Glaucoma
Apple Ophthalmology treats glaucoma. Glaucoma is a group of eye conditions that damage the optic nerve, which is vital for good vision. This damage is often caused by abnormally high pressure in your eye and can lead to blindness if not treated. It is one of the leading causes of blindness for people over the age of 60, though it can occur at any age.
Types of Glaucoma
Open-Angle Glaucoma: The most common form of the disease, where the drainage angle formed by the cornea and iris remains open, but the trabecular meshwork is partially blocked. This causes a gradual increase in eye pressure, leading to optic nerve damage. Open-angle glaucoma develops slowly and is a lifelong condition.
Angle-Closure Glaucoma (Closed-Angle Glaucoma): This type occurs when the iris bulges forward to narrow or block the drainage angle formed by the cornea and iris. As a result, fluid can't circulate through the eye and pressure increases. Angle-closure glaucoma may occur suddenly (acute angle-closure glaucoma) or gradually (chronic angle-closure glaucoma).
Normal-Tension Glaucoma: In this condition, the optic nerve becomes damaged even though the pressure in the eye is not considered high. The reason for optic nerve damage in normal-tension glaucoma is not well understood.
Secondary Glaucoma: This type occurs as a result of another condition or disease, such as inflammation, trauma, or advanced cataract, which causes or contributes to increased eye pressure, leading to optic nerve damage.
Congenital Glaucoma: This rare type is present at birth and is the result of an abnormal development of the eye’s drainage system.
Symptoms
Open-angle glaucoma: Often has no symptoms in its early stages. As it progresses, blind spots develop in your peripheral (side) vision.
Angle-closure glaucoma: Can present sudden symptoms such as severe headache, eye pain, nausea and vomiting, blurred vision, halos around lights, and eye redness.
Normal-tension glaucoma: Similar to open-angle, with slow onset and peripheral vision loss.
Secondary and congenital glaucoma: Symptoms depend on the underlying cause but can include symptoms of other glaucoma types, plus possible visible eye abnormalities in congenital cases.
Risk Factors
Age over 40
Family history of glaucoma
High intraocular pressure (IOP)
Certain medical conditions, like diabetes, heart disease, or high blood pressure
High myopia (nearsightedness)
Long-term steroid medication use
Eye injuries or certain types of eye surgery
Diagnosis and Treatment
Glaucoma is diagnosed through a comprehensive eye exam, including tests to measure intraocular pressure (tonometry), inspect the drainage angle (gonioscopy), examine the optic nerve (ophthalmoscopy), test peripheral vision (visual field test), and measure the thickness of the cornea (pachymetry).
Treatment for glaucoma aims to lower eye pressure to prevent further optic nerve damage. Options include:
Medications: Eye drops or oral medications can reduce eye pressure by improving fluid drainage or decreasing fluid production in the eye.
Laser therapy: Procedures such as trabeculoplasty, iridotomy, and cyclophotocoagulation can increase fluid outflow or decrease fluid production.
Surgery: Conventional surgery like trabeculectomy or minimally invasive glaucoma surgeries (MIGS) may be considered when medications and laser therapy don't sufficiently lower eye pressure.
Early detection and treatment of glaucoma are crucial to prevent vision loss. Regular eye exams are essential, especially if you're at higher risk.