Symptoms, treatment of glaucoma





Glaucoma, a disease that affects people in their late 40s and older, is defined as increased pressure inside the eye that damages the fibers of optic nerves, culminating in visual field defects.

Glaucoma is a mismatch between production of fluid in the eye and drainage of the fluid. Theoretically, it can occur when there is increased production or decreased drainage of fluid. In reality it is usually an obstruction to the exit of fluid.

Physiology of the eye

The fluid inside the eye is necessary to supply nutrition to various parts of the eye: cornea, lens, and retina. This fluid also removes waste material. This fluid is produced from the ciliary body, between the colored part of the eye and the lens.

The fluid flows in front of the lens through the pupil to the front chamber of the eye. It leaves the eye through tiny channels, called trabecular meshwork.

Types of glaucoma

If trabecular meshwork becomes blocked it causes open angle glaucoma.

Sometimes we can see lens particles or iris pigment in the meshwork. This is called secondary open angle glaucoma, as it is secondary to another cause from which the offending particles arose. At other times there are no observable particles and the fault lies in the anatomy of the meshwork itself. We call this primary open angle glaucoma.

Another type of glaucoma is called narrow angle glaucoma. This occurs when the lens and the iris touch each other, blocking the flow of fluid. The most common cause is swelling of the lens from cataracts.

Treatment of glaucoma

The treatment of glaucoma depends on the cause of the disease. It is imperative to perform tests to find the exact cause.

The goal of treatment is to avoid optic nerve damage, which leads to visual field defects. Medical treatment relies on drops, which can decrease production of fluid or increase outflow. Laser treatment is another option.

New surgical modalities, like iStent and Ex-Press shunt, are exciting developments and will be discuss in the next article.

Khanna’s office is in Thousand Oaks. His book, “The Miracle of Pi in Eye,” is available on Amazon.



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