What you need to know about glaucoma

Eyes are among the most used sensory organs. Any disease, condition, or trauma that affects our vision can have a serious negative impact on the quality of our life. Across the globe, it is estimated that in 2020, 80 million people had glaucoma the number of cases was expected to increase to 111 million by 2040. Each year, January is the glaucoma-awareness month; it is an attempt to educate the general population and potentially lower the number of cases. اضافة اعلان

What is glaucoma?

Glaucoma is a group of eye conditions that damage the optic nerve, which functions as a highway of information for visual stimuli and delivers information from the eyes to the brain. Any damage to the optic nerve results in vision loss, and as the disease progresses, it may result in blindless. Fortunately, if the disease is diagnosed early on, additional vision loss may be prevented.


(Photo: Envato Elements)

Currently, glaucoma is the second leading cause of blindness around the world and the third leading cause of blindness in Jordanian adults.

Anatomy of the eye

The eye has two chambers that are filled with fluid, with a lens that serves as a divider. The space between the cornea (the outermost part of the eye) and the lens is filled with a clear watery fluid known as aqueous humor. The aqueous humor is responsible for maintaining the spherical shape of the eye as well as for providing nutrients to the structures contained within.

In order to maintain the appropriate pressure and resupply nutrients, the aqueous humor needs to drain and fill in balance. The two main structures responsible for draining aqueous humor are the trabecular meshwork and the uveoscleral outflow.

How does glaucoma cause blindness?

Glaucoma is traditionally characterized by increased intraocular pressure (IOP). Although this pressure in the eye is often a main characteristic of glaucoma, it may not always be present, therefore glaucoma may be more accurately defined by the damage to the optic nerve. Given the broad definition, there are multiple ways in which glaucoma may present, the two most common being open-angle glaucoma (OAG) and angle-closure glaucoma (ACG). The main difference between these two types is the angle formed between the cornea and the iris, which is the colored portion of the eye and rests atop the lens.


(Photo: Envato Elements)

In OAG, the iris is in the correct position and the uveoscleral drainage canals are clear, but the trabecular meshwork has impaired draining. In ACG, on the other hand, the iris is pressed against the cornea, which blocks the uveoscleral drains as well as the trabecular meshwork. For those with ACG, the main cause of increased IOP is largely due to improper drainage that results from damage and scarring of the drainage structures. In both of these disease, increased IOP is the major cause for optic nerve damage.

Risk factors for glaucoma

The exact causes of glaucoma are not fully understood, but there are certain risk factors associated with it. Generally, age is an important risk factor. Those older than 60 tend to be at greater risk of developing glaucoma of either type. Race also determines the type of glaucoma that is most prevalent. In the white and black population, OAG is most common, whereas ACG is more common in Asian populations. Furthermore, the prevalence of OAG in the black population is three times higher than in the white population. Finally, having a family history of glaucoma may increase your risk.

Currently, glaucoma is the second leading cause of blindness around the world and the third leading cause of blindness in Jordanian adults.

Although the exact cause has yet to be identified, it is believed that there is a genetic component involved. Additionally, a mutation in the myocilin gene has been identified in some cases of OAG, further suggesting that genetics play a role in disease development. More specific to OAG, certain systemic conditions may increase the risk of developing glaucoma, such as diabetes, hypertension, and preexisting condition that result in increased IOP. In ACG, those who are farsighted, are taking certain medications, and the female population are at greater risk of developing glaucoma.

Symptoms of glaucoma

Symptoms of glaucoma vary, depending on the type. For example, in OAG, symptoms are rare and the disease is often diagnosed by chance during routine eye exams. In ACG, the onset is often rapid, and symptoms are likely experienced. Common symptoms in ACG include decreased vision, halos around lights, headaches, severe eye pain, nausea, and vomiting.

How to prevent glaucoma

Early detection of the disease is important as it will allow for treatment before the onset of severe optic damage, which may result in complete blindness. Early detection is done by regular comprehensive eye exams and scheduling may be based on your doctor’s medical opinion. In general, the American Academy of Ophthalmology (AAO) recommends comprehensive eye exams based on age as follows:

For those under the age of 40, comprehensive eye exams every 5-10 years

For those 40-54, comprehensive eye exams every 2-4 years

For those 55-54, comprehensive eye exams every 1-3 years

For those 65 and older, comprehensive eye exams every 1-2 years

Increased screening may be needed if you have a family history of glaucoma. It is important to consult your healthcare provider with any questions or concerns in order to set up a schedule appropriate for you. Similarly, regular, moderate exercise may help reduce the risk of developing glaucoma and your doctor may help develop an exercise regimen.


(Photo: Envato Elements) 

For those who have been diagnosed with glaucoma, regularly taking your medication is important. Treatment typically comes in the form of eye drops that help regulate the pressure in the eye.

Glaucoma is a progressive disease and in order for the treatment to work properly, the medication must be used regularly and as prescribed, even if you do not experience any symptoms. Prematurely stopping the medication may cause the disease to progress and further deteriorate vision.


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