Glaucoma: symptoms, causes and treatment

Definition

What is glaucoma?

Glaucoma or glaucoma is damage to the nerves of the eye that causes vision problems and blindness. Usually this condition is caused by high eye pressure.

The eye nerve is a group of nerve fibers that connect the retina to the brain. When the nerves in the eye are damaged, the signals that convey what you see to the brain are disrupted. Gradually, this causes complications of glaucoma in the form of loss of vision or blindness.

There are several types of glaucoma, namely open angle, closed angle, normal pressure, congenital, and secondary glaucoma. Among them, open-angle glaucoma is the most common.

How common is this disease?

Glaucoma is a common eye disease. The condition of pressure on the eyeball can occur at any age but is more common at the age of more than 60 years. This disease is one of the causes of blindness.

Signs & symptoms

What are the signs and symptoms of glaucoma?

Your symptoms and signs depend on the type of glaucoma you have, although almost all of them have similar symptoms. The following are common signs and symptoms of glaucoma:

• severe headache
• eye pain
• nausea and vomiting
• blurred vision
• see a rainbow circle around the light
• Red eye

In open-angle glaucoma, the patient initially feels no symptoms. However, you may see the blind spot which is a small area of ​​your peripheral or center vision.

Another complaint that emerged was tunnel vision , which is in the form of a vision conical forward like a tunnel or seeing a black spot that hovers following the movement of the eyeball.

In most cases, symptoms only appear several years after the patient develops this disease, so it is sometimes difficult to detect in the first place. However, in acute cases that occur suddenly, the above symptoms can appear suddenly.

When should I see a doctor?

You should contact your doctor if you experience any of the above symptoms. Untreated glaucoma can lead to vision problems and blindness. People over 40 years of age are advised to get screened to see if you have certain conditions on the eyeball that can lead to blindness.

If you have any signs or symptoms above or any other questions, please consult your doctor. Everyone's body is different. Always consult a doctor to treat your health condition.

Cause

What causes glaucoma?

The main cause of glaucoma is high eye pressure which causes nerve damage to the eye. Increased eye pressure can be caused by fluid buildup in the eye.

Normally, fluid flows through a duct in the eye called a trabecular meshwork . This accumulated fluid occurs because the production is excessive or cannot be drained out smoothly.

The causes of glaucoma depend on the type. The following are some of the causes based on the type of glaucoma:

• Open angle glaucoma
  In this type, the drainage angle formed by the cornea and iris is open. The cause of this type of glaucoma is partial blockage in the trabecular meshwork .
• Closed angle glaucoma
  In this type of condition, the blockage occurs due to the closed drainage angle or the iris protrudes and clogs the drainage of the fluid. Usually this type of eye pressure condition occurs slowly but can also be sudden (acute).
• Normal pressure glaucoma
  The cause is not eye pressure, but it is not certain. Eye nerve damage is usually caused by poor blood flow or hypersensitivity. Poor blood flow can result from a buildup of fat, which is also known as atherosclerosis.
• Secondary glaucoma
  This type of pressure on the eyeball is caused due to other health conditions or due to drugs. These conditions can include complications of uncontrolled diabetes or high blood pressure. Some drugs that are at risk of causing this disease are corticosteroid drugs.
• Congenital glaucoma
  This type of pressure on the eyeball is caused by an abnormality when the baby is born.

Risk factors

What increases my risk of getting this disease?

There are many risk factors that can affect your eyes to experience this condition, namely:

• Age over 60 years.
• Have a family history of this disease (parents or siblings).
• Using certain drugs over a long period of time, for example, corticosteroid eye drops.
• Have other diseases, such as diabetes, heart disease, hypertension, and sickle cell anemia.

People with diabetes are also at risk for this condition

Diabetics are 40 percent more likely to develop glaucoma than people without diabetes. In addition, if you have diabetic retinopathy, you also have a higher risk of pressure on your eyeball.

People with hypertension who get glaucoma are more at risk of developing blindness

Hypertension will damage the blood vessels in the retina, the back of the eye that acts as a light-catcher or receptor for your vision. This eye damage can lead to blindness if your hypertension is not controlled.

Diagnosis and treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the usual tests for glaucoma?

In the process of diagnosis, the doctor will first ask about your medical history and perform a thorough eye examination.

Based on information from the Mayo Clinic, here are some types of tests that are done to detect glaucoma:

• tonometry, to measure the pressure of the eyeball
• gonioscopy, to check the angle of discharge of fluid in the eye
• visual field examination to find out how wide your vision is
• pachymetry , to measure the thickness of the cornea
• a test to check for damage to the optic nerve

If a number of examinations have shown signs of progression of this condition, you need to seek treatment immediately. With treatment, the risk of developing glaucoma can be reduced by up to 50 percent.

What are my treatment options for glaucoma?

There are four choices of glaucoma treatment methods that doctors commonly use to avoid the risk of blindness. Here's the description:

1. Use eye drops

Eye drops to treat glaucoma are certainly not drops that you can get freely in stalls or pharmacies. Drops for this condition must be obtained by prescription, because the type and dose will be determined by the doctor based on the severity of your condition.

The eye drops for glaucoma that doctors most often prescribe are:

• prostaglandin analogs (latanaprost, travoprost, tafluprost, and bimatoprost)
• adrenergic antagonists (timolol and betaxolol)
• carbonic anhydrase inhibitors (dorzolamide and brinzolamide)
• parasympathomimetic (pilocarpine)

These drugs can be used separately, or as a combination.

2. Drinking medicine

There are two choices of oral medication, namely:

• Carbonic anhydrase inhibitors, like acetazolamide. This drug is generally only used for short treatment of acute glaucoma attacks. However, in some cases, this drug can be given over a long period of time to patients who are unable to undergo surgery but eye drops are no longer effective.
• Hyperosmotic group, like glycerol. This drug works by drawing fluid from the eyeball into the blood vessels. Administration is only done in acute cases and for a short period of time (hours).

However, the risk of side effects from oral medications is higher than for eye drops. So, drinking drugs are less recommended as a treatment for this condition.

3. Laser

There are two types of lasers that can be done to help drain excess fluid from the eyeball, namely:

• Trabeculoplasty. This procedure is commonly done for people who have open-angle glaucoma. The laser helps to maximize the drainage angle.
• Iridotomy. This procedure is performed in cases of angle closure glaucoma. Your iris will be perforated using a laser beam to allow the liquid to flow better.

4. Operation

Surgery is generally performed in cases where medication is no longer improving. The operation usually lasts 45-75 minutes.

Common surgical procedures to treat this condition include:

• Trabeculectomy, performed by making a small incision in the white of the eye and also making a pocket in the conjunctiva area (bleb). Thus, excess fluid can flow through the incision into the bleb bag and then be absorbed by the body.
• A glaucoma drainage device or implant. This procedure involves placing a tube-like implant to help drain the extra fluid in the eyeball.

Discuss further with your doctor to find out what kind of treatment method is most suitable for you.

Home remedies

What are some lifestyle changes or home remedies for glaucoma?

Here are the lifestyle and home remedies that can help you:

• Get regular check-ups and follow your doctor's directions and recommendations to prevent glaucoma from getting worse.
• Tell your doctor if you are taking certain medications.
• Tell your doctor if you have other illnesses (asthma, high blood pressure, diabetes, heart disease) or are allergic to the medication given.
• Always wear protective glasses if you are doing strenuous exercise to avoid trauma to the eye.
• Call your doctor if your symptoms get worse.

If you have any questions, consult your doctor for the best solution to your problem.