What is Glaucoma?
Glaucoma is a group of eye problems that cause damage to the optic nerve (the nerve responsible for transmitting visual signals to the brain) which leads to permanent vision loss in its progressive stages.
The different types of Glaucoma include:
- Open-angle glaucoma
- Closed-angle glaucoma
- Normal-tension glaucoma
- Pigmentary Glaucoma
- Exfoliation Glaucoma
- Primary Juvenile Glaucoma
- Neovascular Glaucoma
You may explore more about glaucoma and its various types, the most frequently occurring of which is Primary Open-angle Glaucoma, accounting for about 90% of cases in the US.
In the light of this fact, and the rapidly increasing frequency of the eye disease, modern science and technology are making efforts to find effective treatments that could stop or slow down its progression.
Understanding Risk Factors for Treatment
The major risk factors for glaucoma include:
Most procedures for glaucoma offer a generalized treatment which is directed at dealing with these risk factors, however some forms of glaucoma are more critical and thus require immediate and specialized treatment.
The single primary aim common to all glaucoma treatments is an effort to reduce the Intraocular Pressure (IOP) of the eye.
Since the root cause of visual damage in glaucoma is the death of optic-nerve cells, thereby making it impossible for neurons in the eye to transmit visual signals to the brain, therefore the damage once occurred due to glaucoma cannot be completely cured or reversed.
The treatments consist of techniques that would stop the disease in its tracks even if it may not be completely cured.
Measures for Prevention
The ‘silent thief of sight’ typically undergoes steady development over a long time span and does not show any symptoms for the most part until it has already progressed to an advanced stage, however, once diagnosed and treated immediately, it can be controlled.
The following steps for eye care are important to diagnose glaucoma timely and to be able to curb its further progression.
Regular Dilated Eye Examination
Be sure to get yourself a dilated eye exam once every two years, which is the sole method of screening out glaucoma in its early stages. The eye exam should also include the measurement of intraocular pressure through tonometry to rule out the risk factor for glaucoma and thus be able to prevent it.
Know your Family Medical History
In comparison to the general population, people who have first-degree blood relative with Glaucoma are at a higher risk for developing it and thus should keep themselves aware of it.
Knowing your chances of procuring this eye condition can help you be more conscious of eye-health as well as take timely measures to keep eye-diseases from developing.
As the biggest risk factor for glaucoma includes increased intraocular pressure as well as poor management of blood pressure, you could ensure relative safety from glaucoma by keeping in check your lifestyle habits that may be contributing toward either of these factors.
Several daily routine habits can be indirect risk factors for glaucoma, such as unhealthy eating, taking low vitamin-D diet, excessive alcohol and caffeine consumption, cigarette smoking, extensive use of screens without breaks, inverted or head-down positions during exercise or wearing tight neck-ties for long periods of time contribute toward risk of glaucoma.
Careful lifestyle choices in this regard can surely put you at a lower risk for glaucoma and act as protective factors despite whatever genetic predisposition you may have for the disease.
Use Protective Eye-gear
Glaucoma can be initiated due to external damage or trauma to the eye, so for safety it is important that you practice wearing protective eye gear during activities around the house or workplace, such as handling power tools, swimming or playing sports.
Cure for Glaucoma
There is no permanent solution for glaucoma, however, various treatments are available that can help stop the condition from worsening, and possible blindness due to it can be prevented.
Explained here is a list of treatments that are available at present to counter the different types of glaucoma.
Eye Drops and Medicines
In the initial stages of glaucoma development, if the condition is successfully diagnosed, most physicians begin treatment by prescribing eye-drops for the patients.
In open-angle glaucoma, obstruction occurs in the absorption of aqueous humor within the trabecular meshwork, leading to increased resistance and pressure which builds up in the eye. On the contrary, in Closed-angle glaucoma the flow of aqueous humor becomes restricted resulting in its accumulation. This causes a critical increase in eye-pressure and is painful.
The primary function of eye-drop prescriptions is to reduce the intraocular pressure in both cases, which is done by either improving the process of how fluid drains from the eye or by decreasing the amount of fluid your eye produces.
However, these medicines often also cause side-effects such as hyperpigmentation in the eye-lid, stinging of the eyes, redness etc., which the patient should be willing to put up with or if possible, these may be eliminated with the doctor’s coordination and suggestions.
Eye-drop medications include:
- Alpha-adrenergic agonists
- Carbonic anhydrase inhibitors
- Rho-kinase inhibitor
- Miotic / Cholinergic agents
For all types of oral medication, it is important that the patient takes his prescribed medicine with strict regularity, without which these do not have any effect.
If the effect of eye-drops observed for glaucoma treatment is not substantial for an individual, the doctor may also prescribe other oral medicines to take alongside it. These are usually anhydrase inhibitors which help bring the intraocular pressure down to the desired level.
These medicines may also have side-effects such as frequent urination, digestive problems, kidney stones, depressive mood and tingling sensations in fingers or toes etc.
These side-effects can be catered to some extent by consultation with the doctor and subsequent changes in medicine to choose what best suits your body chemistry.
Argon laser trabeculoplasty (ALT) is a type of therapy that is used to treat open-angle glaucoma. This can effectively allow the flow of aqueous humor in the eye and thus lower intraocular pressure.
The procedure involves using a 50-μm argon spot which is aimed at the problematic region of the eye (which in this case is the trabecular meshwork) in order to stimulate its opening, unclogging the channels and allowing more aqueous humor to flow outward from it. This lowers the eye pressure and helps treat glaucoma.
For people with closed-angle glaucoma, a slightly different procedure is carried out known as Laser Peripheral Iridotomy (LPI). As the root problem of these patients is the narrow angle formed due to the contact of iris and trabecular meshwork within the eye, the laser technique is used to create a small opening in the iris, also uncovering trabecular meshwork so that the aqueous humor can have a pathway for flow.
This form of treatment may have side-effects.
The ultimate aim of this procedure is also to reduce intraocular pressure and the future risk of developing chronic angle closure glaucoma.
Incisional surgeries are one of the forms of treatment available for glaucoma. These are so far the most promising form of treatment particularly in case of Primary Juvenile Glaucoma, which occurs in babies and young infants. It can easily be diagnosed during the first year of a child’s life.
Approximately 11% of all glaucoma patients opt for incisional surgical treatments.
The different types of surgeries include:
This surgery employs the microcatheter technology which is done to make an incision within the eye for the enlargement of drainage channel and the smaller passages in the eye through the injection of a sterile, gel-like substance called viscoelastic. By widening the canal, it is hoped to relieve the intraocular pressure.
Trabeculectomy is one of the most frequently performed surgical treatment for glaucoma in which the surgeon creates a passage in the white portion of the eye, known as sclera, after which a part of trabecular meshwork is removed to allow a controlled leak of fluid from the eye and help achieve lower intraocular pressure.
One of the post-surgery changes may include scarring of the flap-opening which is created during the procedure, but this scarring can possibly nullify the effectiveness of the surgery altogether.
To counter this problem, chemotherapeutic adjuvants, such as mitomycin C, are carefully applied on the wound to prevent the unwanted outgrowths on the meshwork-opening from becoming scarred.
Laser-assisted Non-penetrating deep sclerectomy (NPDS) is a modified form of Trabeculectomy which is performed using a CO2 laser system, with the common aim of puncturing sclera to drain the eye fluid.
Glaucoma Drainage Implants
For people who do not respond to other medical therapies, a flow tube is surgically inserted into the eye and an implantation of a plate is done to assist the flow of aqueous fluid.
Typically, in most surgical treatments, a sudden drop occurs in the intraocular pressure after the procedure is completed, but in the glaucoma drainage implants, this postoperative problem is catered for through procedural techniques.
Low Vision Aids
All the treatments for glaucoma basically provide alternate ways of management of the problem, helpful ways to cope with it and reduce its chances of progressing toward an advanced stage.
One such means of effective treatment has been introduced by modern technological devices such as the low vision aids which have revolutionized how a person inflicted with an eye-disease sees and moves around in the world.
There are several low-vision aid devices available in the market which have been specialized so as to contain facilitative features that cater for a number of eye diseases including glaucoma.
Since people with glaucoma initially lose their peripheral vision, the low-vision aids are designed to give the patient access to peripheral visibility through a comfortable navigation of touch-screen options, different viewing modes, magnification option, bubble view and extra-wide field of view and more.
Among many others, IrisVision is one such device that has quickly proved its mark in the usefulness of technology in assisting medical field. It incorporates these efficient features which help people with glaucoma and other eye-diseases broaden their vision, and see and interact fully with the world.
Promising New Research
Researchers worldwide are working toward newer and better ways to treat glaucoma and possibly find a means to undo the visual damage that it causes.
The top research ideas for glaucoma cure that are being worked upon for innovative drugs, optic nerve cell regeneration therapies, micro-pumps and developing such tech-efficient devices that transmit visual signals directly to the brain to fill the vision gap created due to the optic nerve damage in glaucoma.