain medical conditions, medications, and eye abnormalities can also cause secondary glaucoma.
In normal-tension glaucoma, the eye pressure stays within the "normal" range, but the optic nerve is still damaged. Poor vascular perfusion is speculated to be the cause of this condition.
Who is at risk of developing glaucoma?
Glaucoma is more likely to develop in individuals with the following conditions:
Elevated eye pressure
Increased age
Family history of glaucoma
Physical injury or surgery to the eye
Cardiovascular conditions (such as high blood pressure, low blood pressure, heart conditions, etc.)
Certain eye-related conditions (such as decreased optic nerve tissue, retinal detachment, eye tumours, eye inflammation, etc.)
How is glaucoma detected?
Often, glaucoma cannot be detected without telling symptoms, so a routine eye exam is the only way to find out. An optometrist uses special equipment to examine the optic nerve and retinal layers directly inside the eye in order to determine if they have been damaged. Other imaging and tests may be conducted to measure any functional vision loss and structural changes in the eye.
Glaucoma treatment: how does it work?
Glaucoma can be treated with a number of medications. It is usually treated with eye drops that reduce elevated eye pressure. A single medication or combination of medications may be prescribed. When a medication does not reduce pressure sufficiently or has adverse effects, it may need to be changed.
Surgery can be used to reduce eye pressure if medication is not enough. Some surgical options include laser trabeculoplasty, trabeculectomy, drainage implants, and laser peripheral iridotomy.
Laser Trabeculoplasty helps to drain fluid out of the eye. A laser beam is used to open up the drainage system of the eye to reduce eye pressure and prevent optic nerve damage. The results may be temporary and the procedure may need to be repeated.
Trabeculectomy is a filtering surgery that involves creating a drainage flap. The flap allows fluid from the eye to drain into a small blister on the surface of the eye called the bleb, which empties out to the vascular system of the body. This reduces eye pressure to prevent further damage to the optic nerve.
Drainage implants are another surgical option where a small silicone tube is inserted in the eye to help drain the excess fluid buildup in the eye and to reduce eye pressure. It may be appropriate for people with uncontrolled glaucoma, secondary glaucoma and children with glaucoma.
Laser Peripheral Iridotomy is a procedure that creates a small hole in the iris to allow fluid drainage into the different compartments of the eye to reduce eye pressure. This procedure is done to prevent and treat angle-closure glaucoma.
If you or your senior loved one suspects the presence of glaucoma, speak to your Optometrist about regular eye exams and treatment options.
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