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Glaucoma


Alternative Names:

Open-angle glaucoma; Chronic glaucoma; Chronic open-angle glaucoma; Primary open-angle glaucoma; Closed-angle glaucoma; Narrow-angle glaucoma; Angle-closure glaucoma; Acute glaucoma; Secondary glaucoma; Congenital glaucoma

Symptoms:

OPEN-ANGLE GLAUCOMA

  • Most people have no symptoms
  • Once vision loss occurs, the damage is already severe
  • There is a slow loss of side (peripheral) vision (also called tunnel vision)
  • Advanced glaucoma can lead to blindness

ANGLE-CLOSURE GLAUCOMA

  • Symptoms may come and go at first, or steadily become worse
  • Sudden, severe pain in one eye
  • Decreased or cloudy vision, often called "steamy" vision
  • Nausea and vomiting
  • Rainbow-like halos around lights
  • Red eye
  • Eye feels swollen

CONGENITAL GLAUCOMA

  • Symptoms are usually noticed when the child is a few months old
  • Cloudiness of the front of the eye
  • Enlargement of one eye or both eyes
  • Red eye
  • Sensitivity to light
  • Tearing
Treatment:

The goal of treatment is to reduce eye pressure. Treatment depends on the type of glaucoma that you have.

If you have open-angle glaucoma, you will probably be given eye drops. You may need more than one type. Most people can be treated successfully with eye drops. Most of the eye drops used today have fewer side effects than those used in the past. You may also be given pills to lower pressure in the eye.

Other treatments may involve:

  • Laser therapy called an iridotomy
  • Eye surgery if other treatments do not work

Acute angle-closure attack is a medical emergency. Blindness will occur in a few days if it is not treated. If you have angle-closure glaucoma, you will receive:

  • Eye drops
  • Medicines to lower eye pressure, given by mouth and through a vein (by IV)

Some people also need an emergency operation, called an iridotomy. This procedure uses a laser to open a new pathway in the colored part of the eye. This relieves pressure and prevents another attack.

Congenital glaucoma is almost always treated with surgery. This is done using general anesthesia. This means the patient is asleep and feels no pain.

If you have secondary glaucoma, treatment of the underlying disease may help your symptoms go away. Other treatments may be needed.

Expectations (prognosis):

Open-angle glaucoma cannot be cured. However, you can manage your symptoms by closely following your doctor's instructions. Regular check-ups are needed to prevent blindness.

Angle-closure glaucoma is a medical emergency. You need treatment right away to save your vision.

Babies with congenital glaucoma usually do well when surgery is done early.

How well a person with secondary glaucoma does depends on the disease causing the condition.

Calling your health care provider:

Call your health care provider if you have severe eye pain or a sudden loss of vision, especially loss of peripheral vision.

Call for an appointment with your health care provider if you have risk factors for glaucoma and have not been screened for the condition.

Prevention:

All adults should have a complete eye exam before age 40, or sooner if you have risk factors for glaucoma or other eye problems. You are more likely to get glaucoma if you are African American or have a family history of open-angle glaucoma.

If you are at high risk for acute glaucoma, talk to your doctor about having eye surgery to prevent an attack.

References:

Anderson DR. The Optic Nerve in Glaucoma. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 48.

Kwon YK, Caprioli J. Primary Open-Angle Glaucoma. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 52.

Giaconi JA, Law SK, Caprioli J. Primary Angle-Closure Glaucoma. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 53.

Mandelcorn E, Gupta N. Lens-Related Glaucomas. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 54A.


Review Date: 9/14/2011
Reviewed By: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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