Glaucoma is a chronic eye disease that causes damage to the optic nerve. This damage results from an excessively high intraocular pressure. Due to the loss of optic nerve fibers, blind spots arise in the field of vision. Glaucoma is worldwide a common cause of visual impairment. The final stage of glaucoma is blindness.
Cause
The exact cause of glaucoma is not known. However, there are factors that increase the risk of glaucoma:
- The higher the intraocular pressure, the more risk of damage to the optic nerve.
- When glaucoma occurs in the family, the risk of glaucoma is almost ten times higher than when it doesn’t.
- Defects in blood vessels in or near the eye.
- Negroid people have glaucoma more often.
- High blood pressure.
- Highly nearsighted or highly farsighted.
- Age of 40 years or older (even higher risk in people aged over 70 years).
- Use of corticosteroids.
- Cardiovascular diseases.
Symptoms
There are two types of glaucoma: chronic and acute. The signs and symptoms of glaucoma depend on the type of glaucoma:
- Chronic glaucoma is characterized by an insidious pattern. In the beginning, there are no symptoms. The field of vision decreases gradually and the patient will be seeing less sharp. This is often noticed afterwards, when the condition is already at a more advanced stage.
- Acute glaucoma is less common. Unlike the chronic variant of glaucoma, in acute glaucoma, usually only one eye is affected and the symptoms are soon getting clear: the eye is painful, red and dull. The eyeball feels hard and sensitive and often the patient also has blurred vision. Additionally, general symptoms occur, such as nausea, headache, vomiting and possibly abdominal pain.
Diagnosis
The diagnosis of glaucoma is made by an ophthalmologist, using tonometry. The optic nerve is also examined with a special microscope. In addition, visual field measurement is carried out in order to see which parts of the field of vision are affected.
Treatment
There are several treatments available for glaucoma:
- Eye drops. It’s important to drip consistently. There can be dripped with agents that reduce the production of aqueous humor, with agents that stimulate the drainage of aqueous humor or with a combination of these agents. This treatment should be carried out, in principle, for life.
- Laser treatment. Several laser treatments are possible, this depends on the type and severity of the glaucoma.
- Surgery. Different operations are possible as well, this also depends on the type and severity of the glaucoma. The operations are intended to drain the aqueous humor, or to create more space in order to lower the intraocular pressure.
Prognosis
The objective is to normalize intraocular pressure and prevent further damage. Therefore, lifelong treatment and checks are necessary. Early detection of glaucoma is very important. By early intervention, damage might be limited. However, damage to the optic nerve that has already occurred, is beyond repair. If glaucoma is not treated, it can lead to blindness.
Considerations
- The main measure a person can take for himself, is faithfully using ocular hypotensive agents.
- Exercise is good for blood circulation in the small capillaries of the optic nerve. In addition, physical activity lowers intraocular pressure to a small extent. Yoga exercises, in which someone must be standing prolonged (longer than one minute) on the head, may increase intraocular pressure. These kind of exercises are therefore dissuaded. A lot of bent-over work can also lead to increased intraocular pressure.
- Excessive drinking can slightly increase intraocular pressure. Especially rapidly drinking large amounts of fluid at once can lead to pressure peaks. Coffee and tea in itself can do no harm.
- People with high blood pressure often have glaucoma. There is also a relationship between (too) low blood pressure and glaucoma. Some antihypertensive drugs are so powerful that blood pressure drops too low during sleep. That is not good for the optic nerve and glaucoma damage may increase.
- Some medications, such as anti Parkinson’s, prostatic hyperplasia and antidepressants, can enlarge the pupil of the eye. This can sometimes lead to an attack of high intraocular pressure.
- Smoking is bad for blood vessels and hence also for the small capillaries of the optic nerve.
- Stress doesn’t increase intraocular pressure.
