Glaucoma refers to a group of related eye disorders that all cause damage to the optic nerve that carries information from the eye to the brain. Glaucoma usually has few or no initial symptoms.
In most cases, glaucoma is associated with higher-than-normal pressure inside the eye - a condition called ocular hypertension. But it also can occur when intraocular pressure (IOP) is normal. If untreated or uncontrolled, glaucoma first causes peripheral vision loss and eventually can lead to blindness.
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There are two main types of glaucoma,open angle and closed angle (angle closure) glaucoma.
Closed Angle Glaucoma (acute glaucoma) can come on suddenly, and the patient commonly experiences pain and rapid vision loss.
(chronic glaucoma) - progresses very slowly.
Low-tension Glaucoma - another form in which though eye pressure is normal, optic nerve damage still occurs.
Pigmentary Glaucoma - this type generally develops during early or middle adulthood.
What are the Warning Signs of Glaucoma:
Presence of the following warning signs, indicates that you need a thorough examination by an eye doctor:
Unusual trouble adjusting to dark rooms
Difficulty focusing on near or distant objects
Squinting or blinking due to unusual sensitivity to light or glare
Change in color of iris
Red-rimmed, encrusted or swollen lids
Recurrent pain in or around eyes
Dark spot at the center of viewing
Lines and edges appear distorted or wavy
Excess tearing or "watery eyes"
Dry eyes with itching or burning; and
Seeing spots, ghost-like images
Potentially serious problems that might require emergency medical attention:
Sudden loss of vision in one eye
Sudden hazy or blurred vision
Flashes of light or black spots
Halos or rainbows around light
The symptoms listed above may not necessarily mean that you have glaucoma. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.
Glaucoma often is called the "SILENT THIEF OF SIGHT", because most types typically cause no pain and produce no symptoms until noticeable vision loss occurs. The most common types of glaucoma - primary open-angle glaucoma and angle-closure glaucoma - have completely different symptoms.
Primary open-angle glaucoma signs and symptoms include:
Gradual loss of peripheral vision, usually in both eyes
Tunnel vision in the advanced stages
Acute angle-closure glaucoma signs and symptoms include:
Nausea and vomiting (accompanying the severe eye pain)
Sudden onset of visual disturbance, often in low light
Halos around lights
Reddening of the eye
When to see a doctor?
Don't wait for noticeable eye problems.
Comprehensive eye exam for all adults starting at age 40, and
Every three to five years after that if you don't have any glaucoma risk factors.
If you have other risk factors or you're older than age 60, you should be screened every one to two years.
Severe headache or pain in your eye, nausea, blurred vision, or
Halos around lights may be the symptoms of an acute angle-closure glaucoma attack.
If you experience some or several of these symptoms together, seek immediate care at an emergency room or at an eye doctor's (ophthalmologist's) office right away.
Your doctor may perform several tests to diagnose glaucoma, including:
Measuring intraocular pressure: Tonometry is a simple, painless procedure that measures your internal eye pressure (intraocular pressure), after numbing your eyes with drops. It's usually the initial screening test for glaucoma.
Test for optic nerve damage. To check for damage in your optic nerve, your eye doctor uses instruments to look directly through the pupil to the back of your eye.
Visual field test. To check whether your visual field has been affected by glaucoma, your doctor uses a special test to evaluate your side (peripheral) vision.
Visual acuity. Your doctor will test your ability to see from a distance.
Your eyes are numbed for this test, which determines the thickness of each cornea, an important factor in diagnosing glaucoma..
Other tests. To distinguish between open-angle glaucoma and angle-closure glaucoma, your doctor may use a technique called Gonioscopy in which a special lens is placed on your eye to inspect the drainage angle. Other tests, such as imaging tests, have been developed and may sometimes be used.
Treatment aims to reduce the pressure in the affected eye, called intraocular pressure.
Any damage to your vision caused by glaucoma can't be repaired so it's important to get an early diagnosis and treatment to prevent further damage.
The type prescribed may depend on:
How your condition is progressing
Weather you have other medical conditions
Whether you are taking any other medications
Weather the eye drops cause side effects when you use them
Using eye drops:
To use eye drops:
Use your finger to gently pull down your lower eyelid
Hold the bottle over your eye and allow a single drop to fall into the pocket you have created in your lower lid
Close your eye and keep it closed for several minutes
If you are using two different types of eye drops, allow at least five to 10 minutes between using the different types.
If you usually wear contact lenses and have been prescribed eye drops, you may need to stop wearing your lenses and wear glasses instead.
This is because medication in the eye drops can build up in the lenses and may harm your eyes. You should discuss this with healthcare professionals treating you.
Some of the common Side effects of eye drops include:
Enlarged blood vessels in the white part of your eye, making your eye look red
Changes to your eye colour - it often gets darker
Eyelashes growing thicker and darker
Eye pain and irritation
Blepharitis - a condition where the rims of your eyelids become red and swollen
Sensitivity to light
Stinging or burning sensation in your eye
Eye drops from the class Beta-blockers can make some medical conditions worse, so do not use them if you have:
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Laser treatment, which uses high energy beams of light, can be used to open up the blocked trabecular meshwork (drainage tubes) within your eye. This is called lasertrabeculoplasty.
Laser treatments are usually quick and painless, although during the procedure you may feel a brief twinge of pain or heat. You may still need to use eye drops after having laser treatment.
A trabeculectomy is the most common type of glaucoma surgery. It involves removing part of the trabecular meshwork to allow fluid to flow through the eye's drainage system.
The procedure will be carried out under local anaesthetic (you are awake) or general anaesthetic (you are unconscious).
Other types of surgery include:
an aqueous shunt implant
Speak to your surgeon to find out more about your procedure and risks involved.
If you are having surgery, your surgeon may choose to use anti-scarring medicines.
Monitoring your condition
If you have been diagnosed with glaucoma your condition will be closely monitored to check for further damage to your vision.
Depending on how your glaucoma is progressing, you may need further appointments every one to four months or up to 12-24 months apart. These will either be with:
an optometrist - a healthcare professional who examines eyes, tests vision and is trained to recognize eye diseases and vision defects.
an ophthalmologist - a medical doctor who specializes in eye diseases and their treatment and surgery
The main complication of glaucoma is loss of vision that can't be repaired. This is why early diagnosis and treatment is so important.
Loss of vision
Complications from treatment
If you have surgery to treat glaucoma, there is always a risk of infection. Most infections can be treated with a course of antibiotics.
You may also have a reaction to certain types of eye drops. Speak to the healthcare professionals treating you if you feel unwell while being treated for glaucoma.
If you have glaucoma, it could affect your ability to drive. It's your legal obligation to inform the Driver and Vehicle Licensing Agency about a medical condition that could affect your driving ability.
Childhood glaucoma - also referred to as congenital glaucoma, pediatric, or infantile glaucoma - occurs in babies and young children. It is usually diagnosed within the first year of life.
How is it Treated?
In an uncomplicated case, surgery can often correct such structural defects. Both medication and surgery are required in some cases.
Medical treatments may involve the use of topical eye drops and oral medications. These treatments help to either increase the exit of fluid from the eye or decrease the production of fluid inside the eye. Each results in lower eye pressure.
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Who is at Risk for Glaucoma?
The most important risk factors include:
Age: You're at a higher risk of glaucoma if you're older than age 60,
Elevated eye pressure
Family history of glaucoma
Past injuries to the eyes
History of severe anemia or shock
Individuals with diabetes and hypertension may also have an increased risk of developing open-angle glaucoma (OAG).
Your ophthalmologist will weigh all of these factors before deciding if you need treatment for glaucoma; or whether you should be monitored regularly as a glaucoma suspect to detect the early signs of damage to the optic nerve.
Aerobic exercise (walking, jogging or cycling) lowers IOP, even after 5 minutes. This reduction is greater with longer duration and higher intensity. It may have more effect in individuals with glaucoma.
Increasing Intraorbital Pressure - Playing Wind Instruments
IOP can almost double within 20 seconds when playing a wind instrument, but returns to baseline almost immediately.
The inverted position in yoga has been associated with significant increases in intraocular pressure in some people and could lead to worsening of glaucoma.
Exercise can be dangerous for patients who have Pigmentary glaucoma.
Vigorous high-impact exercise causes pigment to be released from the iris, which increases eye pressure.
Talk with your doctor about an appropriate exercise program.
If you have elevated intraocular pressure or glaucoma, follow these lifestyle tips.
Eat a healthy diet.Eating a healthy diet can help you maintain your health, but it won't prevent glaucoma from worsening. Several vitamins and nutrients can help improve your vision.
Exercise safely. Regular exercise may reduce eye pressure in open-angle glaucoma. Talk to your doctor about an appropriate exercise program.
Limit your caffeine. Drinking high amounts of caffeine may increase your eye pressure.
Sip fluids frequently. Drink only moderate amounts of fluids at any given time during the course of a day. Drinking a quart or more of any liquid within a short time may temporarily increase eye pressure.
Living With Glaucoma:
If Your Vision Begins To Change
Some people with glaucoma have "low vision". Low vision means there may be problems doing daily, routine things even if using Glasses or contact lenses. With glaucoma, this can include loss of contrast sensitivity (the ability to see shades of the same color), problems with glare, light sensitivity, and reduced visual acuity (the ability to see fine details). A variety of products and resources are available to help people who have low vision. Examples include magnifiers, colored lenses, and computer text enlargers. If you have low vision concerns, help is available. Discuss your concerns with your doctor.
Working With Your Doctor
As a newly diagnosed person with glaucoma, you may need to have your eye pressure checked every week or month until it is under control.
It is important that your doctor listens and responds to your concerns and questions, is willing to explain your treatment options, and is available for calls and checkups. If you do not feel confident and comfortable with your doctor, remember, you always have the right to seek a second opinion.
What You Can Do To Manage Your Glaucoma
Know And Keep Track Of Your Medications
Some medications may cause you to experience strong side effects. Be sure to tell your doctor about any side effects you experience once you have started your medication.
Make your medications part of your daily routine, perhaps by taking them when you get up, at mealtimes, and/or at bedtime. Use an alarm watch to remind you of when to take your medication.
Get an extra supply of medication in case you misplace a bottle of eye drops or pills.
Take an extra prescription along with you on trips away from home.
Find out about possible side effects.
It's important that you tell everyone on your healthcare team - including your family doctor and any other specialists - that you have glaucoma and what medications you are taking.
Let your doctor know if, for any reason, your medications are not working for you, or if your daily routine has changed. Your doctor may be able to solve such problems by changing the type or timing of your medications.
Report any changes to your doctor, especially eye irritation, watering, blurring or scratchiness, unusual discharge in the corner of your eye, temporarily cloudy vision, continual headaches, flashes of light or floating objects in the field of vision, or rainbows around lights at night
Keep a record of each medication you are taking.
Write down the name, the dosage, and the number of times it should be taken each day.
Keep it in your purse or wallet, or place it where you will see it every day.
Schedule your next checkup before you leave the doctor's office, and put your appointment on your calendar.
Go for a checkup before you go on a long trip or start a long-term, demanding project.
Write down any questions you have about your eyes, vision, or medications before you see your doctor. During your checkup, bring the list of questions, and write down your doctor's answers.
Your Lifestyle Counts
Try to keep your eyes clean and free of irritants.
Women might want to be careful about eye cosmetics, by using non-allergenic brands and by replacing them often.
Don't rub your eyes, even though some glaucoma medications might make them feel itchy or blurry.
If you have had eye surgery, it's a good idea to wear goggles when swimming and protective glasses when doing yard work or when playing contact sports.
Take care of the rest of your body. Keeping in good general health is just as important as taking care of your eyes.
Eating healthy foods, getting enough exercise, not smoking, not ingesting too much caffeine, and staying at a healthy weight are important.
Be sure to check with your doctor before you start any strenuous exercise program. Space out your fluid intake. This will help prevent fluid retention.
Lower your salt intake to prevent fluid retention.
Your Feelings Are Important:
Glaucoma has another side-the emotional and psychological aspects of having a chronic, sight-threatening health condition. When you are first diagnosed with glaucoma you may experience worry, fear, helplessness, depression, or lethargy.
Take the time to learn about the disease and you'll find that there are many steps you can take to help manage glaucoma.
Even if you lose some of your vision, you can work with low vision rehabilitation counselors to learn how to continue leading an active life.
As a glaucoma patient, you have the chance to teach your friends and relatives about this disease. Many people are unaware of the importance of eye checkups and do not know that individuals with glaucoma may have no symptoms. You can help protect their eye health by encouraging them to have their eye pressure and optic nerves checked regularly.
You can continue with what you were doing before glaucoma was diagnosed.
You can make new plans and start new ventures.
Take good care of yourself and your eyes, and get on with enjoying your life.
Share your feelings with loved ones so they can be supportive.
SUNGLASSES & GLAUCOMA:
Glaucoma can cause the eyes to be very sensitive to light and glare. Medications can worsen this problem. Sunglasses solve this problem and are important for prevention of cataracts. Protective sunglasses do not have to be expensive. But it is important to select sunglasses whose product labels state they block at least 99 percent of UVB rays and 95 percent of UVA rays.
Polarized and mirror-coated lenses do not offer any protection against UV radiation. It is not clear if blue light-blocking lenses, which are usually amber in color, provide UV protection.
An all fruit diet is suggested for post-operative 5 days. In this regimen, take two meals a day of fresh juicy fruits such as orange, apple, pineapple, pear, peach, grapes and papaya at five hourly intervals
Adopt a well-balanced diet, based on seeds, nuts and whole grains, vegetables and fruits, on the following lines:-
1. Upon arising from Hospital:
Black raisins soaked overnight in water along with the water in which they are soaked and water kept overnight in a copper vessel.
Fresh fruit, a glass of milk, sweetened with honey, and some seeds or nuts.
Freshly-prepared steamed vegetables, whole-wheat wheat tortilla and a glass of buttermilk.
A fresh fruit.
Raw vegetable salad and sprouts such as green gram beans, with lime juice dressing an cottage cheese or buttermilk.
6. Bedtime Snack:
A glass of fresh milk with few dates.
Alcohol and tobacco,
White flour and
Products made from refined foods,
Condiments and pickles.
Raw vitamin C-rich foods like citrus fruits,
Green leafy vegetables,
Indian gooseberry (Indian gooseberry),
Sprouted Bengal and green grams,
Vitamin B-complex, and
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1. Various methods of relaxing and strengthening the eyes.
2. Proper sleep and adequate rest.
3. Fresh air and outdoor exercises, especially brisk walks.
Researchers provided a seven-point set of guidelines for reducing risk. They are:
1. Consume abundant amounts of colorful fruit and vegetables.
2. Avoid high intake of salt in patients with hypertensive glaucoma.
3. Refrain from high-calorie diets (restricting fat) to avoid an increase in body fat.
4. Consider eating fish or nuts rich in omega-3 PFA, which appear to reduce risk.
5. Avoid drinking large amounts of liquid in a single take. It is preferable to drink small amounts in the course of the day.
6. Avoid coffee and caffeinated beverages into reduce increased blood pressure if you already have glaucoma.