Types of Glaucoma

1. Primary Open-Angle Glaucoma (POAG): The most common form, characterized by a gradual increase in IOP due to impaired aqueous humor drainage through the trabecular meshwork.
2. Angle-Closure Glaucoma: A less common but more severe form caused by sudden blockage of the drainage angle, leading to a rapid increase in IOP.
3. Normal-Tension Glaucoma: Occurs despite normal IOP levels, indicating other risk factors contribute to optic nerve damage.
4. Secondary Glaucoma: Develops as a result of trauma, inflammation, or medication-induced changes affecting IOP regulation.
5. Congenital Glaucoma: A rare condition present at birth due to abnormal development of the eye’s drainage system.

Risk Factors:

– Increased intraocular pressure
– Family history of glaucoma
– Age > 40 years
– African, Hispanic, or Asian descent
– Myopia or hyperopia
– Diabetes and hypertension
– Prolonged corticosteroid use

Symptoms:

Glaucoma remains asymptomatic in early stages. As it progresses, patients may experience:
– Peripheral vision loss (tunnel vision)
– Blurred vision
– Halos around lights
– Eye pain and redness (in acute cases)

Diagnosis

Early detection is crucial. Diagnostic evaluations include:
– Tonometry: Measures IOP.
– Gonioscopy: Assesses drainage angles.
– Ophthalmoscopy: Examines optic nerve damage.
– Perimetry (Visual Field Test): Detects peripheral vision loss.
– Optical Coherence Tomography (OCT): Evaluates optic nerve and retinal nerve fiber thickness.

Treatment Options:

– Medications: Topical eye drops (prostaglandin analogs, beta-blockers, carbonic anhydrase inhibitors) to lower IOP.
– Laser Therapy:
– Trabeculoplasty for POAG
– Iridotomy for angle-closure glaucoma
– Surgical Interventions:
– Trabeculectomy: Creates a new drainage pathway.
– Glaucoma Drainage Implants: Enhances aqueous humor outflow.
– Minimally Invasive Glaucoma Surgery (MIGS): A safer, less invasive option.