1 Glaucoma The silent thief of sight
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Glaucoma
The silent thief of sight
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Glaucoma
GlaucomaTypes, diagnosis, and Treatment
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Glaucoma
In general, Glaucoma occurs as a result of increased intraocular pressure (IOP) caused by a malformation or malfunction of the eyes drainage system. Normal IOP is 19 – 21 inches of mercury. The increased pressure causes compresssion of the retina and the optic nerve, and causes progressive, PERMANENT loss of eyesight if left untreated.
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Glaucoma
Glaucoma can be classified into several different and unique types:
Primary Open Angle Glaucoma (POAG)
Angle – closure Glaucoma (Acute Glaucoma)
Congenital Glaucoma
Secondary Glaucoma
Pigmentary Glaucoma
Normal – tension Glaucoma (NTG)
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Glaucoma
Primary Open Angle Glaucoma
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Glaucoma
Primary Open AnglePrimary Open Angle Glaucoma Glaucoma is caused when the normal is caused when the normal drainage system of the eye becomes partially blocked, causing drainage system of the eye becomes partially blocked, causing pressure to build within the eye.pressure to build within the eye.
Normal Eye
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Glaucoma
Primary Open AnglePrimary Open Angle Glaucoma Glaucoma is caused when the normal is caused when the normal drainage system of the eye becomes partially blocked, causing drainage system of the eye becomes partially blocked, causing pressure to build within the eye. Glaucoma usually affects the pressure to build within the eye. Glaucoma usually affects the perimitery vision first, with sight gradually being lost towards the perimitery vision first, with sight gradually being lost towards the center of the eye. center of the eye.
Vision loss with Glaucoma
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Glaucoma
Primary Open Angle Glaucoma
Normal EyeNormal Eye
Pressure builds when the drainage system Pressure builds when the drainage system is blocked. This increasing pressure is blocked. This increasing pressure presses against the Optic Nerve and presses against the Optic Nerve and
causes a gradual loss of sight.causes a gradual loss of sight.
Total loss of Total loss of visionvision
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GlaucomaPrimary Open Angle Glaucoma
Symptoms In the very early stages there are NO symptoms.
Mild pain in the eye, increasing gradually over time.
“Halos” appearing around lights.
Gradual loss of Peripheral vision.
Loss of night vision
Who is at risk? Patients with a family history of Glaucoma
African Americans
Patients suffering from Myopia
Patients suffering from Diabetes
People over 35 years of age
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Glaucoma
Angle – closure Glaucoma (Acute Glaucoma)
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Angle Closure Glaucoma (Sometimes referred to as Narrow Angle Glaucoma) is caused when the normal drainage system of the eye becomes suddenly blocked, causing pressure to build within the eye at a very rapid rate. Complete blindness can occur in as little as 3 to 5 days!
Normal Eye Sudden blockage causes pressure to build rapidly.
Glaucoma
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Angle Closure Glaucoma
Symptoms Severe Pain
Pressure over the eye
Cloudiness to the Cornea
Eye extremely sensitive to light
Halos seen around lights.
Nausea and/or vomiting
Who is at risk? Patients with a family history of Glaucoma
African Americans
Patients suffering from Myopia
Patients suffering from Diabetes
People over 35 years of age
Glaucoma
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Glaucoma
Congenital Glaucoma
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Glaucoma
Congenital Glaucoma results as a condition from birth. Children are born with conditions such as an abnormal development of the Anterior Chamber angles which prohibit the normal drainage of fluid from the eyes, which then causes an increase in the pressure within the eye, and subsequent Retinal and Optic Disc damage.
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Glaucoma
Parents normally are the first to recognize the symptoms of Congenital Glaucoma:
Cloudiness of the cornea due to Edema
Distension of the eye
Photophobia (sensitive to light)
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Glaucoma
In most cases, numerous surgeries are required to correct Congenital Glaucoma. Lasers are sometimes used, as well as Filtration Surgery and insertion of Tube shunts:
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Glaucoma
Secondary Glaucoma
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Glaucoma
Secondary Glaucoma is usually the result of a trauma to the eye, although it can develop due to several causes:
Abnormal deposits in the eye fluid
Uveitis
Lens Changes
Drugs
Haemorrhage
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Glaucoma
Pigmentary Glaucoma
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Glaucoma
Pigmentary Glaucoma can develop as a result of small pieces of the Iris breaking off. These small particles can lodge themselves in the normal drainage canals and subsequently interfere with the normal drainage of
fluids from the eye.
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Glaucoma
Normal Tension Glaucoma
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Glaucoma
Normal Tension Glaucoma occurs when there is damage to the Optic nerve detected in patients who have completely normal Inter – Occular
pressure. It has the same characteristics as Primary Open – Angle Glaucoma.
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Glaucoma
Diagnosis and Treatment
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DiagnosisTonometry is often used as a diagnostic tool. The Tonometer is gently pressed against the eyeball, and the resistance (internal pressure) is measured. This requires that the eye be numbed prior to the test.
Gonioscopy can be used to determine if the angle where the iris meets the cornea is open or closed.
Glaucoma
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Diagnosis
Perimetry is an essential method used to determine if there is any loss of the visual field.
Glaucoma
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Primary Open Angle Glaucoma
DiagnosisSlit Lamp Examination is another method of diagnosis of patients with suspected Glaucoma.
Glaucoma
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Stereo disc photography of the optic disc is performed to determine if there is abnormal cupping in the optic nerve head.
Subsequent exams or photos are compared over time.
Glaucoma
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Measurement of Retinal Nerve Fiber Layer thickness with the StratusOCT is the most recent advancement in technologythat aids in the diagnosis of Glaucoma.
Glaucoma
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Treatment
Medication
Laser Surgery
Filtration Surgery
Medications Medications are available in are available in several forms.several forms.
Laser surgery Laser surgery can reduce the can reduce the
need for need for medicationsmedications
Filtration Filtration Surgery Surgery
creates a new creates a new drainage drainage channelchannel
Glaucoma
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Treatment
Laser Iridotomy
Filtration Surgery
In Laser Iridotomy, a small hole is cut in the
Iris
Filtration Surgery creates a new drainage
channel
Glaucoma
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