In Closed-Angle Glaucoma, the
drain of the eye closes intermittently, leading to episodes of
greatly increased pressure in the eye. In between episodes, eye
pressure can be normal. This type of glaucoma usually occurs because
of the anatomic configuration of the structures in the eye.
Known major risk factors for glaucoma include:
- Age
- Family History
- African descent
- Increased eye pressure
- Thin corneas
Previously, it was thought that glaucoma was a disease of increased
pressure inside the eye. However, many patients with high eye
pressures never develop glaucoma and conversely, many patients
with “normal” pressures do develop glaucoma.
Glaucoma is a slowly progressive disease in which changes may
occur over many years, making it a difficult disease to diagnose.
Because of this, we follow a number of patients as “Glaucoma
Suspects”. These patients have risk factors for glaucoma
or have an unusual appearance to the optic nerve that may be suggestive
of glaucoma.
A complete eye exam is the only way to detect the presence of
glaucoma. The exam may include:
- Measurement of intraocular pressure
- Measurement of corneal thickness
- Inspection of the angle (gonioscopy)
- Dilated examination of the optic nerve
- Laser measurements of the optic nerve
for serial comparison (GDx)
- Formal visual field evaluation
Treatment of glaucoma is focused on lowering the pressure inside
the eye. Prescription eyedrops are the initial treatment in all
patients, and depending on the response, may be all that is required.
In cases where medications alone are not sufficient, laser treatment
(laser trabeculoplasty) can be done. If all else fails, surgery
to relieve the pressure in the eye may be required (trabulectomy
or tube shunt).
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