Glaucoma has long been associated with people over the age of 60. Over the years, however, there are cases of younger age groups being affected by it.

It is a condition that occurs gradually and damages the optic nerve. It causes high pressure inside the eyeball affecting the optic nerve and ends up damaging it. Once the optic nerve is damaged, it affects your vision dramatically. In most cases, glaucoma leads to complete blindness without timely intervention.

The deterioration in the optic nerve may be so gradual that you will not notice any changes in vision for a while. In many cases, the condition is detected only at an advanced stage, when it is too late to save the optic nerve.

Glaucoma causes

Though it is a widespread problem, doctors are still not able to completely fathom why some people get glaucoma. It is not yet possible to predict if you are prone to it or not. You might see your eye doctor only when you notice changes in your vision. However, science has been able to establish that glaucoma is often hereditary in nature. If your grandparents or parents had it, then you might also carry the same gene.

  • There is a fluid known as the ‘aqueous humour’ that flows through the inside of the eye to keep it lubricated and moist. In a normal eye, it flows through without stopping via the mesh of tissues at the back of the eyeball. This is the site where the cornea and iris are located.
  • But due to some anomaly, the aqueous humour might accumulate in the tissues instead of flowing out. Thus, it causes a gradual pressure on the optic nerve.
  • The fluid keeps accumulating and building pressure over time, causing a deterioration in the optic nerve. Soon, it starts affecting your vision. Prolonged pressure without treatment may result in permanent blindness in one or both eyes.

Glaucoma manifests itself as disturbed, blurred vision with spots. The symptoms of the condition depend on the type of glaucoma you have. There are two types of glaucoma primarily depending on the pathophysiology.:

The types of glaucoma

1 Open angle glaucoma: Most common type where there is an increase in intraocular pressure without a blockage of flow of aqueous humour in which the symptoms include patchy spots, or blind spots in your peripheral vision. This happens in both eyes and the onset and progression are slow and gradual.

2 Acute angle-closure glaucoma: There is a blockage to the flow of aqueous humour, which has more severe symptoms. The eyes become watery and red, accompanied by pain while blinking, severe headache, vomiting, blurred vision and halos appearing around lights. Its an emergency.

The risk factors for glaucoma

Though glaucoma may happen to anyone, there are certain risk factors that exacerbate or accelerate it. These are:

  • Hereditary factors: Familial progression is very common, especially in open angle glaucoma
  • Ethnicity: Asians are at an increased risk, in closed angle glaucoma.
  • Advanced age
  • Diseases like hypertension, diabetes, sickle cell anaemia
  • Existing eye problems like farsightedness or near-sightedness
  • Corneas that are thin at the centre or predisposed to thinning
  • Taking eye drops or other medication for a long time
  • Certain kinds of eye surgery or injury to the eye
  • Diagnosis of glaucoma:

    Is based on measurement of intraocular pressure by a procedure called tonometry. Also the angle of the eye measurement is carried out through gonioscopy. Visual field testing is done to check any peripheral visual field defect. Pachymetry is carried out to measure the corneal thickness. Coherence tomography, laser polarimetry and ophthalmoscopic examinations are carried out to evaluate the Optic nerve fibre affection.

    Treatment of glaucoma:

  • Medication and eye drops to reduce the intraocular pressure
  • Surgery to remove the blockage either through laser or conventionally to facilitate flow of aqueous humour leading to a drop in intraocular pressure.
  • Glaucoma drainage implants to promote drainage of aqueous humour to bring down the intraocular pressure

  • The Opthalmologist decides on a singular or combination of treatment after diagnosis, evaluation of extent of damage to the Optic nerve, existing comorbidities and age of the individual.

    When to consult your doctor

    If you notice pain in one or both of your eyes, accompanied by spots in your peripheral vision, or blurred vision, rush to your doctor at once. With treatment, the doctor may be able to slow down the progression of the condition. However, in advanced stages, blindness may still set in.

    Disclaimer : The details provided herein is meant for informative purposes only. For detailed information related to the disease and its treatment please consult a relevant qualified specialist.

    Though there may not yet be a cure for glaucoma, you can do a few things to prevent it from occurring in the first place. Consider taking these steps:

    • Get your eyes checked every year. Regular eye check-ups are necessary after the age of 35 years, since some amount of macular degeneration starts setting in for most people. This practice also helps your doctor find the early signs of glaucoma and start treating you before the problem becomes acute. Regular eye examinations are a must if there is a history of glaucoma in the family.

    • Exercise in moderation. Exercise is important, but it must not lead to glaucoma. On the other hand, exercise may actually reduce the onset of glaucoma, or help in draining the aqueous humour in an efficient way. Your doctor can help you with a good exercise plan.

    • Protect your eyes. The eyes are quite delicate, and many factors can damage them. From prolonged exposure to harsh sunlight to lack of goggles when playing racquet sports or handling power tools, there are many ways that you can damage your eyes. Eye injuries may lead to glaucoma in the future.

    • Use eye drops regularly as advised. Your doctor will give you eye drops to use to reduce the symptoms of glaucoma. Use them regularly as prescribed, even if you do not feel the symptoms every day. However, do not use them beyond the prescribed limit.