Eye Conditions
Dr Aaron Chiam
Jun 8, 2022

Glaucoma - Diagnosis, Treatment, & Prevention

Glaucoma is a condition that damages the optic nerve in the back of the eye, leading to vision loss or even total blindness if left untreated. 

It is essential to understand that most people with Glaucoma have no early symptoms or pain. This makes it necessary to seek eye care services regularly so that you can diagnose and treat Glaucoma early on. 

The condition affects millions of people around the world each year, but the good news is that most people with Glaucoma can keep their eyes healthy by following their treatment plan and having regular eye exams. 

Let's learn a bit more about Glaucoma, how it is caused and what can be done to treat or prevent it.

What is Glaucoma?

Glaucoma is often associated with a buildup of fluid that causes pressure in the eye. The pressure damages the optic nerve that sends images to your brain. 

The condition can occur at any time, but it is more prevalent in older adults. In most cases, Glaucoma affects both eyes, but one may be more affected than the other.

Types of Glaucoma

There are many different types of glaucoma but typically there are four types; Primary Open Angle Glaucoma, Angle Closure Glaucoma, Normal Tension Glaucoma, and Secondary Glaucoma. 

Of these, the two most common types of Glaucoma are: 

Primary Open-Angle Glaucoma

Glaucoma of this kind is a slow process in which the eye doesn't drain fluid as efficiently as it should. As a result, eye pressure rises, damaging the optic nerve. This kind of Glaucoma is painless at first and does not cause visual abnormalities initially. Regular eye exams are necessary to detect early symptoms of optic nerve impairment.

Angle-Closure Glaucoma

Also known as closed-angle Glaucoma or narrow-angle Glaucoma, this type occurs when the iris is too close to the cornea and can potentially obstruct the drainage angle.

Eye pressure rises fast when the drainage angle is completely blocked, referred to as an acute attack. It's a genuine eye emergency, and you should contact your ophthalmologist immediately to avoid the risk of going blind.

Why Do We Get Glaucoma?

In a healthy eye, the aqueous humor (i.e. the fluid inside your eye) generally drains out through a mesh-like channel. However, if the eye produces too much fluid, this route becomes clogged.

Other less common causes of Glaucoma include physical or chemical damage to the eye, a severe eye infection, clogged blood vessels inside your eye, and inflammatory diseases. Sometimes eye surgery to treat another problem might also trigger Glaucoma.

The most common type of Glaucoma, primary open-angle glaucoma, is hereditary. If your immediate family members have Glaucoma, you are at a much higher risk than the rest of the population. Family history increases the risk of Glaucoma four to nine times.

Symptoms of Glaucoma

The majority of patients with open-angle Glaucoma have no symptoms. If symptoms do appear, it is generally late in the course of the disease. The most common symptom is vision loss and peripheral vision loss.

Angle-closure Glaucoma symptoms generally appear sooner and are more noticeable. Damage can occur fast. 

If you have any of the following symptoms, you should speak with your eye doctor to rule out glaucoma;

  • Halo effects around lights
  • Loss of vision
  • Red eyes 
  • Blurry pupil 
  • Vomiting or an upset stomach
  • Pain in the eyes

How Is Glaucoma Diagnosed?

A specific procedure is called tonometry is the only method to diagnose Glaucoma correctly.

This involves several painless tests that determine the intraocular pressure, the status of the optic nerve and drainage angle and visual fields are used to diagnose the presence of glaucoma and monitor its progression.

This is simple and painless procedure that tour eye doctor will perform during your routine eye exam, to measure the internal pressure of your eye. (aka checking your ocular pressure)

How long does it take to go blind from glaucoma?

Glaucoma is generally considered a slow-progressing disease of the eye. In the most common form of glaucoma, primary open-angle glaucoma, damage to the retinal cells occurs quite slowly. Untreated glaucoma can progress to blindness within several years.

What Are The Treatment Options for Glaucoma?

To reduce the pressure in your eye, your optometrist may use prescription eye drops, oral medicines, laser surgery, or microsurgery. As with any other illness, inform your doctor about any other medical conditions you may have or drugs you are taking.

Eye Drops: Can reduce or enhance the flow of fluid out of your eye, reducing ocular pressure. Allergies, redness, stinging, impaired vision, and irritated eyes are all possible side effects of using eye drops. Stop immediately if you experience any of those symptoms while using eye drops.

Oral Medications: Your doctor may also prescribe an oral medicine, such as a beta-blocker or a carbonic anhydrase inhibitor. These medications can help with drainage or slow the production of fluid in the eye.

Laser Surgery: If you have open-angle Glaucoma, laser surgery can help to increase the flow of fluid out of your eye. If you have angle-closure Glaucoma, it can help you avoid fluid obstruction. 

Microsurgery: In this type of surgery, your doctor constructs a new channel to drain fluid and relieve eye strain. The doctor may implant a tube to aid in the drainage of fluid. This operation can result in temporary or permanent visual as well as bleeding or infection.

Eye doctors usually start with medications as the primary treatment option, but early laser surgery or microsurgery may be more effective for some patients.

How Can We Prevent Glaucoma?

Unfortunately, Glaucoma cannot be prevented entirely. 

However, there are things we can do to manage the disease if caught in the early stages. Glaucoma is usually treated with eye drops, although laser treatment and surgery can also be used. Early diagnoses and regular eye examinations are your best hope of fighting Glaucoma.

Schedule regular eye exams

Get a comprehensive eye exam from your eye doctor every 1 to 2 years if you're over 40 and have a family history of the illness. 

If you have diabetes or are at risk for other eye disorders, you may need to visit more frequently. 

The Verdict on Glaucoma?

Glaucoma is a serious eye condition that requires urgent attention. However, there is a high chance of recovery if detected and treated in the early stages.

The earlier your doctor detects glaucoma symptoms, the better chances that you have of fighting off issues caused by Glaucoma. 

If you follow the treatment plan as prescribed by your eye doctor, this can help ensure you have healthy eyes well into your senior years.

Contact The Sigma Eye Care team if you are concerned about Glaucoma or any other eye-related disease. We are here to help. Reach out and ask us a question, or make a booking online.

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Images thanks to;

Top graphic - Optc.ca Manitoba

Image of Eye - by Harpreet Singh