Glaucoma: Causes, Symptoms & Treatment

Glaucoma is a group of eye diseases characterized by progressive optic nerve damage, usually associated with elevated intraocular pressure (IOP). The optic nerve transmits visual information from the eye to the brain. Damage to this nerve results in irreversible vision loss, often without early symptoms. Glaucoma is the second leading cause of blindness worldwide, but early detection and treatment can prevent blindness in most cases.

Main types:

• Primary open-angle glaucoma (POAG): most common
• Angle-closure glaucoma: acute presentation
• Secondary glaucoma: from other eye disease

Risk factors include:

• Elevated intraocular pressure
• Age over 60
• Family history of glaucoma
• Myopia (nearsightedness)
• Thin corneas
• African descent
• Diabetes
• Cardiovascular disease

Early stages are usually asymptomatic. Progressive vision loss includes:

• Peripheral visual field defects
• Gradual central vision loss
• Difficulty adapting to darkness
• Halos around lights

Acute angle-closure glaucoma causes:

• Sudden severe eye pain
• Blurred vision
• Eye redness
• Nausea and vomiting
• Hazy cornea

Diagnosis involves:

• Tonometry (intraocular pressure measurement)
• Optic nerve evaluation (ophthalmoscopy, OCT)
• Visual field testing (perimetry)
• Gonioscopy (angle assessment)
• Corneal pachymetry

Treatment goal: lower intraocular pressure to slow or stop progression.

Medical therapy (first-line):

• Prostaglandin analogs (latanoprost, travoprost)
• Beta-blockers (timolol)
• Alpha-agonists
• Carbonic anhydrase inhibitors
• Rho kinase inhibitors

Laser therapy:

• Argon laser trabeculoplasty (ALT)
• Selective laser trabeculoplasty (SLT)

Surgical intervention:

• Trabeculectomy
• Tube shunt placement

While primary glaucoma cannot be prevented, risk reduction includes:

• Regular eye examinations
• Maintaining healthy IOP
• Regular physical activity
• Dietary antioxidants

All adults should have baseline eye exams, especially over age 40. Those with risk factors need more frequent screening. Seek immediate care for sudden eye pain, vision changes, or halos around lights.