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Glaucoma

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Glaucoma is a complicated disease in which damage to the optic nerve leads to progressive, irreversible vision loss. Glaucoma is the second leading cause of blindness.

Glaucoma is actually a group of diseases. The most common type is hereditary.

Primary Open-Angle Glaucoma

This is the most common form of glaucoma. It happens when the eye’s drainage canals become clogged over time. The inner eye pressure (also called intraocular pressure or IOP) rises because the correct amount of fluid can’t drain out of the eye. With open-angle glaucoma, the entrances to the drainage canals are clear and should be working correctly. The clogging problem occurs further inside the drainage canals, similar to a clogged pipe below the drain in a sink.

Most people have no symptoms and no early warning signs. If open-angle glaucoma is not diagnosed and treated, it can cause a gradual loss of vision. This type of glaucoma develops slowly and sometimes without noticeable sight loss for many years. It usually responds well to medication, especially if caught early and treated.

Angle-Closure Glaucoma

This type of glaucoma is also known as acute glaucoma or narrow angle glaucoma. It is much more rare and is very different from open-angle glaucoma in that the eye pressure usually rises very quickly.

Treatment of angle-closure glaucoma usually involves either laser or conventional surgery to remove a small portion of the bunched-up outer edge of the iris. Surgery helps unblock the drainage canals so that the extra fluid can drain.

Normal-Tension Glaucoma

Also called low-tension or normal-pressure glaucoma, in normal-tension glaucoma the optic nerve is damaged even though the pressure in the eye is not very high.

Other Types of Glaucoma

Most other types of glaucoma are variations of open-angle or angle-closure types. These types can occur in one or both of your eyes;er Types of Glaucoma

  • Secondary Glaucoma
  • Pigmentary Glaucoma
  • Pseudoexfoliative Glaucoma
  • Traumatic Glaucoma
  • Neovascular Glaucoma
  • Irido Corneal Endothelial Syndrome (ICE)
  • Congenital Glaucoma (Childhood Glaucoma)

Treatments of Glaucoma

Medication

Eye drops used in managing glaucoma decrease eye pressure by helping the eye’s fluid to drain better and/or decreasing the amount of fluid made by the eye. Drugs to treat glaucoma are classified by their active ingredient. These include: prostaglandin analogs, beta blockers, alpha agonists, and carbonic anhydrase inhibitors. Combination drugs are available for patients who require more than one type of medication.

Laser Surgery

  • Selective Laser Trabeculoplasty (SLT)

For the treatment of primary open-angle glaucoma (POAG). SLT uses a laser that works at very low levels. It treats specific cells "selectively,” leaving untreated portions of the trabecular meshwork intact. For this reason, SLT may be safely repeated.

  • Argon Laser Trabeculoplasty (ALT

For the treatment of primary open-angle glaucoma (POAG). The laser beam opens the fluid channels of the eye, helping the drainage system work better. In many cases, medication will still be needed.

Surgery

When medicines and laser surgeries do not lower eye pressure adequately, doctors may recommend a procedure called filtering microsurgery (sometimes called conventional or cutting surgery).

In filtering microsurgery, a tiny drainage hole is made in the sclera (the white part of the eye) in a procedure called a trabeculectomy or a sclerostomy. The new drainage hole allows fluid to flow out of the eye and helps lower eye pressure. This prevents or reduces damage to the optic nerve.