The Second Leading Cause of Blindness

What do you know about your eyes? have you closed your eyes for few minutes before? and do you know that there are some people living in such environment you experience when you close your eyes for the rest of their live?
Do you know that glaucoma is the second leading cause of blindness after cataract and that your eyes are at risk of developing glaucoma?

Now lets look at what glaucoma is all about.
Glaucoma is a group of eye disorders that is associated with raised eye pressure (intraocular pressure) which damages the optic nerve. The function of the optic nerve is to transmit image impulses to the brain so that we can see. Glaucoma is often confused with ocular hypertension which is used for people with raised eye pressure without any associated optic nerve damage.
When the fluids in the eye (aqueous humour) is high, it produces a pressure which compresses and damages the optic nerve resulting in failure to carry image impulses to the brain.
Raised eye pressure occurs when there is increased eye fluid production by the ciliary body or when the drainage system of the eye fluid is blocked.

Types of Glaucoma

There are two main types of glaucoma; open-angle and angle-closure glaucoma.

Open-Angle Glaucoma: This is the most common form of glaucoma and is characterized by decreased outflow of eye fluid due to increased resistance to fliud outflow caused by age-related thickening and sclerosis of a mesh-like channel (trebacular meshwork) between the cornea and iris angle. When the increased resistance results in optic nerve damage, it is referred to as chronic open-angle glaucoma.
In open-angle glaucoma, there is a wide and open angle between the iris and cornea with obviously no early warning signs or symptoms. It develops slowly and sometimes without noticeable sight loss for many years. This is because the peripheral vision loss that occurs is gradual and is usually noticed when it has caused reasonable damage.

Angle-Closure Glaucoma: This type is as a result of closing or narrowing of the angle between the iris and cornea (anterior chamber angle). It develops very quickly and is also called acute glaucoma or narrow-angle glaucoma.
Angle-closure glaucoma has the following symptoms.

• Hazy or blurred vision
• Appearance of rainbow colored circles around bright lights
• Severe eye and head pains
• Nausea or vomiting accompanying severe eye pain
• Sudden sight loss
• Reddening of the eyes

Both open-angle glaucoma and angle-closure glaucoma can be primary or secondary conditions. It is primary when the cause is unknown and secondary when it is associated with ocular or systemic diseases or conditions such as injury, medications, inflammations etc.

Another type of glaucoma is the Normal-Tension Glaucoma in which the optic nerve is damaged even though the eye pressure is not very high.

Risk Factors of Glaucoma

• Ocular Hypertension:  If your eye pressure is higher than normal, you're at increased risk of developing glaucoma.
• Age: you may be at higher risk of developing glaucoma if you're older than age 40.
• Race: Africans, African-Americans and Asians are at greater risk of developing glaucoma.
• Family History: If any of your relation has glaucoma, then you're at greater risk of developing it.
• Medical Conditions: Several medical conditions such as diabetes, hypertension, thyrotoxicosis and heart diseases may increase your risk of developing glaucoma.
• Cigarette Smoking: Cigarette smoking has been linked to glaucoma development in young individuals.
• Eye Conditions: Severe eye injuries, tumors, eye inflammations, retinal detachment, myopia and lens dislocation may increase your risk of developing glaucoma.
• Long-Term Use of Steroid: Use of corticosteroid medication (especially eyedrops) for a long period of time may increase your risk of developing secondary glaucoma.

Treatment

Glaucoma can't be cured and the damage on the optic nerve can never be reversed. However treatment can slow or prevent further damage and subsequent loss of vision.
Glaucoma can be treated with eye eyedrops, oral medications and/or surgery.

Eyedrops: Eyedrops reduces raised eye pressure by either increasing the outflow of the fluid in the eye or by reducing the rate at which they are produced by the ciliary body. Example of such eyedrops includes; prostaglandins (xalatan and lumigan), Beta blockers (timolol and betaxolol), Alpha-adrenergic agonist (iopidine and alphagan), Carbonic anhydrase inhibitors (trusopt and azopt) and Miotic or Cholinergic agents (pilocarpine and carbachol).
Oral Medications: Doctors usually prescribe oral medications when eyedrops alone can't bring your eye pressure down to a desired level. The oral medication is usually in form of carbonic anhydrase inhibitors.
Surgery: You may need surgery if medications are ineffective or if you can't tolerate them but there are possible complications from glaucoma surgery such as inflammation, infection, loss of vision etc.
Surgery that may be performed to treat glaucoma are laser surgery, filtering surgery and drainage implant.

Health Tips

1. Get regular eye examination by an ophthalmologist or optometrist.
2. Treat ocular hypertension if you have it.
3. Eat a healthy diet and avoid cigarette smoking.
4. Wear eye protection especially when engaged in sports activities as eye injuries can lead to secondary glaucoma (traumatic glaucoma).
5. If you develop glaucoma, tell your family about it and have them get good exams.
6. Take regular exercise such as walking or joggling three or more times every week.
7. Eat more antioxidant rich foods and avoid foods like bread, pasta and sugar.
8. Reduce or stop the intake of trans fatty acids found in fries, donuts, processed foods, cookies, crackers etc.
9. Avoid coffee, alcohol, tobacco and drink 6-8 glasses of filtered water daily.