What are the symptoms of glaucoma? How to recognize it?
Often, glaucoma does not cause any symptoms in the early stages . It sneaks in like a stealthy enemy. That is why many people in Sri Lanka do not even know they have glaucoma. Sometimes, symptoms only start to appear after irreversible damage has been done to the eye.Commonly seen symptoms:
These are some of the more common symptoms:- Feeling pain or pressure in the eyes
- Headache
- Redness or bloodshot eyes
- Seeing one image as two, a condition called ``diplopia``
- Blurred vision
- Gradually weakening of eyesight
- Gradual development of dark spots in the vision (scotomas) or a narrowing of the field of vision, as if looking through a tube (tunnel vision). Imagine that when you read a newspaper, the letters on one side seem to be blurred, or when you walk on the street, you feel that both sides are not clear.
Symptoms that require urgent attention!
Some types of glaucoma, especially angle-closure glaucoma, can cause sudden, severe symptoms.In such cases, immediate medical attention is required, or permanent vision loss may occur. These are the symptoms of this emergency:- A collection of blood in front of your black eye (hyphema)
- Bulging or enlarged eyes (buphthalmos) (this affects young children more)
- Nausea and vomiting with eye pain /pressure
- When you look at the lights, you see rainbow-colored rings around them. Just like when you drive at night, you see colored circles around the street lights.
- Sudden or increasing occurrence of floaters (myodesopsias) (small black dots, floaters, etc.) before the eyes
- Sudden loss of vision by any means
- Sudden flashes of light before the eyes ( photopsias )
Why does glaucoma develop? What is the cause?
The main cause of glaucoma is damage to the optic nerve inside your eye . This is like the cable that carries what we see to the brain. It can happen for no apparent reason, but there are many factors that contribute to this condition. One of the most important of these risk factors is the pressure inside the eye (intraocular eye pressure) . Think of it this way, a fluid called aqueous humor is constantly produced inside our eyes to nourish the eye. This fluid flows through the black eye into the front of the eye. In a healthy eye, this fluid drains out of the eye through a network of drainage systems called the trabecular meshwork, which is where the white eye meets the colored eye (the colored part around the black eye). It's like a water tank with a pipe attached to it to drain water. In glaucoma, the drainage system becomes blocked or becomes resistant to the flow of fluid. This fluid has nowhere to go and builds up inside the eye. This excess fluid builds up, causing pressure inside the eye to increase. Eventually, this increased pressure can damage your optic nerve, leading to glaucoma. The cause of this fluid buildup inside the eye can vary depending on the type of glaucoma you have.Are there types of glaucoma?
Yes, there are different types of glaucoma, but they can be broadly divided into several categories:- Primary open-angle glaucoma: An open-angle glaucoma is a condition in which the drainage channels, which are the places where the white of the eye meets the outer edge of the colored part of the eye, are open. Aqueous humor flows into these channels and drains from the anterior chamber of the eye. This is the most common type of glaucoma.What happens is that the drains gradually become clogged, like a sink drain gradually filling with dirt. This happens so slowly that there may be no symptoms at first.
- Primary angle-closure glaucoma: Normally, aqueous humor should flow from the posterior chamber of the eye, through the sclera, to the anterior chamber. But sometimes, the lens of your eye bulges too far forward, blocking the flow of fluid through the sclera. The excess fluid in the posterior chamber can push the sclera forward, narrowing or completely closing the angle through which the fluid drains. This can often be a sudden, sudden condition. The eye may become red and painful.
- Secondary glaucoma: This occurs when pressure in the eye increases due to another condition or event. For example, it can be caused by eye injuries (think of a cricket ball hitting the eye), pigmentary dispersion syndrome (small pieces of pigment in the eye that break off and block the drainage canal), uveitis (inflammation of the inside of the eye), certain medications (especially corticosteroids and cycloplegics), and eye surgery.
- Congenital glaucoma: This is glaucoma that develops during the fetal period, that is, when the baby is in the womb. For example, conditions such as aniridia (the iris of the eye does not form properly), Axenfeld-Rieger syndrome, Marfan syndrome, congenital rubella syndrome, and neurofibromatosis type 1 can cause this. This is a condition that is present at birth, and if the baby's eyes are large, watery, or sensitive to light, you should seek medical advice immediately.
What are the risk factors for developing glaucoma?
There are several risk factors that can affect the development of glaucoma. Let's take a look at what they are:- Age: Most types of glaucoma affect people over the age of 40. (Congenital glaucoma is the main exception to this.) Experts estimate that about 10% of people over the age of 75 have glaucoma. This means that it is important to take care of it as you get older.
- Race/Ancestry: People of African descent, especially those of Afro-Caribbean descent, are at a much higher risk of developing primary open-angle glaucoma. People of Asian (including us) and Inuit descent are also at a higher risk of developing angle-closure glaucoma.
- Gender:Women are at higher risk of developing angle-closure glaucoma. Experts believe this is largely due to gender differences in the structure of the eye.
- Refractive errors: People who are nearsighted, or myopia, are at higher risk of developing open-angle glaucoma. Similarly, people who are nearsighted, or hyperopia, are at higher risk of developing angle-closure glaucoma.
- Family history: If someone in your family, especially your mother, father, child, or sibling, has had glaucoma, you are at a higher risk of developing it. This is similar to how diseases like diabetes and high blood pressure tend to run in our families. Some conditions that cause secondary glaucoma are also genetic.
- Chronic diseases: Research has found that people with certain chronic diseases, such as high blood pressure and diabetes, are at a higher risk of developing glaucoma. So if you have these diseases, it's good for your eyes to control them well.
What are the possible complications of glaucoma?
Imagine what would happen if you didn't get treatment to control the pressure inside your eye. If that happens, glaucoma can damage your retina and optic nerve, eventually causing them to stop working. This is what causes the main complication of glaucoma, which is vision loss and eventually complete blindness. The end result is what experts call absolute glaucoma. This means that the affected eye becomes completely blind. It can also feel hard, like a rock, when you touch it, and may even be painful.How is glaucoma diagnosed?
An ophthalmologist can diagnose glaucoma with an eye exam. In fact, these eye exams can detect glaucoma before you have any symptoms or damage to your eyes. During these exams, your pupil is dilated (mydriasis), which allows the doctor to see inside your eye. Here are some of the main tests that can help diagnose glaucoma:- Visual acuity testing - testing how well you can see (by asking you to read a line of letters).
- Visual field testing - Checking the range of your vision and whether you can see both sides.
- Depth perception testing
- Tonometry - The measurement of pressure inside the eye. This is done by using a device that blows air into the eye or by touching the eye.
- Pachymetry - Measurement of the thickness of the cornea, the transparent part at the front of the eye.
- Slit lamp exam - A magnified examination of various parts of the eye using a special microscope.
- Gonioscopy - A special lens is placed on the eye to examine the angle through which the fluid drains.
- `Optical coherence tomography (OCT)` - This scans the delicate layers inside the eye, especially the thickness of the fibers of the optic nerve.
- Fluorescein angiography - a test to look at the blood vessels in the eye.
- Ultrasound examination `(Ultrasound)`
- Rarely, a computed tomography (CT) scan or magnetic resonance imaging (MRI) scan is done.
What are the treatments for glaucoma?
The main goal of glaucoma treatment is to reduce the pressure inside the eye (intraocular pressure) and stop the disease from getting worse . There are several main treatments that can help with this:- Medications: These are mainly medications that lower the pressure inside your eye. If your eye pressure is higher than normal (a condition called `ocular hypertension`), these medications can help prevent glaucoma from developing or prevent damage from causing symptoms. These can come as eye drops or pills. It is important to take these medications exactly as your doctor tells you to.
- Glaucoma surgeries: These surgeries are designed to help the aqueous humor drain more easily and reduce pressure inside the eye. These surgeries include trabeculectomy (creating a new path for the fluid to drain), tube shunts (inserting a small tube into the eye to drain the fluid), laser therapy (using a laser to open up the drainage system), and minimally invasive glaucoma surgeries (MIGS).
What is the outlook for glaucoma?
In fact, if left untreated, glaucoma can lead to permanent vision loss and blindness. But with treatment, the disease can be controlled or even stopped from getting worse . But since this can vary from person to person, the best person to talk to about this is your eye doctor. He or she can tell you what the outlook is for your specific condition and what you can do to turn it around.Can glaucoma be prevented?
Unfortunately, glaucoma cannot be completely prevented. ButEarly diagnosis and treatment can help control intraocular pressure and prevent or delay vision loss. There are several key things you can do to help:- Get regular eye exams: You can detect high pressure inside your eyes before glaucoma symptoms appear. Early detection can help you and your eye doctor prevent glaucoma from getting worse, or at least slow it down. It’s a good idea to have your eyes checked at least once a year after age 40, especially if you have a family history of glaucoma.
- Controlling ocular hypertension: If the pressure inside your eyes is higher than normal, your eye doctor will suggest treatment options. It is very important to follow their advice. This can help you prevent or at least delay vision loss.
- Know and control your risk factors: You can try to control or prevent certain conditions, such as high blood pressure and diabetes. Also, using things like safety glasses can help prevent eye injuries.
If I have glaucoma, what can I do to help myself?
If you have glaucoma, the best thing you can do is follow your eye doctor's instructions for treating and managing the condition . He or she may also recommend some changes to your lifestyle and habits. These may include:- Do not ignore new symptoms or changes in vision.
- Maintaining a healthy weight for you.
- Staying physically active (but ask your doctor about exercises you should avoid, as some exercises, such as yoga with your head down, can increase eye pressure).
- Going to see him as the doctor recommends.
When should I seek medical advice?
Some types of glaucoma, such as angle-closure glaucoma, can develop very quickly. So immediate medical attention is needed to prevent permanent damage and vision loss. If you have any of these symptoms, whether they start suddenly or get worse, get them checked out right away:- Severe eye pain or pressure
- Headache
- Seeing two images at once (diplopia) or blurred vision
- Nausea and vomiting with eye pain/pressure
- Seeing rainbow-colored rings around lights
- Sudden loss of vision by any means
- Flashes of light begin to appear before the eyes.
- Sudden onset or increase in the appearance of floating objects in front of the eyes (myodesopsias)
What questions should I ask my ophthalmologist?
It's a good idea to ask your eye specialist questions like these:- What type of glaucoma do I have?
- What is the cause of my glaucoma?
- What treatment options do I have, and what do you recommend?
- What are the possible side effects or complications of the treatment(s)?
- What are the symptoms or changes that I should call your office for or seek medical advice?
Don't be afraid to ask these questions. The better you understand your condition, the more likely you are to support treatment and protect your vision.For many of us, our eyesight is truly an essential, perhaps even the most important, sense in life. So it's natural to be afraid and anxious about losing your sight due to a condition like glaucoma. But the good news is that glaucoma is a condition that can be detected and treated early. The sooner you detect the disease and start treatment, the better your chances of stopping it from getting worse. While it can't be stopped completely, it can often delay the onset of serious effects for years, even decades.
The most important things we need to remember from this article (Take-Home Message)
Okay, so here are some things to keep in mind from what we've talked about about glaucoma:- Glaucoma can be a silent disease: it may not cause any symptoms in the early stages. That's why regular eye exams are so important, especially if you have risk factors.
- Early detection is the best protection: If detected early, treatment can largely prevent further vision loss.
- Be aware of risk factors: If you have a family history of the condition, are over 40 years old, or have conditions like diabetes or hypertension, you need to be a little more careful.
- Follow your doctor's instructions exactly: If you are diagnosed with glaucoma, it is essential to follow the medication and instructions given by your doctor exactly.
- Don't ignore emergency symptoms: If you experience sudden eye pain, blurred vision, or seeing rings around lights, see a doctor immediately.
Remember, your eyes are very precious to you. Therefore, it is your responsibility to take care of them. Don't be afraid, if you are aware and take the necessary steps, you can live well even with glaucoma.
` Glaucoma, eye pressure, eye disease, vision loss, blindness, optic nerve, eye exam
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