Glaucoma: Causes, Treatment, and Diagnosis

What is Glaucoma?

Glaucoma is an eye condition categorized by damage to the optic nerve. The optic nerve transmits light detected by the eye as electrical signals to the brain so it can decipher an image. When the optic nerve suffers damage, such as in glaucoma cases, it can lead to sight loss if not treated promptly. Typically, glaucoma is genetic, and the common disease affects 1 in 50 Europeans over 40.

Symptoms

Glaucoma is usually slow progressing and in most cases, the patient will have been suffering from the disease, asymptomatic, before they first seek advice from an ophthalmologist. Initial warning signs of glaucoma are changes to your peripheral (outer edge) vision, blurred vision, or seeing rainbow circles. Glaucoma is often discovered during a routine eye health check-up and treatment can progress from there. Occasionally, acute cases of glaucoma can come on rapidly, causing intense eye pain, nausea, red eyes, tenderness, seeing rings around lights, and blurred vision. It is imperative to seek medical attention, such as an emergency eye clinic or A&E care if you think you may be suffering from glaucoma; the sooner a glaucoma patient can be diagnosed, the sooner they can get treatment, potentially saving their sight.

Types

Most glaucoma cases are primary open-angle glaucoma. This type of disease usually progresses slowly over years and is typically caused by drainage channels in the eye becoming clogged over time. There is also acute open-angle glaucoma: where the drainage channels suddenly become clogged, causing sudden and immense pressure build-up. Acute glaucoma is uncommon, but it is vital that you know where your nearest A&E or emergency eye clinic is in case you ever suffer from the disease. Secondary glaucoma is a different variation of the disease caused by a separate, underlying, eye condition. For example, inflammation of the eye (uveitis) can lead to secondary glaucoma. Congenital glaucoma is an extremely uncommon type of glaucoma, occurring in young children, which is caused by an abnormality of the eye.

Causes

Currently, opticians are unsure of anything you can do to reduce your risk of glaucoma. However, your chances of developing the condition are increased for these reasons: you have a family member with glaucoma; you are of African, Caribbean, or Asian descent; you suffer from long-sightedness, short-sightedness, or diabetes; you are of an older age. It is crucial to let your optician know if you have symptoms of glaucoma, especially acute glaucoma if you fall into any of these categories. It is also important to follow your optician’s advice and to regularly go to eye appointments to test for glaucoma and a multitude of other diseases.

Tests

The most common test for glaucoma is the non-contact tonometry test or the NCT. This involves an optician releasing a puff of air into your eye. A machine can then measure your eye’s resistance to the air, without needing any contact. This procedure is painless and non-invasive and can be performed in a regular opticians appointment. Opticians also have machines that can measure the pressure in your eye, another investigative method for diagnosing glaucoma.

Treatments

Unfortunately, opticians are unable to solve vision loss which happened before a glaucoma diagnosis; their main aims will be to alleviate symptoms and to prevent further damage to the optic nerve. Treatment options for glaucoma depend on the severity, and type, of the case. Most patients suffering from primary open angle glaucoma will be prescribed eye drops-reducing pressure. Other treatment plans, typically for more severe cases, include laser eye treatment to release blocked drains and to reduce how much fluid your eyes produce; surgery to improve the drainage channels, allowing more fluid to be released, reducing pressure; more regular appointments with an optician or ophthalmologist to assess your glaucoma.

Link between Diabetes and Glaucoma

Those who suffer from diabetic retinopathy are more likely to develop glaucoma. Retinopathy can lead to abnormal blood vessel growth which can cause the natural drainage of the eye to become blocked. Because of this link between certain types of diabetes and glaucoma, it is important that you communicate with your endocrinologist (specialist hormone doctor) and ophthalmologist to ask whether regular screening needs to happen.

Sophie Farr, Youth Medical Journal 2020