Health

Glaucoma: silent theft of sight

I can still remember my dad’s kind and loving eyes. While he never fully lost his sight, I can also remember the visible symptoms of the "silent thief"… glaucoma.
I can still remember my dad’s kind and loving eyes. While he never fully lost his sight, I can also remember the visible symptoms of the "silent thief"… glaucoma.

Glaucoma is not a single clinical disease. Glaucoma is a condition in which the optic nerve that carries the images we see to the brain, is damaged. "Technically, glaucoma is due to damage to the optic nerve, sometimes as a result of increased pressure of the aqueous humor, the clear, watery fluid that circulates in the chamber of the eye between the cornea and the lens. But the term glaucoma is now defined as a collection of diseases that causes optic nerve damage. As a result, the diagnosis is no longer solely based on whether a person’s Intraocular Pressure (IOL) is elevated or not."

It is a combination of visual conditions that result in damage to the optic nerve head and a loss of the visual field. The optic nerve is like a fiber optic cable containing about 1.2 million strands. Glaucoma can damage nerve fibers, causing blind spots to develop. Untreated, glaucoma can permanently damage the nerve, leading to reduced vision or even blindness. Glaucoma often goes undiagnosed because there may be no noticeable symptoms until there is an impact on the peripheral vision.

What are the types and symptoms of glaucoma? According to the American Health Assistance Foundation and Medem Medical Library the following are the most common types and symptoms of glaucoma:

Open angle or Chronic Glaucoma – is the most common type. Here the area of trouble is that the filter (called the trabecular meshwork), for various reasons, gets clogged or obstructed and does not filter the acqueous humor fluid efficiently. It progresses with few or no symptoms until the condition reaches an advanced stage. As increased eye pressure continues to damage your optic nerve, you lose more and more of your peripheral vision. Open-angle glaucoma usually affects both eyes, although at first you may have symptoms in just one eye.
• Sensitivity to light and glare
• Trouble differentiating between varying shades of light and dark
• Trouble with night vision
Narrow Angle Glaucoma is a vision emergency. Here there is an obstruction in the drainage of the acqueous fluid due to a narrowing of the angle between the base of the iris and the cornea. The symptoms can be a sudden, painful red eye, nausea, vomiting, headache and visual halos. An attack often happens in the evening when the light is dim and your pupils are dilated. In the event of the symptoms above, go directly to the emergency room and call your ophthalmologist. Signs and symptoms include:
• Blurred vision
• Halos around lights
• Reddening of the eye
• Headache
• Severe eye pain
• Nausea and vomiting
• Hardness of the affected eye

Chronic angle-closure glaucoma: Like open-angle glaucoma, may cause vision damage without symptoms. Symptoms may include:
• eye ache
• blurred vision

Although angle-closure glaucoma is unusual, people of Asian or Eskimo ancestry are at higher risk of developing it. As with other forms of glaucoma, age and family history are also risk factors and the problem seems to occur in older women more often than others.

Both open-angle and angle-closure glaucoma can be primary or secondary. A primary condition is one that cannot be attributed to any known cause. A secondary condition can be traced to another cause, such as previous injury or illness.

"Normal (or low) tension" glaucoma: This is an unusual and poorly understood form of the disease. In this type of glaucoma, the optic nerve is damaged even though the patient's intraocular pressure is consistently within a range usually considered normal. Symptoms include:
• Sensitivity to light and glare
• Trouble differentiating between varying shades of light and d

January 13, 2003
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