healthy eye is nourished and protected
by fluid, which, just like your blood, has
pressure. Glaucoma is a condition that results in damage to the
nerve, which carries images from the eye to the brain when the eye pressure
rises to a dangerous level. This damage can reduce
your vision and even cause
Glaucoma can occur in one to four main forms .
Acute glaucoma - called acute closed angle glaucoma develops
rapidly usually with no warning. Normally a clear fluid called the aqueous humor
circulates in and out of the front of your eyeball delivering nutrients and
washing away wastes. If the area of the eye through which the fluid normally
drains becomes blocked the fluid builds up inside the eye. This buildup of
fluid increase pressure inside the eye potentially causing irreversible damage
to the optic nerve. If the optic nerve is damaged the ability to transmit
images to the brain is reduced potentially leading to blindness .
Chronic glaucoma - called chronic open angle glaucoma is the
most common form of the disease. Chronic glaucoma develops gradually over a
period of several years form the pressure of excess fluid inside the eyeball.
- which is present at birth, is
the result of defective development of the fluid outflow channels of the eye.
Surgery is required for correction. Congenital glaucoma is often hereditary.
Secondary glaucoma -is caused by other diseases, including eye
diseases such as uveitis (inflammation of the the
uvea, the layer between the
sclera and the
retina, which includes the iris, ciliary body, and the choroid.),
systemic diseases, and drugs such as corticosteroids.
Glaucoma is the third most common cause of blindness in the
U.S. Chronic glaucoma develops gradually as you age .Unless you have a regular
eye examination that includes a test for glaucoma you may not realize you have a
problems until the disease has caused considerable injury and your sight is
affected. Damage caused by glaucoma is irreversible but if the condition is
detected early and treated the harmful buildup of pressure inside the eye can be
prevented. For this reasons your eyes should be tested for glaucoma
every year after age 40. You are more likely to develop
chronic glaucoma if you are over 40, black,
have a family history of glaucoma are a nearsighted or have diabetes.
Free radical damage from ultraviolet
Decreased blood supply to the eye (caused
by low blood pressure, vasoconstriction, or hardening of the arteries)
Elevated eye pressure, and
Toxic influences on the optic nerve
(caused by various drugs, alcohol, artificial sweeteners, MSG, tobacco
Chronic use of steroid eye drops and skin creams.
No conclusive studies prove a connection
between specific foods and glaucoma, but it is reasonable to assume that
what you eat and drink and your general health have an effect on the
Elevated Intra Ocular Pressure
or the increased
pressure drainage of
aqueous from the
anterior chamber into the trabecular meshwork. Increased
pressure occurs when the fluid within the eye (called aqueous humor) does not
drain properly. The pressure pushes on the junction of the optic nerve and the
at the back of the eye. This reduces the blood supply to the optic nerve,
which carries visual information from the eye to the brain. Loss of blood
supply causes the individual nerve cells to progressively die. As the optic
nerve deteriorates, blind spots develop in the field of vision. The average IOP ranges between 14 and 20 millimeters of mercury (mmHg). A pressure of 22
is considered to be suspicious and possibly abnormal.
Insufficient blood supply
to the optic nerve head
and adjacent retina. This is presently believed to be a major risk factor for
glaucomatous damage. However, other
abnormalities, such as increased
erythrocyte agglutinability, decreased
erythrocyte deformability, increased serum viscosity, or increased platelet agreeability
may also play a role.
Low blood pressure, abnormally low intracranial
pressure, autoimmune phenomena, sleep apnea, sleeping with the pillow or one's
knuckles pressed against the eye, an abnormally hard or soft lamina
cribrosa, inherited or acquired abnormalities of the
connective tissue of the lamina cribrosa, primary ganglion cell degeneration,
and other as yet unconsidered possibilities.
WARNING SIGNS OF ACUTE GLAUCOMA
Chronic glaucoma develops very slowly. Most people have no
symptoms until the disorders has damaged the optic nerve and impaired their
visions. Chronic glaucoma is usually detected during a regular eye examination
by an ophthalmologist.
By contrast acute glaucoma occurs suddenly and requires
immediate medical attention to reduce the buildup of pressure inside the eye.
Acute glaucoma may cause symptoms such as blurred visions, severe eye pain, a
headache, rainbow halos around the cornea, nausea or vomiting.
Unlike chronic glaucoma which usually causes no
symptoms until your visions is impaired acute glaucoma occurs suddenly.
Acute glaucoma requires emergency medical treatment to save your vision. If
any of the following symptoms occur suddenly call your doctor or go to the
nearest emergency room
Severe eye pain
Rainbow halos around lights
Nausea and vomiting
Your ophthalmologist can examine yours eyes and perform
tests to determine if you have glaucoma or are at risk of developing it. He or
she will measure the pressure inside your eye examine the
drainage angel for signs of blockage and
examine yours optic nerves for signs of damage. Yours doctor may also
evaluate the completeness of your visions in each to see if the disease has
affected your sight.
The test for measuring the pressure inside your eyes
called tonometry is quick safe and
painless. Your ophthalmologist will put a
drop to numb it before putting in each eye. Then he or she will place an
instrument called a tonometer against your
cornea. During this test which takes a few seconds for
each eye you will see a small circle of bright blue light coming closer to your
Your ophthalmologist will also look into your eye through
the cornea to evaluate the depth of the front of your eyeball. A shallow or
narrow drainage angel suggests that the drainage of fluid from the eye may
eventually that can lead to acute closed angel glaucoma.
Confrontation visual field exam may
also be conducted which is a quick and basic evaluation of the visual field done
by an examiner sitting directly in front of you. With one eye covered, you are
asked to look at the examiner's eye and tell when you can see the examiners
To evaluate the health of the optic nerve the doctor may
use a hand held viewing instrument called an ophthalmoscope which has a very
bright light to look through your
pupil. The optic nerve located in the back of your eye transits images from the
eye to your brain. Glaucoma can cause irreversible damage to this nerve which
can lead to blindness.
Your doctor may want to test the
visual field of each eye to determine if your sight has been affected by
glaucoma. To do this he or she will move an object such as a pencil into your
view form the side while your look straight ahead. If you cannot see the object
until it is almost directly in front of your peripheral vision may have been
impaired by glaucoma.
If your doctor suspects your have glaucoma he or she is
likely to recommend additional tests including gonioscopy to
examine the drainage angle of your eye. This lens has mirrors and facets that
enable the doctor to view the drainage angle and look for any changes or signs
of blockage. Your eye will first be numbed with anesthetic drops to reduce any
discomfort during the procedure.
Your doctor may also use a special camera to take
photographs of each optic nerve. These pictures are used
to document and monitor any changes in or damage to the nerves.
The whole purpose of
treatment for glaucoma is to prevent further loss of vision. Once the nerve
cells have been damaged and the vision carried by those nerve cells lost, they
cannot be replaced.
LOSS OF VISION IN GLAUCOMA IS IRREVERSIBLE.
Lowering the intraocular pressure (IOP) will not restore lost vision, but is an
attempt to prevent further vision from being lost.
The only treatment which has so far been proven to be
effective remains lowering IOP. This again requires chronic use of
medications. Administration of
anti-glaucoma drops and its spacing should be followed under the strict
guidance of an ophthalmologist.
Some patients might experience side effects, such as
redness and allergy.
Alternative treatments options
Finding and eliminating allergies,
The B-vitamins, antioxidant vitamins,
co-enzyme-Q-10, magnesium (nature's own calcium channel blocker) at
least 1,500 micrograms of vitamin-B-12 a day,
flax seed and
oils, and quercitin for allergy.
If your have glaucoma your doctor will first prescribe
medication in the from of
eye drops. This medication decrease pressure inside
the eye either by slowing the amount of fluid produced in the eye or by
improving the flow of fluid out of the eye . You must take the eye drops
regularly usually several times a day for the rest of your life to prevent
damage from glaucoma and to preserve your visions . Xalatan (latanaprost),
Alphagan (brimonidine) and Trusopt (dorzolamide) are examples of these new
drugs. Do not stop taking the drops
because the medication is effective in preventing glaucoma only for as long as
you use it. Tell your doctor if you experience and side effects from the eye
drops which may include a stinging sensation in your eyes redness in your eyes
blurred visions or irregular heartbeat. In some cases the does of medication can be
adjusted to reduce these side affects.
Medications taken in form of pills can also reduce pressure inside
the eye. However because this medications may have more serious side affects
than the eye drops it is used only if eye drops have not been effective. Side
effects of the pills may include tingling of your fingers and toes, drowsiness,
loss of appetite, constipation, kidney stones, or reduced ability of your blood to
clot. If you experience any of these side effects call your ophthalmologist
immediately. He or she may be able to adjust the doses or prescribe a different
If you have acute closed angle glaucoma or you are at risk
of developing it treatment is likely to include a surgical procedure called an
Iridotomy which is usually performed using
laser beams which creates a tiny drainage hole in the iris. The procedure is
painless takes only a few minutes and is done in the doctors or an outpatient
Step-1 A thick contact lens is held in front of the eye, and a laser beam
is focused through it into the bulging iris. The Laser then cuts a small
hole right through the iris.
Step-2 Fluid trapped behind the iris flows
through the hole. The iris returns to its normal shape, and the drainage
angle opens, allowing the eye to drain normally.
If you have chronic prone angle glaucoma that cannot be
controlled with eye drops or pills your doctor may recommended laser surgery to
create a better flow of fluid through the drainage angle. This relives the
dangerous pressure inside the eye. The procedure which is painless takes a few
minutes an is done in the doctor’s office or in an outpatient facility . In some
cases traditional surgery in a hospital operating room may be necessary to
create an opening in the front of the eye to allow excess fluid to drain out.
The procedure which is done using general or local anesthesia takes about I to 1
˝ hours. Complications may include pressure inside the eye that is too high or
too low or bleeding. In some cases the procedure is not effective and must be
In a recent study, it was observed that people
with glaucoma who exercised regularly for three months reduced their IOPs an
average of 20%. These people rode stationary bikes 4 times per week for 40
minutes. Measurable improvements in eye pressure and physical conditioning
were seen at the end of three months. These beneficial effects were maintained
by continuing to exercise at least three times per week; lowered IOP was lost
if exercise was stopped for more than two weeks. Regular
exercise may be a
useful addition to the prevention of visual loss from glaucoma, but only your
eye doctor can assess the effects of exercise on your eye pressure.
Some of the vitamins and minerals important to
the eye include zinc and copper, antioxidant
A (as beta
carotene), and selenium, an antioxidant mineral. While no disease in humans
has been proven to arise as a result of vitamin E deficiency, vitamin E added
to regular glaucoma medication improved visual fields in a majority of
patients studied. Vitamin E has also shown promise in the treatment of
Using eye drops for glaucoma
Because the surface of your eye can hold only a limited
amount of fluid when you use eye drops any excess liquid will run out of
your eye . This extra fluid also pools in the corner of your eye and a small
amount may even drains into your nose where it can enter your bloodstream
and possibly cause side effects . In additional these medications can be
expensive so you should not want to waste any.
Here are some tips for taking your eye drops
Ask your doctor for drops that come in a metered dose
dispenser which carefully controls the amount of medications in each drop
Take your drops while lying down or tilting your head
Look up and pull your lower lid away from your eye to
from a small pouch to catch the drop
After putting the drop in close your eye and gently
press your finger against the inner corner of the eyelid the medication from
drawing out to the nasal passage
Wait for 5 minutes between drops if your doctor has
prescribed more than one drop for each eye .
glaucoma results in severe and permanent vision loss after the onset of
symptoms. Vision can be preserved with prompt treatment. With proper care,
regular eye exams, eye drops and appropriate treatment, there’s tremendous hope
for maintaining your vision for a lifetime.