Glaucoma is an eye disease that results in the destruction of the optic nerves due to increased intraocular pressure.
Glaucoma is an insidious disease whose symptoms progress slowly and without intervention, vision loss progresses steadily. Although it causes vision loss during this process, it is a progressive eye disease that can result in permanent blindness if not intervened. Therefore, it is critical to control glaucoma with early diagnosis and treatment.
Two types of glaucoma are more common than other types. Open-angle glaucoma progresses slowly and painlessly and may not cause any symptoms for a long time. Closed-angle glaucoma, on the other hand, can suddenly become symptomatic. Therefore, the symptoms of glaucoma may appear suddenly or gradually.
Eye pressure affects both sides of the eye. Although people over 40 are more likely to have glaucoma, it is the most common cause of vision problems in people over 60.
What is Glaucoma?
Glaucoma is an eye disease caused by an abnormal increase in intraocular pressure and damage to the optic nerves as a result of the inability to expel the fluid that feeds the lens of the eye due to blockage of the trabecular meshwork.
In glaucoma, the accumulation of fluid in the eye is high enough to damage vision. Over time, the pressure on the optic nerves increases indirectly with the accumulation of fluid. This increases the damage to the optic nerve, which is responsible for vision. As eye pressure progresses, the visual field of the person gradually narrows.
There is no definite threshold for this increase in pressure. In one person, this pressure may be higher than in another, but the damage to the optic nerves may not have started and glaucoma may not have started to occur.
Due to the structure of the optic nerves, it is not possible for them to regenerate themselves or to be repaired in such a way that they can be restored by surgical intervention. From the moment visual nerve damage occurs, the first stage of glaucoma begins. Therefore, early diagnosis of the disease is extremely important for treatment.
What are the Causes of Glaucoma?
While glaucoma is mainly caused by a single cause, its triggers may be different.
The eye fluid produced to protect and nourish the lens of vision is called aqueous humor fluid. Glaucoma begins when the channels responsible for the simultaneous drainage of this fluid (trabecular meshwork) become blocked.
As the aqueous humor fluid is not adequately excreted and accumulates, pressure builds up. This pressure presses on the optic nerves responsible for vision, causing a gradual decrease in the patient's vision. Accordingly, nerve fiber destruction progresses with the increase in this pressure over time.
If this pressure cannot be balanced and continues to be severe, blindness occurs over time. In some patients, although the intraocular pressure is at normal levels, the visual nerves are damaged due to the lack of normal blood flow in the visual nerves.
As these nerves die over time, permanent vision loss occurs. If treatment is delayed, there is a risk of permanent blindness.
In addition, fluid accumulation in the eye alone is not enough to diagnose Glaucoma Accompanying this condition, vision loss must occur as a result of pressure on the optic nerves.
What are the Risk Factors of Glaucoma?
- People with high intraocular pressure are at increased risk of the disease. However, this does not necessarily result in glaucoma.
- Thin corneal thickness is a risk factor for the disease.
- Although glaucoma is a problem that can be seen at any age, it is more common in people over the age of 40. Over 60 years of age, the risk is much higher. At the same time, the risk of the disease increases with age.
- Glaucoma may also be related to genetics. People whose family members have a history of the disease are more likely to develop the disease. These people should have regular check-ups once a year.
- People with diabetes, hypothyroidism (goiter), heart disease and high blood pressure are at higher risk of developing the disease.
- Smoking is a risk factor for glaucoma as it is for many retinal diseases.
- Long-term cortisone treatment is a risk factor.
- Severe eye injuries can increase the risk of glaucoma.
- High degrees of myopia and hyperopia increase the risk of glaucoma.
How Can Glaucoma Risk Be Prevented?
- Regular eye examinations are critical for detecting the problem before significant eye pressure damage occurs. Regular examinations every 5 years before age 40, every 3 years after age 40 and every year after age 60 are critical for early diagnosis of glaucoma.
- Be informed about your family's health history: Genetic factors play an important role in the risk of developing glaucoma. It is important to know the family history for the risk and early detection of the disease. It is important for people with a family history of this disease to have regular examinations.
- Regular exercise and an active lifestyle are important for reducing the risk of the disease. Avoiding bad habits and a healthy lifestyle are effective in reducing the risk of the disease.
- Serious eye injuries can cause glaucoma. Therefore, always take precautions.
- If you have been prescribed any eye drops by your doctor, their regular use can help prevent the onset of the disease.
What are the Symptoms of Glaucoma?
While glaucoma symptoms do not manifest themselves in the early stages of the disease, different patients may experience different symptoms. Common symptoms of the disease are as follows:
- Headache accompanied by pain in and around the eyelid, caused by changes in the level of aqueous humor fluid during the day,
- Feeling of tightness and stiffness in the eye, pain when pressed on it,
- Pain in the forehead area,
- Sudden or rapid loss of visibility,
- Nausea
- Patients report symptoms of glaucoma such as temporary blurring of vision and halos around lights at night.
In addition, symptoms such as sensitivity to light and watery eyes are observed in childhood.
When should you consult a doctor?
Patients complain of severe headache, which usually occurs regularly in the morning hours, as well as blurred vision at certain times.
In addition, people with a family history of glaucoma should be more sensitive to certain symptoms and it is useful to go for regular check-ups once a year. Finally, people who experience severe headache and eye pain, as well as acute closure of the angle of vision, should consult an ophthalmologist immediately.
What are the Types of Glaucoma?
There are different types of glaucoma. Each type can have different symptoms and treatment options. The types of glaucoma are:
- Open angle glaucoma
- Angle-closure glaucoma,
- Normal pressure,
- Developing after injury,
- The type of glaucoma seen in children,
- Exfoliation syndrome,
- Congenital glaucoma,
- Ocular hypertension,
- Pigmenter,
- Novascular glaucoma
How is glaucoma diagnosed?
The diagnosis of glaucoma is made through a comprehensive and varied series of examinations. First, the patient is measured for glaucoma with a tonometry device. Afterwards, a fundus examination is performed to determine whether there is any damage to the optic nerves.
After this point, multiple tests for glaucoma can be performed if deemed necessary by the attending physician. In acute glaucoma crises, diagnosis is much easier as the patient shows much more pronounced symptoms. In such cases, the patient is intervened urgently.
Because the later the intervention, the greater the visual field loss of the patient. The methods and tests used in the diagnosis of the disease are as follows:
- Measurement of intraocular pressure and examination of drainage angle,
- Optic nerve examination (ophthalmoscopy),
- Computerized visual field testing,
- OCT,
- HRT
Glaucoma can be diagnosed by applying some or all of these tests.
How to Treat Glaucoma ?
The damage to vision caused by the destruction of the optic nerves is irreversible but can be controlled. Among the glaucoma treatment methods, other methods can be applied if the disease cannot be controlled in medication treatments.
Eye pressure treatment methods, eye drops and oral medications, laser treatments and surgical interventions are applied to prevent the progression of the disease and keep it under control. Only one of the aforementioned treatments can be applied, or in some patients, depending on the condition of the disease, there may be complicated applications.
