Understanding Glaucoma: Causes, Types, and Treatment

Glaucoma is a group of eye conditions that damage the optic nerve, often caused by increased pressure in the eye (intraocular pressure). Known as the “silent thief of sight,” glaucoma can lead to irreversible vision loss if not detected and treated early. It is one of the leading causes of blindness worldwide, especially in older adults.

This blog will guide you through the causes, types, and treatment options for glaucoma, helping you stay informed about this serious eye condition.

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What Is Glaucoma?

The optic nerve is vital for transmitting visual information from the eye to the brain. In glaucoma, damage to the optic nerve occurs, often due to elevated intraocular pressure. However, some forms of glaucoma can develop without increased pressure.

Glaucoma progresses slowly in most cases, and symptoms may not appear until significant damage has occurred, making regular eye exams essential for early detection.

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What Causes Glaucoma?

Glaucoma is primarily linked to a buildup of fluid in the eye. Aqueous humor, the fluid inside the eye, normally flows out through a drainage system. When this flow is blocked or disrupted, pressure can build up, leading to optic nerve damage.

Other contributing factors include:

• Age: People over 60 are at higher risk.
• Family History: Genetics can play a role, with a higher risk if a close relative has glaucoma.
• Ethnicity: African Americans, Hispanics, and Asians are more susceptible to certain types of glaucoma.
• Medical Conditions: Diabetes, hypertension, and cardiovascular disease can increase risk.
• Eye Trauma: Previous injuries or surgeries can lead to secondary glaucoma.

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Types of Glaucoma

There are several types of glaucoma, each with distinct characteristics:

1. Primary Open-Angle Glaucoma (POAG)

• The most common type.
• Develops slowly as the drainage canals gradually become clogged.
• Often asymptomatic until significant vision loss occurs.

2. Angle-Closure Glaucoma

• Less common but more severe.
• Occurs when the iris blocks the drainage angle, causing a sudden spike in eye pressure.
• Symptoms include severe eye pain, nausea, and blurry vision, requiring immediate medical attention.

3. Normal-Tension Glaucoma (NTG)

• The optic nerve is damaged despite normal eye pressure.
• More common in individuals with a family history or vascular disorders.

4. Secondary Glaucoma

• Results from another condition, such as inflammation, trauma, or cataracts.
• Can also be caused by prolonged use of steroid medications.

5. Congenital Glaucoma

• A rare condition present at birth due to abnormal eye development.
• Symptoms in infants include cloudy eyes, sensitivity to light, and excessive tearing.

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Symptoms of Glaucoma

The symptoms of glaucoma vary depending on the type and stage of the condition:

Open-Angle Glaucoma

• Gradual loss of peripheral vision (often unnoticed).
• Tunnel vision in advanced stages.

Angle-Closure Glaucoma

• Severe eye pain and headache.
• Nausea and vomiting.
• Sudden onset of blurred vision.
• Halos around lights.

Congenital Glaucoma

• Cloudy or enlarged corneas in infants.
• Excessive tearing and light sensitivity.

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Diagnosing Glaucoma

Routine eye exams are crucial for early detection of glaucoma, particularly for high-risk individuals. During an exam, your Ophthalmologist may perform:

• Tonometry: Measures intraocular pressure.
• Ophthalmoscopy: Examines the optic nerve for damage.
• Visual Field Test: Assesses peripheral vision.
• Pachymetry: Measures corneal thickness, which can affect pressure readings.
• Gonioscopy: Evaluates the drainage angle for blockages.

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Treatment Options for Glaucoma

While glaucoma damage cannot be reversed, treatments can slow or prevent further progression, preserving remaining vision.

1. Medications

• Eye Drops: Reduce eye pressure by decreasing fluid production or improving drainage.
• Oral Medications: In severe cases, oral drugs may be prescribed to further reduce pressure.

2. Laser Treatments

• Selective Laser Trabeculoplasty (SLT): Improves fluid drainage in open-angle glaucoma.
• Laser Peripheral Iridotomy: Creates a small hole in the iris to relieve pressure in angle-closure glaucoma.

3. Surgery

• Trabeculectomy: Creates a new drainage channel for fluid.
• Drainage Implants: Tiny devices inserted into the eye to facilitate fluid flow.
• Minimally Invasive Glaucoma Surgery (MIGS): Offers a safer, less invasive option for managing eye pressure.

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Lifestyle and Home Remedies

While medical treatments are essential, lifestyle changes can complement them:

• Exercise Regularly: Helps reduce eye pressure.
• Protect Your Eyes: Use protective eyewear to prevent injuries.
• Avoid Overuse of Steroids: Use steroids only under medical supervision.
• Eat a Balanced Diet: Nutrient-rich foods support overall eye health.

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Preventing Glaucoma

Although not all cases of glaucoma can be prevented, regular eye exams and early detection are key to minimizing its impact. If you are at high risk, your doctor may recommend more frequent screenings.

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Final Thoughts

Glaucoma is a serious but manageable condition with early intervention and consistent care. Understanding its causes, types, and treatment options empowers you to protect your vision. Regular eye exams and an open dialogue with your Optometrist are your best defence against the “silent thief of sight.”

For more information visit NHS England