Glaucoma is the name for a group of diseases that can lead to damage of the eyes optic nerve and result in blindness. But through early detection and with proper treatment, satisfactory sight can usually be preserved indefinitely.
Your eye needs a certain amount of pressure to keep your eyeball in shape so that it can work properly. In some people, the damage is caused by raised pressure. Others may have an eye pressure within normal limits but damage occurs because there is a weakness in the optic nerve. In most cases both factors are involved but to a varying extent.
Why can increased eye pressure be serious?
Eye pressure is not to be confused with blood pressure. If the optic nerve comes under too much pressure then it can be injured. How much damage there is will depend on how much pressure there is, how long it has lasted, and whether there is a poor blood supply or other weakness of the optic nerve. A really high level of pressure will damage the optic nerve immediately. A lower level of pressure can cause damage more slowly, and sight would be lost gradually if not treated.
There are four main types of Glaucoma
Chronic Glaucoma - The most common, when the drainage channels become blocked slowly over many years. The eye pressure rises very slowly and there is no pain to show there is a problem. But the field of vision gradually becomes impaired. Once damage is done it cannot be repaired. However with early diagnoses and regular check ups and treatment, damage can be kept to minimum
Acute Glaucoma - This happens when there is a sudden and more complete blockage to the flow of the fluid to the eye. This is because the narrow angle closes to prevent fluid getting to the drainage channel. The eye becomes red, vision deteriorates and you may even faint. You may also experience nausea and vomiting. In the early stages you may see coloured rings around white lights. This can be very painful and will cause permanent damage if not treated promptly. In some cases Acute Glaucoma does not always cause sudden pain. You can have a series of mild attacks, often in the evening. There may be some discomfort in the eye, coloured lights around a white light, and hazy vision. If you experience either of these systems you should contact your Doctor.
Secondary Glaucoma - Two other main types of glaucoma occur when a rise in eye pressure is caused by another eye condition. This is known as secondary glaucoma. Secondary glaucoma can develop as a complication of other medical conditions. They are sometimes associated with eye surgery or advanced cataracts, eye injuries, certain eye tumours, or uveitis (eye inflammation). Pigmentary Glaucoma occurs when pigment from the iris flakes off and blocks the meshwork, slowing fluid drainage. Neovascular Glaucaoma is linked to diabetes. Congnital Glaucomma (Buphthalmos) - Over 80% of cases are diagnosed in the first three months of life. Due to an abnormality of the angle of the anterior chamber, blocking drainage. As glaucoma becomes much more common over the age of 40 you should have a regular eye test at your ophthalmologist, who will then carry out further tests.
What is the treatment for Chronic Glaucoma
The treatment aims to reduce the pressure in the eye, either by helping fluid to drain out of your eye or by reducing the amount of fluid produced. Usually treatment is started using eye drops. If this does not help, surgery may be considered, using either a laser or by an operation called trabeculectomy.
What Is The Treatment for Acute Glaucoma?
Once damage is done it cannot be repaired. However with early diagnosis and regular check ups and treatment, damage can be kept to a minimum. If you have an acute attack you need to go to hospital immediately so that the pain and pressure in the eye can be relieved. Drugs will be given to improve the drainage system in the eye and reduce the production of aqueous liquid. If treated promptly an acute attack can usually be brought under control within a few hours, the eye will become more comfortable and your sight will start to return. When the inflammation and pain has reduced, the specialist will advise on treatment. Usually this is done by a small operation or laser treatment. However, delay can cause loss of sight in the affected eye. Treatment may be required if the eye pressure remains a little raised and would then be treated as chronic glaucoma. A new method for the prevention of glaucoma progression is implemented at the Glaucoma Department of the Malayan Eye Center in Yerevan, Armenia, thanks to the iStent - Trabecular Micro-Bypass (Glaukos). It is the smallest medical device ever approved by the FDA (Food and Drug Administration), USA. The iStent is designed to create a permanent opening in the trabecular meshwork, and works continuously to improve the outflow of fluid from the eyes to help control eye pressure. Dr. Lilit Voskanyan, head of the Glaucoma Department at Malayan Eye Center, is the only expert in Armenia that implants iStent. She did a fellowship with Dr. Hill in the USA through the AECP fellowship program. After fellowship Dr. Voskanyan has been using her knowledge and innovative medical practice not only at local but also international levels.