Glaucoma or glaucoma: what are its causes, symptoms and treatment?

Glaucoma, more accurately and technically glaucoma, is a long-term progressive and irreversible disease of the optic nerve. It is the second most common cause of blindness worldwide.

The main disadvantage in the fight against it is that for a long time it proceeds undetected and without typical symptoms. That is also why it is referred to as the silent thief of sight.

The disease affects the optic nerve. If delayed or neglected, it leads to severe visual impairment and even blindness.

It is reported that to date, approximately 11 million people worldwide have gone blind due to this disease.

It is not true that it only affects the elderly, although it is most prevalent in this period of life.

However...

It occurs at all ages. That's why it's important to have an eye and vision examination, especially after the age of 40.

Your frequently asked questions:
What is glaucoma and what are the symptoms?
How is it different from cataracts?
How is it treated, what drops help and is natural treatment and herbs effective?
Answers to the questions and lots of interesting information are given in the article.

Commonly, glaucoma is said to be glaucoma. Beware, however, in no way does this disease cause clouding of the lens or other eye structures.

So why is it called glaucoma, you ask?

The name originated in the past.
Because a green tint is present when the eye is severely affected.
The explanation is the simultaneous gray discoloration of the cornea and the fading of the iris.
Together, these give the impression of a green tint to the eye.

In cataract, clouding of the lens of the eye is present. This clouding is subsequently significant in visual impairment.

How is glaucoma defined?
+ basic characteristics

Glaucoma is a disease of the eye. It is defined as:

Chronic, progressive and irreversible optic neuropathy with characteristic changes in the optic nerve target and visual field.

Chronic = long-term
Progressive = progressive
Irreversible = irreversible

This is damage to the optic nerve that has a multifactorial basis.

In most cases, people associate it with increased intraocular pressure. Yes, for the most part, that's true. However, increased pressure inside the eye is not a prerequisite for the problem.

The disease is widespread throughout the world. It is reported that approximately 1.5 to 4% of the population over the age of 40 suffers from it. The percentage then increases with increasing age.

Glaucoma is classified and divided into several forms:

1. primary - the cause is unknown
2. secondary - occurs in diseases of the eye, but also in other diseases, after trauma and surgery, and after medication
3. congenital/childhood - presence of glaucoma in children until adulthood (congenital, juvenile)

Plus...

It also differs in terms of the corneo-corneal angle ratio. There are structures within the eye that provide for the formation and drainage of fluid within the eye.

In the area where the ventricular fluid drains, the cornea and iris are in a certain position. And depending on how they fit together, the angle is either open or closed.

Accordingly, primary glaucoma is divided into:

1. open chamber angle
2. closed chamber angle

Mostly open angle primary glaucoma is represented.

2. Plus...

This is the form in which the intraocular pressure is normal.

Plus, you may have heard of ocular hypertension. This is reported when there is higher pressure inside the eye but the optic nerve is not yet damaged.

This disease affects the quality of life and has a psychological impact from the progression of the condition. Daily and long term treatment, impaired vision and visual field, leading to limitations in daily activities (self-care, shopping, driving, hobbies) can also be considered as a certain type of burden.

Similarly, glaucoma has significant economic impacts, both on the individual and on society, such as loss of employment and the financial costs of treatment.

Glaucoma in children

It is divided according to the age of the child.

The first is congenital. This congenital form manifests by the 3rd month of life. The second is infantile, which occurs from the 3rd month to the 3rd year of life. Juvenile glaucoma is from the 3rd year of life.

Glaucoma in children, as in adulthood, is either primary or secondary. Primary are due to a disorder of the ventricular angle. Secondary to an ocular or other systemic disease.

What could be behind all this, you ask, what is the basis of glaucoma?

Why does optic nerve damage occur? There are several causes. That is why it is said to be a multifactorial disease.

Primary glaucoma does not have a precise cause. Several risk factors combine to cause damage to the optic nerve.

Among the most important are increased intraocular pressure.

Intraocular pressure...

Inside the eye is the ventricular fluid. It fills both the anterior (in front of the lens) and posterior (behind the lens) chambers of the eye. It is important for several reasons (it holds the shape of the eye and has a role in the flow of substances in the eye). This fluid normally forms and drains evenly.

The production of intraocular fluid is in the pars plicata of the corpus ciliare - the ciliary muscle (which is the ciliary body located in the posterior chamber). It also flows through the pupil into the anterior chamber. The largest amount then drains along the path of the ventricular angle and small veins. A small volume also drains through the iris, ciliary body and cornea.

The ventricular fluid is the basis for intraocular pressure.

It has an individual value for each person. It ranges from 9 to 21 mm Hg (with an average of usually 16).

During the day, the pressure rises and falls, even by 8 mm Hg, and is usually highest in the morning.

The increase in intraocular pressure causes:

• Caffeine
• smoking
• corticosteroids
• diving with diving goggles
• tie and tightly buttoned shirt
• looking up
• weight training and strength exercises
• change from sitting to lying position

Alcohol, marijuana or general anesthetics contribute to the reduction, with regular and prolonged aerobic exercise and sauna being the healthier ones. But so does iritis and retinal detachment.

Women, blacks and Hispanics have higher intraocular pressure.

So...

Intraocular fluid for the most part drains through the outflow pathways that are located between the cornea and the iris.

Back to the causes of glaucoma

It's caused by multifactorial action.

Risk factors include:

• Increased intraocular pressure.
• increased age
• female gender
• race, more common in blacks and Hispanics
• vascular disease and impaired blood circulation at the optic nerve site, but also
  • low blood pressure
  • fluctuating blood pressure
  • also high blood pressure
  • disorders of blood vessel regulation, vasospastic syndrome
  • and also disorders of blood clotting and blood viscosity (density)
• diabetes
• genetic predisposition and hereditary factor (15 times more common in familial occurrence)
• refractive errors of the eye (especially severe myopia)
• anatomical proportions of the eye (corneal thickness, anatomical size of the eye)
• Raynaud's syndrome
• Migraine
• and other diseases

Three theories of glaucoma formation have been put forward:

1. mechanical
2. vascular
3. neuropathological

1. Open-angle glaucoma

The increase in pressure inside the eye is usually caused by a disturbance of the circulation of the fluid or its overproduction. As a consequence, the intraocular pressure rises. The long-term increase in pressure is behind the progressive damage to the optic nerve.

This form accounts for almost 90% of all glaucomas.
Bilateral eye involvement, but with varying degrees.

Goes undetected, no symptoms = silent thief of sight.

Professionally referred to as primary open-angle glaucoma. It is a progressive form. It is long term. The result is damage (neuropathy) to the optic nerve.

2. Closed-angle glaucoma

Also referred to as acute glaucoma, angular glaucoma (angulus = angle), PACG (primary angle closure glaucoma).

Drainage of fluid is prevented by a narrowed or closed space between the cornea and the iris. The fluid cannot drain sufficiently. It accumulates, resulting in a sudden increase in pressure in the eye and acute discomfort.

It often arises because of an anatomical disparity in the eye.

Examples include a smaller anterior-posterior length of the eye, a larger radius of the anterior and posterior surfaces of the cornea, a smaller radius of the anterior surface of the lens, a larger lens and its displacement, or a lens hinge that is too loose.

Thus, fluid accumulation pushes the lens onto the iris (posterior pupillary block) or the iris root onto the chamber angle (anterior block).

The pressure in the eye can rise to 50-70 mm Hg. It manifests itself in a glaucoma attack.

It occurs with symptoms and various discomforts. Examples are eye pain, headache, nausea, etc. Acute glaucoma attack also occurs in this form.

It is more common in women.
Mostly after the age of 40.
And in farsighted people.

In addition to these two main forms of glaucoma, other, secondary forms are described in the literature. Examples include pseudoexfoliative glaucoma, pigmentary glaucoma, lens-induced glaucoma, after ocular trauma, in ocular inflammation, in tumors inside the eye, in hemorrhages in the eye, after eye surgery, steroid glaucoma, aniridia, iridocorneal anomalies, and others.

+ You may also be interested in:
Can eye strain, reading, watching TV, and working with a computer cause glaucoma?
No, none of the above causes or aggravates glaucoma.

Symptoms occur according to the form of the disease. The open-angle form does not have typical problems. The closed-angle form, however, is acute and is classified as an acute condition in medicine.

How do I know if I have glaucoma?

Symptoms of the primary open-angle form:

• Chronic course without pain
• long period of time without difficulty
• often detected incidentally during an eye examination
• frequent change in correction of visual acuity
• with progression of the condition and with advanced optic nerve damage
  • vague visual disturbances
  • visual field disturbances
  • deterioration of visual acuity
  • problem with vision in twilight
  • blurred vision - can lead to misdiagnosis of cataract
  • headaches in the eye area

Symptoms in acute glaucoma (acute glaucoma attack):

• acute condition
• can be provoked by
  • increased psychological stress
  • mydriasis - pupil dilation after medication, in the dark
  • bending over for prolonged periods of time
  • reading on the stomach and lying on the stomach
• intense pain in the eye, sometimes severe, which leads the person to an eye doctor
• pain around the head
• nausea, nausea or vomiting
• abdominal pain (which is why it is often confused with indigestion)
• sweating
• bradycardia (slowing of the heart rate)
• blurred vision
• increased sensitivity to light (photophobia)
• visual disturbance
• seeing rainbow colours around lights (irisisation)
• to loss of field of vision and loss of sight (blindness)
• redness of the eye, conjunctiva of the eye
• different dilation of the pupils of the eyes
• whitish and swollen cornea

A glaucoma attack may be preceded by subthreshold symptoms, even for several months.
These are nonsignificant subjective complaints.

The table lists 10 features of a glaucoma attack

Are you wondering if you may go blind due to glaucoma?

Yes.

If left untreated, the disease leads to severe optic nerve damage and therefore visual impairment and even blindness.

In most people, a slow progressive and clinically silent (mute) asymptomatic form is found. In this case, the diagnosis is often made incidentally during an eye examination. For this reason, preventive eye examinations are also of great importance, especially in the 40s.

Otherwise, one seeks a doctor during a glaucoma attack, which is subjectively very unpleasant.

The ophthalmologist examines the eyes in addition to the medical history. He uses methods such as:

• intraocular pressure examination
• visual field examination - perimeter
• slit lamp examination and anterior segment examination
• gonioscopy - examination of the iris-corneal angle
• pachymetry - measurement of corneal thickness
• optic nerve examination - optic nerve targets
  • HRT - optic nerve target tomography with Heidelberg retinal tomograph
  • OCT - optical coherence tomography, examination of the peripapillary layer of nerve fibres

Alternatively, secondary causes and differential diagnosis are sought. Systemic diseases such as diabetes, hypertension and other risk factors are also examples.

Cataracts may also run along with glaucoma.

Remember:
The earlier the disease is diagnosed and treatment is initiated, the better the chances of minimizing its effects and damage to vision.

The course of the disease depends on the form. The open-angle form has a prolonged and creeping course with late onset of difficulties. That is why it is also referred to as the silent eye thief.

In its case, a person feels symptoms only in the case of advanced damage to the optic nerve.

The opposite is true for acute glaucoma.

In its case, one feels subjective discomfort as indicated by the symptoms. An example is the occurrence of prodromes. This term includes mild subjective discomfort caused by a slight increase in eye pressure.

The eye pain is accompanied by a headache. Sudden visual disturbances, visual disturbances and blindness are associated.

Total loss of vision = absolute glaucoma.

In addition, it is possible to feel heaviness on the stomach, nausea to vomiting and abdominal pain. These difficulties are caused by irritation of the parasympathetic nervous system.