Glaucoma

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WHAT IS GLAUCOMA?


Glaucoma is a group of diseases that can affect the optic nerve head and eventually lead to blindness. By destroying the fibers of the optic nerve, glaucoma will slowly deteriorate the visual field. A key warning sign of glaucoma is having a higher than normal Intraocular Pressure (IOP).

The rise of the pressure can be related to an over-production of aqueous humor (a natural fluid of the eye) and/or a lack of its evacuation. There are two major forms of this disease: open-angle glaucoma & closed-angle glaucoma. Both will result in the destruction of the optic nerve fibers leading to the deterioration of the visual field.

Glaucoma is second leading cause of blindness across the world. It affects more than 65 million people worldwide and, although it can occur at any age, it is more common in older ages.



The signs and symptoms of glaucoma vary depending on the type and stage of your condition.

OPEN-ANGLE GLAUCOMA
Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes Tunnel vision in the advanced stages

ACUTE CLOSURE-ANGLE GLAUCOMA

Severe headache, Eye pain, Nausea and vomiting, Blurred vision, Halos around lights, Eye redness

Because the various forms of glaucoma have no warning signs, it is important to have regular eye exams including eye pressure measurement. The earlier glaucoma can be detected the higher the efficiency of treatments can be.

Whatever form of glaucoma you may have a series of exams will be conducted by your ophthalmologist:

  • Measuring intraocular pressure (tonometry)
  • Testing for optic nerve damage
  • Checking for areas of vision loss (visual field test)
  • Ultrasound imaging of the angle of the eye (UBM)
  • Measuring corneal thickness (pachymetry)
  • Inspecting the drainage angle (gonioscopy)

Glaucoma cannot be cured. If you have this condition, you will generally need treatment for the rest of your life. Glaucoma is treated by lowering the eye pressure (intraocular pressure).
Depending on your situation, your options may include prescription eye drops, oral medications, laser treatment, surgery or a combination of any of these.

Treatment with eye drop requires daily instillations. Various types of molecules can be used and some-times used in combination.

Laser treatment will differ according to the type of glaucoma. In case of angle-closure glaucoma, whether in its acute or chronic form, a laser procedure called iridotomy can be performed.
Selective laser trabeculoplasty (SLT) is a laser treatment if you have open-angle glaucoma. This outpatient procedure is performed with an SLT laser to open clogged channels in the trabecular meshwork.

A new laser option is available for advanced and refractory glaucoma. This operating room procedure uses a non-thermal laser that will decrease the production of aqueous humour and improve its drainage. In case your eye doesn’t reply to laser procedures or eye drops, surgical procedures can be proposed by your ophthalmologist. A filtering surgical procedure called trabeculectomy can be performed. Small drainage devices such as tubes or MIGS (minimally invasive glaucoma surgery) can be inserted in the eye to drain away excess fluid and lower the eye pressure.