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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
  • 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. You may notice:

  • 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 most often 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

SECONDARY GLAUCOMA

  • Symptoms are most often related to the underlying problem causing the glaucoma
  • Depending on the cause, symptoms may either be like open-angle glaucoma or angle-closure glaucoma
Treatment:

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

OPEN-ANGLE GLAUCOMA

  • 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 with eye drops.
  • Most of the eye drops used today have fewer side effects than those used in the past.
  • You also may be given pills to lower pressure in the eye.

If drops alone do not work, you may need other treatment:

  • Laser treatment uses a painless laser to open the channels where fluid flows out.
  • If drops and laser treatment do not work, you may need surgery. The doctor will open a new channel so fluid can escape. This will help lower your pressure.
  • Recently, new implants have been developed that can help treat glaucoma in people having cataract surgery

ACUTE ANGLE GLAUCOMA

An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated.

  • You may be given drops, pills, and medicine given through a vein (by IV) to lower your eye pressure.
  • Some people also need an emergency operation, called an iridotomy. The doctor uses a laser to open a new channel in the iris. Sometimes this is done with surgery. The new channel relieves the attack and will prevent another attack.
  • To help prevent an attack in the other eye, the procedure will often be performed on the other eye. This may be done even if it has never had an attack.

CONGENTIAL GLAUCOMA

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

SECONDARY GLAUCOMA

If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed.

Outlook (Prognosis):

Open-angle glaucoma can't be cured. You can manage it and keep your sight by following your doctor's directions.

Closed-angle 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 you do with secondary glaucoma depends on what is causing the condition.

When to Contact a Medical Professional:

If you have severe eye pain or a sudden loss of vision, get immediate medical help. These may be signs of closed-angle glaucoma.

Prevention:

You cannot prevent open-angle glaucoma. Most people have no symptoms. But you can help prevent vision loss.

  • A complete eye exam can help find open-angle glaucoma early, when it is easier to treat.
  • All adults should have a complete eye exam by the age of 40.
  • If you are at risk for glaucoma, you should have a complete eye exam sooner than age 40.
  • You should have regular eye exams as recommended by your health care provider.

If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss.

References:

Anderson DR. The optic nerve in glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 48.

Giaconi JA, Law SK, Caprioli J. Primary angle-closure glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 53.

Kwon YK, Caprioli J. Primary open-angle glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 52.

Mandelcorn E, Gupta N. Lens-related glaucomas. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology. 2013 ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 3, chap 54A.

Saheb H, Ahmed II. Micro-invasive glaucoma surgery: current perspectives and future directions. Curr Opin Ophthalmol. 2012 Mar;23(2):96-104. PMID: 22249233 www.ncbi.nlm.nih.gov/pubmed/22249233.


Review Date: 11/5/2014
Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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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