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Primary Open-Angle Glaucoma (POAG)
Angle-Closure Glaucoma
Medications
Laser Therapy
Surgery
What is Glaucoma?
Glaucoma is a common eye problem in which damage to the optic nerve can lead to vision loss. The optic nerve carries the visual information collected in the eye to the brain. Damage to the optic nerve is often found in patients with high intraocular pressure (IOP), the pressure within the eye.
The deterioration in vision that occurs in glaucoma usually happens gradually and is unnoticeable. Peripheral vision is affected first.
Australia is estimated to have 300,000 people with glaucoma however only 50% of these people will have been diagnosed.[1] For this reason, regular eye checks are advisable for people who are middle-aged or older.
"Depiction of vision for a Glaucoma patient" courtesy of MyUpchar Digital Hospital Licenced under Creative Commons.
Primary Open-Angle Glaucoma (POAG) is the most common type of glaucoma. It develops gradually, causing a slow loss of peripheral vision. In POAG, the drainage network of the eye becomes less efficient over time, leading to an increase in intraocular pressure. Chronic elevated pressure can damage the optic nerve and result in gradual loss of peripheral vision, tunnel vision and if left untreated, eventually blindness.
Angle-Closure Glaucoma occurs when the space between the iris (the colored part of the eye) and the drainage network is too narrow, blocking necessary fluid drainage. Sudden or acute angle closure can result in a sudden increase in intraocular pressure, leading to symptoms like blurred vision, rainbow halos around light, intense pain around the eye or general discomfort and possibly nausea. Acute angle-closure glaucoma is considered a medical emergency.
Types of Glaucoma
There are several types of glaucoma. The most common are Primary Open-Angle Glaucoma (POAG) and Angle-Closure Glaucoma.
Glaucoma Risk Factors[2]
Family history
Aged over 50
Short or long-sighted
Diabetic
High or low blood pressure
Trauma
Surgical procedures to the eye
Managing Glaucoma
Treatment for glaucoma varies depending on the severity and type of glaucoma. Regular eye examinations, especially for individuals at higher risk, are essential for early detection and effective management of glaucoma.
Support Services
Glaucoma Australia is a non-for-profit organisation providing services and resources for individuals diagnosed with glaucoma.
References
1. Prevalence of glaucoma in the Australian National Eye Health Survey. British Journal of Ophthalmology, 103(2), 191–195. Keel, S., Xie, J., Foreman, J., Lee, P. Y., Alwan, M., Fahy, E. T., van Wijngaarden, P., Fan Gaskin, J. C., Ang, G. S., Crowston, J. G., Taylor, H. R., & Dirani, M. (2019).
2. Risk Factors for Glaucoma Onset and Progression. Survey of Ophthalmology, 53(6 SUPPL.). Coleman, A. L., & Miglior, S. (2008).
Medications
Eye Drops are the most common form of glaucoma medication. They work by either reducing the production of aqueous humour (the fluid found in the front of the eye) or by improving its drainage. Compliance with the prescribed eye drop regimen is crucial to prevent disease progression.
Oral Medications may be prescribed in some cases to help lower intraocular pressure. These medications may be used alone or in combination with eye drops.
Laser Therapy
Laser Trabeculoplasty: This procedure uses a laser to improve the drainage of fluid from the eye. Drainage occurs through a network of channels in the region where the cornea and iris meet. The laser in this procedure targets this area known as the trabecular meshwork. It is often used when eye drops are not sufficient to control intraocular pressure.
Laser Peripheral Iridotomy: This is used for certain types of angle-closure glaucoma. It involves creating a small hole in the peripheral iris to improve fluid drainage.
Surgery
Minimally Invasive Glaucoma Surgery (MIGS) These procedures are less invasive than traditional surgery and aim to reduce intraocular pressure by improving the drainage of fluid. Examples include trabecular micro-bypass stents.
Trabeculectomy
Trabulectomy is a surgical procedure that creates a new drainage channel for the aqueous humour to reduce intraocular pressure. A small piece of tissue is removed to create a new opening.
You have a higher risk of developing Glaucoma if you have one or more of these factors: