Glaucoma is the leading cause of blindness, and can affect patients of all ages, many of whom do not experience any symptoms and may not be aware that they have the disease. Glaucoma actually refers to a group of diseases that cause damage to the optic nerve as a result of increased pressure within the eye, but can also be caused by a severe eye infection, injury, blocked blood vessels or inflammatory conditions of the eye.
Causes
- Fluid drains out of your eye through a system of canals. These canals live in a mesh of tissue between your iris (the colored part of your eye) and your cornea (the clear outer layer).
- When your iris and cornea move closer together, it “closes the angle” between them. When this happens suddenly, it’s called an acute attack and is very painful.
- Acute angle-closure glaucoma completely blocks your canals. It stops fluid from flowing through them, kind of like a piece of paper sliding over a sink drain. The pressure that builds up can damage your optic nerve. If you don’t treat the problem quickly enough, you could lose your sight completely.
- You might have an attack of angle-closure glaucoma if you have narrow drainage systems and your eyes dilate (your pupil gets bigger) too much or too quickly.
Treatment
The damage caused by glaucoma can’t be reversed. But treatment and regular checkups can help slow or prevent vision loss, especially if you catch the disease in its early stages.
Glaucoma is treated by lowering your eye pressure (intraocular pressure). Depending on your situation, your options may include prescription eye drops, oral medications, laser treatment, surgery, or a combination of any of these.
Surgery and other therapies
Other treatment options include laser therapy and various surgical procedures. The following techniques are intended to improve the drainage of fluid within the eye, thereby lowering pressure:
- Laser therapy. Laser trabeculoplasty is an option if you have open-angle glaucoma. It’s done in your doctor’s office. Your doctor uses a small laser beam to open clogged channels in the trabecular meshwork. It may take a few weeks before the full effect of this procedure becomes apparent.
- Filtering surgery. With a surgical procedure called a trabeculectomy, your surgeon creates an opening in the white of the eye (sclera) and removes part of the trabecular meshwork.
- Drainage tubes. In this procedure, your eye surgeon inserts a small tube shunt in your eye to drain away excess fluid to lower your eye pressure.
- Minimally invasive glaucoma surgery (MIGS). Your doctor may suggest a MIGS procedure to lower your eye pressure. These procedures generally require less immediate postoperative care and have less risk than trabeculectomy or installing a drainage device. They are often combined with cataract surgery. There are a number of MIGS techniques available, and your doctor will discuss which procedure may be right for you.
After your procedure, you’ll need to see your doctor for follow-up exams. And you may eventually need to undergo additional procedures if your eye pressure begins to rise or other changes occur in your eye.
Treating acute angle-closure glaucoma
Acute angle-closure glaucoma is a medical emergency. If you’re diagnosed with this condition, you’ll need urgent treatment to reduce the pressure in your eye. This generally will require both medication and laser or other surgical procedures.
You may have a procedure called a laser peripheral iridotomy in which the doctor creates a small opening in your iris using a laser. This allows fluid (aqueous humor) to flow through it, relieving eye pressure.
