Glaucoma Surgery

WHAT IS GLAUCOMA
Glaucoma is a common eye condition where the optic nerve, which connects the eye to the brain, becomes damaged. It's usually caused by fluid building up in the front part of the eye, which increases pressure inside the eye.


Not everyone with high eye pressure will develop glaucoma, and some people with normal eye pressure will develop glaucoma. When the pressure inside a person's eye is too high for a particular optic nerve, whatever that pressure measurement may be, glaucoma will develop.
People with glaucoma can lose nerve tissue, resulting in vision loss.

TYPES OF GLAUCOMA
Primary Open-angle Glaucoma: This is the most common type of glaucoma. It happens gradually; where the eye does not drain fluid as well as it should (like a clogged drain). As a result, eye pressure builds and starts to damage the optic nerve. This type of glaucoma is painless and causes no vision changes at first. Some people can have optic nerves that are sensitive to normal eye pressure. This means their risk of getting glaucoma is higher than normal. Regular eye exams are important to find early signs of damage to their optic nerve.

Angle-closure Glaucoma (also called “closed-angle glaucoma” or “narrow-angle glaucoma”): This type happens when someone’s iris is very close to the drainage angle in their eye. The iris can end up blocking the drainage angle. You can think of it like a piece of paper sliding over a sink drain. When the drainage angle gets completely blocked, eye pressure rises very quickly. This is called an acute attack. It is a true eye emergency, and you should call your ophthalmologist right away or you might go blind.

Congenital Glaucoma:- This inherited form of glaucoma is present at birth, with 80 percent of cases diagnosed by age one. These children are born with narrow angles or some other defect in the drainage system of the eye. It's difficult to spot signs of congenital glaucoma, because children are too young to understand what is happening to them. If you notice a cloudy, white, hazy, enlarged or protruding eye in your child, consult your eye doctor.Congenital glaucoma typically occurs more in boys than in girls.

CAUSES OF GLAUCOMA
Glaucoma can occur for a number of reasons.Most cases are caused by a build-up of pressure in the eye when fluid is unable to drain properly. This increase in pressure then damages the nerve that connects the eye to the brain (optic nerve).
It's often unclear why this happens, although certain things can increase the risk, including:
• your age – glaucoma becomes more common as you get older
• your ethnicity – people of African, Caribbean or Asian origin are at a higher risk
• your family history – you're more likely to develop glaucoma if you have a parent or sibling with the condition
• other medical conditions – such as short-sightedness, long-sightedness and diabetes
It's not clear whether you can do anything to prevent glaucoma, but having regular eye tests should pick it up as early as possible.

SYMPTOMS
Glaucoma doesn't usually cause any symptoms to begin with. It tends to develop slowly over many years and affects the edges of your vision (peripheral vision) first.


For this reason, many people don't realise they have glaucoma, and it's often only picked up during a routine eye test.
If you do notice any symptoms, they might include blurred vision, or seeing rainbow-coloured circles around bright lights. Both eyes are usually affected, although it may be worse in one eye.


Very occasionally, glaucoma can develop suddenly and cause:
• intense eye pain
• nausea and vomiting
• a red eye
• a headache
• tenderness around the eyes
• seeing rings around lights
• blurred vision

DIAGNOSIS
The only sure way to diagnose glaucoma is with a complete eye exam. A glaucoma screening that only checks eye pressure is not enough to find glaucoma.


During a glaucoma exam, your ophthalmologist will:
• measure your eye pressure
• Inspect your eye’s drainage angle
• examine your optic nerve for damage
• test your peripheral (side) vision
• take a picture or computer measurement of your optic nerve
• measure the thickness of your cornea

TREATMENT
1. Medical treatment. Eye drops are usually the first line of treatment for glaucoma. There are various types of eye drops that can be used.
2. Laser for narrow or closed-angle glaucoma. Another form of laser surgery called YAG Peripheral Iridotomy (PI) surgery creates an opening through the iris, which allows the eye fluid to bypass the normal drainage pathway. This can reverse closed-angle glaucoma and prevent its development in those who have narrow drainage systems and are at risk of acute loss of vision.
3. Surgery. Surgery can be used to control pressure inside the eye but is generally used only when eye drops have proven unsatisfactory. The surgery for high pressure control is called trabeculectomy.

Benefits of Treatment
Early treatment may decrease your chance of eye damage and loss of vision.
Eye pressure medicines help decrease eye pressure. They may also decrease the amount of fluid your eyes make or help your eyes drain better. These medicines may be eye drops or pills.