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Glaucoma is a group of eye diseases characterised by damage to optic nerve usually due to excessively high intra ocular pressure (eye pressure). If left untreated can lead to optic nerve damage resulting in progressive, permanent vision loss. Glaucoma usually affects people above the age of 40, but can affect younger people as well. This condition causes fluid to build up in the eye, which puts pressure on the optic nerve.
There are broadly two types of glaucoma - Open angle glaucoma ( more common in elderly) and angle closure glaucoma.
Women are more likely to suffer from glaucoma than men are. Ethnicity also plays an important role in determining the risk of suffering from this condition. East Asian and African Americans have a high risk of glaucoma, as they have a shallow, anterior chamber depth. Some of the other conditions that can increase a person’s risk of glaucoma are:
- An earlier eye surgery
- Retinal detachment
- Injury to the eye
- Long term corticosteroid medication
If diagnosed early enough, glaucoma can be treated and its effects can be reduced. However, the damage already caused by glaucoma cannot be reversed. The aim of glaucoma treatment is to either reduce the production of fluid in the eye or improve its flow. This helps slow down the progression of this disease and prevents any further loss of vision. Glaucoma treatment usually takes the form of eye drops or surgery.
Eye drops are the first step towards treating glaucoma. There are many different types of eye drops. Prostaglandin analogues aim at increasing the flow of fluid out of the eye and are usually prescribed in cases of swelling around the rim of the eyes, darkening of the iris and blurred vision. Beta-blockers can also help lower the secretion of fluids in the eye.
Patients who are also suffering from diabetes or lung conditions such as bronchitis may be prescribed cholinergic agents, carbonic anhydrase inhibitors or sympathomimetic drugs. Cholinergic agents help improve the outward flow of fluid in the eyes while Carbonic anhydrase inhibitors reduce fluid production in the eyes. Sympathomimetic drugs do both reduce the production of fluids and improve outflow.
If the eye drops are not effective, surgery may be advised to lower the pressure built up in the eye. Some of the common types of surgery for glaucoma are:
- Trabeculoplasty: This procedure involves directing a high-energy laser beam into the eye to open clogged drainage canals. The surgery has high success rates but the problem may recur after surgery.
- Filtering surgery: This involves creating an opening in the eye and removing a part of the trabecular meshwork, thus allowing fluid to flow outwards.
- Drainage implants: Children or patients with secondary glaucoma may be treated with this surgery where a small silicone tube is placed in the eye to aid in fluid drainage.
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Excessive blinking or the urge to rub your eyes is most often caused by foreign objects in your eyes. This foreign object can be anything from your own eye lash to dust or a shard of metal. The area these foreign objects affect is the cornea or the conjunctiva. It can scratch the cornea causing an infection of affecting your vision if not treated in time. A foreign object usually enters your eye as a result of a high impact collision or force like wind etc. Some of the symptoms of having a foreign object in your eye include:
- Pressure or discomfort in the eye
- Pain in the eye
- Excessive tearing and clear or bloody discharge from the eye
- Increased sensitivity to light
- Redness in the eye
Blinking continuously a few times can dislodge some types of foreign objects. If it affects your vision or causes constant tearing consult a doctor. Do not attempt to rub your eyes in an effort to remove the object. Instead restrict the movement of your eye until a doctor can remove the irritant. To avoid further injury to the eye, bandage the eye with a clean cloth. If the object does not allow you to close your eye, cover it with a paper cup and bandage it. Do not use anything, such as tweezers or cotton directly on the eye.
In some cases, the irritants can be seen with the naked eye. If you think something is stuck in your eye, wash your hands and look at your eye under a bright light. Pulling the lower lid down and flipping the upper eye lid can allow you to see the eye more clearly. To remove a foreign object under the upper eyelid submerge the eye in a flat bowl of water and rapidly open and close it a few times. This can help flush the object out of your eye. Alternatively pour a glass of warm water over your eye while keeping them open. Washing the eye can help get rid of irritants stuck under the lower eyelid.
In more serious cases, anesthetic drops are used to numb the eye. The eye will then be observed under a magnifying glass to see the extent of the injury. Your doctor may use several methods to remove the irritant depending on its size and extent of penetration. You may also be given medication to help deal with the pain caused by the object. If you wish to discuss about any specific problem, you can consult an Ophthalmologist.