Don’t be Blinded by Glaucoma (A peril that should not be overlooked)
Don’t be Blinded by Glaucoma (A peril that should not be overlooked)
Glaucoma is a disease that occurs when the optic nerve fibers are damaged due to high pressure inside the eye. This pressure is caused by an increase in the production of aqueous humor (a clear fluid) and a decrease in its drainage. The normal range for intraocular pressure is between 5-21 mmHg. If the pressure is found to be higher than 21 mmHg, it is considered a risk factor for glaucoma.
At the beginning stages, peripheral vision is affected first, and the patient may start to bump into objects on the side without noticing any abnormality because central vision remains intact. However, as the disease progresses, the visual field gradually narrows, and central vision decreases. It is at this point that patients seek medical attention, which is the late stage of the disease.
What is frightening about glaucoma is that once vision is lost, it cannot be restored to its former state, resulting in permanent blindness. Therefore, treatment aims to prevent further loss of vision and to preserve the remaining visual field.
Types of Glaucoma:
There are several types of glaucoma, with the two main types being open-angle glaucoma and angle-closure glaucoma.
Open-Angle Glaucoma:
This refers to the angle between the cornea and iris of the patient's eye being normal, but the pathway through which aqueous humor flows out of the eye is not functioning properly, leading to a buildup of fluid inside the eye and an increase in intraocular pressure.
Angle-Closure Glaucoma:
This refers to the angle between the cornea and iris of the patient's eye being abnormal, which can cause the iris to block the flow of aqueous humor, leading to an increase in intraocular pressure.
Symptoms of the Disease:
• In the early stages of the disease, most patients do not experience any abnormal symptoms.
• If there is dizziness or decreased vision, it indicates that the disease is in a severe stage.
• Patients with vertigo often do not have eye pain, except for sudden-onset acute closed-angle glaucoma with sudden high intraocular pressure.
Diagnosis of the Disease:
An ophthalmologist is necessary to diagnose vertigo and relies on eye examination and vision testing, including:
• Ophthalmologic examination by an ophthalmologist
• Testing with special equipment, such as scanning of the optic nerve head
• Examination of the eyes with a slit-lamp microscope
• Examination of the visual field
• Examination of the characteristics of the optic nerve head
• Measurement of intraocular pressure
Who is at Risk?
If you have one or more of the following risk factors, you should consult an ophthalmologist:
• Over 40 years of age
• African Americans are up to 6-8 times more likely to have vertigo than Caucasians, while Asians are more at risk for closed-angle vertigo.
• Family history of vertigo
• Long or short-sightedness, thin cornea
• A history of eye trauma
• Continuous use of steroid medications
• History of abnormal blood circulation, such as migraines, diabetes, high blood pressure, anemia, or shock
• High eye pressure detected during an eye exam
• Use of steroid medications
Individuals at risk should receive regular eye exams and avoid purchasing medication with steroid ingredients to use on their own. When experiencing abnormal eye symptoms, seek medical attention promptly.
The Treatment and Prevention of Blindness Due to Glaucoma
Since glaucoma can cause permanent damage to the optic nerve, treatment is necessary to prevent further damage and maintain vision for as long as possible. The type and duration of treatment will depend on the severity and type of glaucoma.
If you have glaucoma, it is important to control your eye pressure and stop the destruction of the optic nerve. Eye pressure can be controlled through:
- Eye drops - this is the most basic and effective method. These drops work by reducing the production of fluid in the eye or by improving the drainage of fluid from the eye. This lowers eye pressure to a safe level and prevents damage to the optic nerve. It is important to use the drops regularly as prescribed by your doctor and to have regular follow-up appointments to assess the effectiveness of the treatment and any side effects.
- Laser treatment - this may be used in certain cases, often in combination with eye drops. The type of laser used will depend on the type and severity of the glaucoma.
• Selective laser trabeculoplasty (SLT) is used to treat open-angle glaucoma when eye drops are not effective or cannot be used, such as in pregnant patients or those allergic to eye drops. It is often used in conjunction with other treatments.
• Laser peripheral iridotomy (LPI) is used to treat angle-closure glaucoma.
• Laser cyclophotocoagulation is used when other treatments have not been effective. It destroys cells responsible for fluid production in the eye, reducing the amount of fluid in the eye.
Surgery is used to treat patients whose eye pressure cannot be controlled by medication or laser treatment.
• Trabeculectomy is a surgical procedure that creates a drainage pathway for the eye to allow excess fluid to flow out, resulting in decreased eye pressure.
• Aqueous shunt surgery is performed if the first surgical method is not successful, and involves inserting a device to drain fluid and reduce eye pressure.
Important things to know:
The use of eye drops does not improve vision or the feeling of treatment, but helps prevent vision from deteriorating.
Consistent and regular use of eye drops is important.
Follow-up appointments with a doctor to evaluate the treatment results are necessary.
Emergency case!!
Sudden dizziness can occur. If you experience the following symptoms, go to the hospital immediately.
• Sudden loss of vision in one eye
• Blurred vision or seeing spots
• Seeing flashes of light or rainbow-colored circles around lights
• Eye pain or headache on one side
• Nausea or vomiting.
The initial signs of glaucoma typically does not cause noticeable symptoms in most patients, especially those with chronic open-angle glaucoma, which accounts for 70-80% of cases. Patients in this group experience gradually increasing eye pressure, which can lead to a gradual tolerance of the rising pressure and a lack of severe pain. However, patients may gradually experience blurred vision starting from the sides of their visual field, causing a narrowing of their field of vision until the central area is affected, at which point they may become aware of a decrease in their visual acuity. Seeking medical attention at this stage is considered the late stage of the disease.
Therefore, chronic open-angle glaucoma does not typically present symptoms in the early stages of the disease, unless it is acute angle-closure glaucoma, which may cause severe eye pain. Therefore, regular screening should be conducted every year, particularly for high-risk patients or those over 40 years of age, to prevent vision loss. Patients should not self-medicate and instead receive medication under the supervision of a physician to maintain existing vision and prevent further deterioration. Therefore, detecting glaucoma in its early stages is crucial for effective treatment and the prevention of blindness.
