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Glaucoma - Symptom, Treatment And Causes

Last Updated: May 06, 2022

What is Glaucoma?

Glaucoma is a medical condition which damages the optic nerve of the eye and can get worse overtime. It occurs due to the buildup of pressure in your eyes. Glaucoma is usually inherited and passed down the genes if your family member has it. Glaucoma usually destroys the nerve which aids in transmitting images to your brain. It can result to irreversible vision loss within a few years if not treated properly. If you have diabetes, you are more prone in developing glaucoma.

Types of Glaucoma:

  • Open angle Glaucoma- This is a very common type of Glaucoma. It is also known as wide-angle glaucoma. In this condition, the trabecular meshwork seems normal but the fluid fails to flow the way it should.
  • Angle-closure Glaucoma- It is also called narrow-angle Glaucoma and acute angle closure. In this condition, the eye doesn’t seem to drain properly because the area between the cornea and the iris is extremely narrow. This can cause an immediate buildup of eye pressure. It is linked to cataracts and farsightedness (clouding of the eye lens)

What are the early symptoms of Glaucoma?

Glaucoma is an intricate eye condition in which the optic nerve damage may occur and it will lead to loss of vision if untreated. The two common forms of glaucoma are primary open-angle glaucoma (POAG) and acute angle-closure glaucoma (ACG). In POAG, you may not experience any symptoms until vision loss. The early symptoms of acute angle-closure glaucoma are blurred vision, severe eye pain with nausea and vomiting, sudden sight loss, the appearance of halos.

In angle-closed glaucoma which is otherwise called narrow-angle glaucoma, the patients may see an increased eye pressure that will lead to optic nerve damage. The eye pressure may occur gradually or suddenly. The symptoms of acute angle-closure glaucoma are much noticeable and the damage may occur quickly. Vision loss because of glaucoma isn't reversible with treatment and even with a medical procedure called therapy. So, immediate medical attention and regular examination are required to prevent vision loss.

Causes of glaucoma:

Glaucoma occurs when the liquid in the eye doesn’t circulate how it should, this in turn results in extremely high pressure in your eyes. The liquid which is called aqueous humor usually starts to flow out your eyes through a channel. If this channel is blocked, the fluid starts building up resulting in Glaucoma. Factor such as inflammatory conditions, blocked blood vessels in the eye, acute eye infection, chemical injury and a blunt can cause Glaucoma. It is rare but possible in some cases. An eye surgery performed to treat another condition can also trigger Glaucoma. It can affect both the eyes.

At what age do you usually get glaucoma?

Glaucoma is usually developed at an age of 60 years or above. This is the general trend of occurrence of the disease. However, in the case of African Americans, the age groups most commonly affected by this condition include people with or more than 40 years of age. The Risk of developing glaucoma increases slightly with age.

Summary: The age groups most commonly affected by Glaucoma mainly include people after the age of 60 years, unlike African Americans who get this disease after 40. With increasing age, the risks of developing Glaucoma also increase.
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Risk factors for Glaucoma:

Risk factors for Glaucoma:

  • If you have Scandinavian, Inuit, Hispanic, Japanese, Russian, Irish or African-American ancestry.
  • If you are over 40 years old.
  • If your family members have Glaucoma
  • Having diabetes.
  • If you take steroid medications such as prednisone.
  • If you have had trauma to one or both the eyes.

How is Glaucoma diagnosed?

At first, the specialist will dilate your pupils with eye drops. He will then check the optic nerve. A test called tonometry can be performed to keep a check on your eye pressure. A visual field test is also done to figure if your peripheral and side vision has been affected or not. Diagnoses for Glaucoma takes very less time and is also quite painless.

What is the best treatment for glaucoma?

The glaucoma medications are intended to control as well as lower the intraocular pressure (IOP) which can harm the optic nerves that send visual data to the cerebrum. The patient is advised with glaucoma eye drops initially and it is very effective in controlling IOP. Sometimes, the ophthalmologist may put on combination glaucoma drops i.e. more than one drug to achieve the best IOP control.

Some types of glaucoma drops are Prostaglandins, beta-blockers, Alpha-adrenergic agonists, Carbonic anhydrase inhibitors, Parasympathomimetics, Epinephrine, and Hyperosmotic agents. There are a couple of ophthalmic drug stores that delivered mix eye drops that contain two distinctive anti-glaucoma prescriptions in a similar container. Depends on the eye condition and the type of glaucoma, the drug/s is advised. It is advisable to put the drops in the eyes as prescribed by the doctor.

Who is eligible for the Glaucoma treatment?

Each and every individual suffering from Glaucoma is eligible for treatment as this eye disease cannot be resolved spontaneously. The damage done to the eye during the condition cannot be reversed and to prevent the further damaging or worsening of the symptoms, treatment is needed.

The treatment is lifelong and lowers the progression of the disease.

Summary: Every individual suffering from Glaucoma is eligible for treatment as treatment is the only option to prevent the progression of the disease towards permanent blindness.

Who is not eligible for the Glaucoma treatment?

Glaucoma is associated with progressive symptoms that eventually lead to loss of vision. These symptoms cannot resolve on their own and need to be controlled and managed with proper diagnosis and treatment. Hence, any individual suffering from this health condition is eligible for treatment.

Summary: The damage already done to the eyes is irreversible in the case of Glaucoma and it is progressive in nature. Thus, it is imperative for every individual to undergo treatment regardless of any other facts.

What are the Glaucoma post-treatment guidelines?

The treatment continues throughout the life of a Glaucoma patient since the disease does not have a cure. Thus, it is important to follow certain preventive measures so as to slow the progression and prevent any further complications.

Important post-treatment guidelines mainly include:

  • Regular eye-check ups under the supervision of an ophthalmologist.
  • Taking medicines on time and throughout life without any second thought.
  • Taking nutritious foods
  • Staying active
  • Following proper instructions as suggested by the doctor.
Summary: Treatment continues throughout the life of a Glaucoma patient and so are the post-treatment guidelines. These should be followed strictly so as to prevent any complications.

What are side effects of Glaucoma treatments?

The treatment of Glaucoma mainly involves medications that can effectively reduce the pressure inside the eyes so as to minimize risks of damaging the optic nerve. Eye drops including prostaglandins analogs, beta-blockers, etc.

and oral pills such as acetazolamide are some of the important medicines preferred in such conditions. Side effects associated with their use may include:

  • Elevated blood pressure levels
  • Fatigue or weakness
  • Headache as well as drowsiness
  • Burning or stinging sensation
  • Tachycardia
  • Dryness of mouth
  • Blurring of vision
Summary: The medicines which are mainly used for the treatment of Glaucoma include eye drops as well as oral pills. These are associated with certain kinds of side effects.

What foods to avoid if you have glaucoma?

  • Trans fatty acids are reported to be associated with higher cholesterol levels and they can damage the blood vessels throughout the body. The blood vessel damage plays a major role in injury to the optic nerve in glaucoma. Avoid processed foods such as fried items, cookies, cakes that contain more Trans fatty acids.
  • Saturated fats including fatty cuts of the pork, lamb, and red meats should be steered from your diet. Excessive use of butter also is to be limited. Get more into olive oil for cooking.
  • A high intake of caffeine is reported to increase eye pressure. The increased IOP will damage the optic nerve. So, refraining from caffeinated products is always good for glaucoma.
  • Simple carbs have to be avoided and they are cereal, pasta, potato, sugar, rice, and bread.

What is the best vitamin to take for glaucoma?

  • Vitamin A plays an essential role in maintaining a clear cornea. It prevents the total eye afflictions. Pumpkins, green leafy vegetables, bell peppers, carrot, egg yolk, and milk are the rich sources of vitamin A.
  • Vitamin E is a potent antioxidant that protects the cells including eye cells. Vitamin E rich diets such as avocado, nuts, salmon fish, whole grains, vegetable oils, fortified cereals help a lot to get a clear eye vision.
  • Vitamin C is also a powerful antioxidant that prevents the eye from free radical damage. Take broccoli, green peppers, citrus fruits, strawberries, tomatoes, white and sweet potatoes to enrich your diet with Vitamin C
  • Vitamin B12, B6 and B9, Vitamin D, Riboflavin, Niacin, Lutein and Zeaxanthin, Omega-3 Fatty Acids, and Thiamine are the best vitamins not only for glaucoma but for overall vision.

How can glaucoma be prevented?

A regular eye examination can only prevent the eyes from glaucoma damage. Since there is no known way to prevent glaucoma, significant eye loss can be prevented at the early diagnosis. In primary open-angle glaucoma, it affects the side vision first and it progresses to the central vision.

Glaucoma medicines decrease the progression of glaucoma by reducing the increased IOP. The headstand and shoulder stand positions should be avoided if you are doing yoga which will simultaneously increase the IOP. Eye injuries may lead to secondary or traumatic glaucoma. So, protecting eyes from further injuries always helps to prevent glaucoma.

Can Glaucoma go away on its own?

Glaucoma is a disease of the eye accompanied by an increase in the pressure inside the eyes. The condition cannot be resolved on its own. It is a lifelong eye abnormality and requires treatment throughout life.

It damages the optic nerve, causing impaired vision. Such damage cannot be reversed, but an early diagnosis of it may slow or prevent vision loss.

Summary: Glaucoma or eye disease is a lifelong condition that keeps on affecting the vision adversely. It requires an early diagnosis, followed by an appropriate treatment throughout life to prevent the worsening of the symptoms.

Should I go to urgent care for Glaucoma?

There are mainly two types of glaucoma including Open-angle type and Acute angle-closure type. The former involves symptoms like patches of blind spots in peripheral or central vision, tunnel vision, etc. It does require treatment but not on an urgent basis.

The latter include more serious symptoms such as headache, blurred vision, severe eye pain, nausea, vomiting, redness in the eyes, etc. These present an emergency condition and need urgent medical care and attention.

Summary: Urgent medical care and attention is required in Acute-angle closure type of glaucoma as it is associated with more serious symptoms like severe headache and eye pain, blurred vision, nausea, vomiting, etc.

How long does it take to go blind from glaucoma?

Glaucoma is a progressive eye disease involving optic nerve damage. The time period is taken for the progression to blindness mainly depends upon the intraocular pressure or the pressure build-up inside the eyes.

If the intraocular pressure ranges from 21 - 25 mm Hg, 25 - 30 mm Hg and more than 30 mm Hg, the time taken to progress towards blindness is around 15 years, 7 years, and 3 years respectively. Based on an average calculation, it can be estimated that untreated cases of Glaucoma take 10 - 15 years to go blind from the initial damage.

Summary: The average time taken for people suffering from Glaucoma to go blind from the initial damage is considered to be around 10 to 15 years depending upon the range of intraocular pressure.

How long does it take to recover from Glaucoma?

Glaucoma is incurable, but treatment is possible. Surgery is the most commonly preferred way for Glaucoma treatment. The results are not permanent but long-lasting after surgeries.

The time taken to recover from Glaucoma mainly depends on the health status of the individual and type of the surgery performed. On average, a time period of one month is needed for complete recovery.

In some cases, recovery does take place in 3 weeks' time while certain cases witness a slow recovery period of up to 6 weeks.

Summary: Recovery from glaucoma mainly depends upon the type of treatment and the response of the body towards it. On average, it takes a time period of around one month to recover from such conditions.

What is the price of Glaucoma treatments in India?

The price of Glaucoma treatment in India is considered to be INR 35000 on average. This is the cumulative sum of the expenses related to the treatment. It mainly involves out-patient department consultation fees, cost of the diagnostic tests, surgery-related expenses, and post-operative care.

Summary: The price of Glaucoma treatment in India is the total sum of the expenses related to OPD consultation fees, diagnosis, surgery, and post-operative care.

Physical Exercise for the people suffering from Glaucoma:

Physical exercises are beneficial in the case of Glaucoma as they lower the rate of progression of the disease. They improve blood circulation to the eyes as well as the brain and prove to be effective in reducing intraocular pressure. Some preferred forms of exercises include the following:

  • Aerobics: These include mainly walking, cycling, biking, swimming, etc. Such exercises should be done at a slower pace for 30 to 45 minutes.
  • Daily life physical activities: These may include climbing stairs, doing household activities like gardening, walking on the lawn, etc.
  • Moderate to vigorous forms of exercises: Cardiovascular exercises are included in this category. Weight-lifting, push-ups, sit-ups, plank, side-lift, etc.
Summary: Physical activities or exercises are helpful for people suffering from Glaucoma as they improve blood circulation to the eyes and brain and also lower intraocular pressure.

Which is the best medicine for Glaucoma?

The treatment of Glaucoma mainly involves the application of medicines. These medicines work on the basis of either lowering the intraocular pressure or increasing the drainage of the fluid responsible for building the pressure inside the eyes.

Important medicines include:

  • Eye drops: These are of different types such as:
    • Prostaglandin analogs: Examples are Bimatoprost, Latanoprost, etc.
    • Beta-blockers: Examples include Betaxolol, Timolol, etc.
    • Alpha-adrenergic agonists: Examples are Brimonidine, Apraclonidine, etc.
    • Carbonic-anhydrase inhibitors: Examples include Dorzolamide.
  • Oral pills: The medicines preferred mainly include carbonic anhydrase inhibitors. Examples are Acetazolamide, Methazolamide etc.
Summary: Medicines preferred in the treatment of Glaucoma mainly include eye drops and oral pills. They either lower the pressure build-up inside the eyes or enhance the drainage of the eye fluid.

Are the results of the Glaucoma treatment permanent?

Glaucoma is incurable. The treatment is mainly done with the help of medicines and surgeries. The results of the treatment are not permanent but may be long-lasting, depending upon the personal health status of the individual or the body's response towards the particular treatment.

Hence, the people suffering from Glaucoma need treatment throughout their life.

Summary: The results of the treatment in the case of Glaucoma are not permanent as it is a lifelong disease and cannot be cured. Only the control and management of the disease are possible.

What are the alternatives to the Glaucoma treatment?

Alternative methods for the treatment of Glaucoma are gaining popularity day by day. These mainly include therapies as well as herbal medicines.

Some of the methods which serve as alternatives to the Glaucoma treatment mainly include:

  • Herbal remedies: Ginkgo biloba is one such remedy that acts as an antioxidant and is known to improve the health of the optic nerve.
  • Acupuncture: It is considered effective for slowing the progression of vision loss.
  • Diet: One should avoid drinking too much water in a short period of time as it is supposed to increase intraocular pressure.
  • Vitamins: Vitamin A is a strong antioxidant and helps to improve nerve health. Vitamin B12 plays a role in decreasing the intraocular pressure as well as enhancing the visual field.
  • Marijuana: It is known to decrease intraocular pressure.
Summary: Although alternative methods of treatment are non-standard and conventional, they are gaining popularity among patients with Glaucoma. They help in recovering from the symptoms one way or another.

References

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Written ByDr. Anurag Agarwal MS - Ophthalmology,MBBSOphthalmology
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