Glaucoma

Glaucoma is caused by optic nerve damage and leads to progressive irreversible loss of vision. The damage occurs when pressure increases within the eye. Vision loss can occur so slowly that it may go unnoticed for a long time. About 3million people in the US and 14 million worldwide are affected. It is the 3rd leading cause of blindness globally and 2nd in the US. Among African and Hispanic Americans it is the primary cause of blindness. People over 40, diabetic or longterm users of corticosteroids are at high risk. Injuries to the eye also increase risk.

Essentially the condition occurs when an imbalance in production and drainage of fluid in thee eye increase pressure to unhealthy levels. Aqueous fluid is produced by a ciliary body behind the Iris. This fluid flows from the pupil to the anterior chambers then exits through the drainage canal between the iris and the cornea. It is meant to be nourishing. When the system is working properly fluid flows like a faucet down into a sink drain but in glaucoma the sink is backed up while the faucet is still running. The fluid is not draining even though new fluid is being produced. The clogged canals cause pressure to increase on the optic nerve. Only being able to tolerate so much the pressure damages the nerve.

There are 2 types of Glaucoma: Open Angle is more common and occurs when canals become clogged over months or years. In this case the pressure in the eye rises more slowly as the fluid production remains normal but drains sluggishly. It can be painless so the most important symptoms are blind spots or patches of vision loss that become larger and coalesce. Peripheral vision is usually lost first. Gradually people develop tunnel vision and then become blind in all directions.

Closed Angle is less common and occurs when drainage canals become blocked or covered because the angle between the iris and and cornea is too narrow. Blockage can occur slowly making the rate of pressure increase slowly. If it is sudden, pressure rises rapidly. Mostly the cause is unknown but it tends to be hereditary. Sometimes damage is caused by infection, inflammation, tumors, large cataracts or even surgery from cataracts. At risk people should have regular eye exams and take care to control pressure throughout life.

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