What is Glaucoma?
Glaucoma is a disease which affects people in their late forties and older. Glaucoma can be defined as increased pressure inside the eye that damages the fibers of optic nerve culminating in visual fields defects. In other words, 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 the waste material. This fluid is produced from the ciliary body which is a structure 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 termed trabecular meshwork.
Types of Glaucoma
If trabecular meshwork gets 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 is no observable particles and the fault lies in the anatomy of the meshwork itself. We call this primary open angle glaucoma.
There is another type of glaucoma called narrow angle glaucoma. This occurs when the lens and the iris touch each other blocking the flow of fluid. The most common reason for this to happen is swelling of the lens from cataract.
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. Some exciting developments in glaucoma treatment are the newest surgical modalities like iStent and express shunt which we will discuss in our next article.
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