Glaucoma Treatment Options

Glaucoma is an eye disorder which can lead to blindness in severe cases. In fact, it is one of the top causes of blindness in the US. Let's understand what causes the disease first. When we see something, an image is formed on the eye retina, the optic nerve transfers these images in the form of visual signals to the brain, and thus we understand what we are seeing. When this very important optic nerve and retina get damaged due to intra ocular pressure, the resulting condition is called glaucoma. The pressure is generally exerted by the liquid fluids within the eye called aqueous humor and vitreous humor. Both these fluids, when not regulated, put pressure on the walls of the eye and other structures, eventually damaging the optic nerve and causing glaucoma.

Types

Glaucoma is categorized into two main types - open angle and closed angle. Open angle is the most commonly occurring type and is generally seen in patients with myopic vision and diabetes history. It occurs when the aqueous humor fluid pressure in the anterior part of the eye is increased due to blockage. This blockage increases with time and so does the damage to the optic nerve. Open angle type is also called chronic glaucoma, as it can occur when some family member of the patient has had a history of this disease. Closed angle or acute glaucoma is a more serious kind, which occurs without any prior noticeable symptoms. It occurs when the exit of aqueous humor fluid from the eye is blocked suddenly. This condition requires sudden medical attention. The other two kinds of this disease are - congenital and secondary. Congenital, as the name suggests, is there in the patient since birth, and the main cause behind it is abnormal development of the fluid outflow channels in the eye. Secondary glaucoma is caused due to secondary causes like overuse of certain drugs, accidents or some kind of trauma, and other eye diseases.

Symptoms

The symptoms differ slightly for the two main types. Open angle glaucoma is rightly referred as the 'silent thief of vision', as it steals the vision silently without showing any major symptoms. The symptoms include gradual loss of peripheral vision. The symptoms of closed angle glaucoma include:

• Severe and sudden eye pain
• Feeling of giddiness, nausea and vomiting
• Problem seeing in dim light
• Vague and unclear vision
• Eye turns red
• Swollen eyes
• Halos around lights

Symptoms of congenital and closed angle glaucoma are the same.

Treatment

There are three main treatment options; the use of eye drops, laser treatment and surgery. The treatment depends on the type and level of severity, and the procedure generally followed is medication in the form of eye drops, laser treatment or surgery. For open angle or chronic glaucoma, the following treatment mechanisms are used.

As the cause of for this eye disease is increased pressure due high volume of fluid, the treatment strategy generally aims to reduce the amount of aqueous fluid or increase the outflow of this fluid. The use of eye drops may result in certain side effects which would go with time. Laser treatment is used if the pain and other symptoms don't go with time. Various eye drops for treating this disease include:

• Prostaglandin analog eye drops, which promote the outflow of the fluid out of the eye, thus reducing the intra ocular pressure. The various variants of prostaglandin are latonoprost and travoprost. The patient may experience some minor symptoms on administration of these eye drops like dry eyes, eye pain, headache and irritation
• Beta blockers, they inhibit the production of aqueous fluid in the eye, thus lowering the pressure on the eye walls. Beta blockers can cause harm to patients of asthma and heart fluid, so it is better to consult doctor before using beta blocker eye drops.
• Carbonic anhydrase inhibitors, they limit the production of aqueous humor fluid in the eye, and the administration sometimes causes nausea, eye irritation and a drying of mouth.
• Sympathomimetics, these drugs help in both, reducing the amount of fluid in the eye and also encourage in the outflow of fluid from the eye.

Laser treatments serve a better option, as they are painless and fast. There are various laser treatments available. The aim of any laser surgery is to reduce the intra-ocular pressure of the fluids. One kind of laser surgery is trabeculoplasty, which unblocks the clogged fluid drainage system of the eye called trabecular mesh-work. The surgery is performed by administering anesthesia to the patient, and also proper care is taken to prevent the damage due to the laser beam. Another mechanism used to control fluid level is destroying some amount of tissue that produces the aqueous humor in the eye. This curtails the production of fluid in the eye. Cyclodiode laser treatment uses the same technique. Surgery is generally done after the patient is administered anesthesia, and involves removing some amount of the trabecular mesh-work, to improve the fluid outflow.

The treatment for closed angle or acute angle glaucoma should be given promptly, as it is much severe than the open angle glaucoma. Eye drops are same as closed angle. The other variant is the use of injections to infuse the medicines in the blood stream. In the laser surgery, the beam targets the iris of the eye, and thus clears the drainage tubes of the eye. Surgery clears the holes of trabecular mesh-work by removing some part of it.

Prevention

It's better to prevent than cure while dealing with this disease. If the symptoms are not addressed on time, it can lead to total blindness. So the only method to prevent this disease is regular monthly visits to the doctor for eye checkups. Also, one should maintain healthy eyes by neatly caring for the eyes. Sometimes, eye injury can also lead to the condition, so it is better to protect eyes using some kind of eye gear. Eye drops can be used on a regular basis to maintain the intra-ocular pressure. One should also maintain a healthy lifestyle by maintaining weight and blood pressure to prevent diabetes, as in several instances, it has been found that insulin resistance results in glaucoma.

This was all about glaucoma, and especially about the treatment. Don't ever ignore eye care, and take all possible measures to keep the eyes healthy.