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Glaucoma: Severe condition not to be overlooked

This disease is caused by the degeneration of the optic nerve, which serves as the primary connection between the eye and the brain. When the optic nerve degenerates, the eyesight gradually dims, and the patient may eventually go blind. Glaucoma is primarily caused by intraocular pressure that is higher than the normal range. Normally, people have intraocular pressure that does not exceed 21 mm Hg. However, glaucoma patients will experience higher-than-normal intraocular pressure, which puts pressure on the optic nerve and causes its gradual deterioration and eventual blindness.

Certain individuals are at a higher risk of developing glaucoma. These risk groups include those with a family history of glaucoma or direct relatives who have been diagnosed with the condition. Such individuals have a nine-fold increased risk compared to the general population. Additionally, individuals with vascular diseases like diabetes, high blood pressure, hyperlipidemia, or migraine are also more susceptible to glaucoma. Furthermore, people with nearsightedness or farsightedness that exceeds the normal range are at a higher risk. Those who have previously experienced an eye injury resulting in lens displacement or abnormal eye anatomy are also more prone to glaucoma. Patients who regularly use specific medications, including steroids in the form of eye drops, oral medications, or inhalers, have an elevated risk as well.

In the early stages of glaucoma, most patients do not experience noticeable symptoms. This is because around 70-80% of glaucoma cases are chronic glaucoma, characterized by a gradual increase in intraocular pressure. Patients adapt to this gradual pressure rise, and as a result, they do not typically experience severe pain. However, they may gradually notice a dimming of their vision, starting from the periphery. This leads to a progressive narrowing of the visual field, eventually causing blurred vision in the central area. It is often at this point that patients realize their vision has deteriorated and seek medical attention, marking the advanced stage of the disease.

Chronic open-angle glaucoma typically does not exhibit symptoms during its early stages, unlike acute angle-closure glaucoma, which is characterized by severe eye pain. Therefore, it is crucial to undergo annual screenings, even in the absence of symptoms, especially for individuals at high risk or those in the elderly age group (over 40 years old). It is essential not to self-medicate with eye drops and instead use medication under the supervision of a physician. The goal is to maintain the current level of vision and prevent further deterioration. Detecting glaucoma in its early stages is of utmost importance to ensure effective treatment and minimize the risk of blindness.

By Dr. Ruthairat Winitchai

Ophthalmologist, Glaucoma Branch