What is Glaucoma?

Glaucoma is not just one disorder but is a group of eye disorders that may eventually lead to blindness. It is defined as damage to the optic nerve associated with a characteristic loss in the field of vision. Unfortunately, glaucoma has no signs or symptoms in the early stages, and by the time people notice a loss of vision, glaucoma has reached a very advanced stage.

One of the main risk factors for glaucoma is elevated Intra-Ocular Pressure (IOP), but notice that IOP is not in the definition of glaucoma. In fact, about one-third of glaucoma patients have a normal IOP. This is one of the many reasons that glaucoma is also known as the “Silent Thief of Sight.”

If you have been diagnosed with glaucoma or you have a family history of glaucoma, it is very important that you have frequent eye examinations to closely monitor your optic nerves and visual field. At Coastal Vision Medical Group, we provide our patients with the newest equipment and tests for the early diagnosis and treatment of glaucoma.

Some of our glaucoma treatments include:

• eye drop medications

• Argon Laser Trabeculoplasty (ALT)

• glaucoma shunts

• glaucoma drainage devices

• eye stents
  
  

Glaucoma and Anatomy

The eye is an organ that makes its own replenishing fluid called the aqueous, whose function is to bathe some of the eye's internal structures and provide nourishment. The aqueous is made inside the eye by the Ciliary Body, which is a very vascular structure that sits behind the iris (the colored part of the eye). Since the eye is a closed system, the aqueous must drain from the eye, or the intraocular pressure (IOP) will rise. The eye’s drainage structure is called the trabecular meshwork, which sits inside the “angle of the eye.” The angle of the eye is an area of great interest to glaucoma patients and glaucoma specialists alike. It is at the angle where most of the glaucomatous action takes place. The trabecular meshwork (remember: the eye's drainage structure which sits inside the angle) has been studied for years and has been found to be behind the pathophysiology of glaucoma.

Glaucoma Types

As mentioned previously, glaucoma is a group of eye disorders. However, for the purpose of the organization, glaucoma may be categorized into 2 basic types: Closed Angle Glaucoma or Open Angle Glaucoma. The glaucoma doctors at Coastal Vision Medical can screen for all types, and recommend treatment options and glaucoma management.

Angle Closure Glaucoma

Angle-closure glaucoma refers to a condition where the aqueous fluid is unable to reach the trabecular meshwork (the eye’s drain), which sits inside the angle of the eye. This results in elevated Intraocular Pressure (IOP). Angle-closure has many causes and may be acute or chronic.

The main risk factors of angle-closure glaucoma are:

• Age

• Asian race

• Hyperopia

• Diabetes

• Uveitis
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Acute Angle Closure Glaucoma / Narrow Angles

This most commonly occurs as a result of a narrow-angle. In normal cases, there is enough space within the angle for the aqueous fluid to reach the trabecular meshwork. Some patients have narrow angles, which means that the angle is crowed by the structures within the eye (i.e. the cornea and the iris are too close to each other). This can lead to a very sudden increase in eye pressure. Some patients may be born this way, and in others, it is due to cataracts getting bigger in size. In any event, Acute Angle Closure is a very dangerous and sight-threatening condition, which may lead to vision loss in a matter of 24 to 48 hours if left untreated.