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DOCTOR AT THE DESK

Glaucoma

"Vision at the End of the Tunnel"
By: Marc Evans Abat, MD, FPCP, FPCGMGlaucoma

You glare at something with those steely eyes, as if your sight needs to penetrate that object.  Your vision tunnels around you, and it becomes painful just looking at anything.  Your eyes are blood-shot , as if ready to bleed out.  Sadly, this is not Clint Eastwood staring down at something through the sight of his gun.  It can be anybody… with glaucoma!

The main culprit in the disease is eye pressure.  In the front of the eye, there is a space called the anterior chamber that is filled with a fluid called aqueous humour.  This fluid drains through a trabecular meshwork near the angle between the iris (the colored part of the eye) and the cornea (the clear covering over the front of the eye).  Any problem that may prevent proper movement or circulation of the fluid through the meshwork causes increased eye pressure and hence, glaucoma.

The most common types of Glaucoma are

  • Open-angle glaucomais the most common type. Think of it as the eye having what seems to be normal structures but the aqueous humour cannot seem to flow properly through the trabecular meshwork, leading to an increased eye pressure. 
  • Angle-closure or Narrow-angle glaucoma is the less common type. The drainage of the aqueous humour is narrow or even suddenly closes, sometimes leading to a rapid increase in eye pressure. 

There are other less common types like congenital glaucoma, or secondary glaucoma from trauma or surgical complications.

So how do you know whether or not you have glaucoma?  Some people can actually go on for some time without feeling any symptoms.  That is why it is important for you to see your ophthalmologist or eye doctor on a regular basis (after age 40), maybe every 1-2 years, for a regular eye exam.Management of glaucoma can be through medications or through surgery.  It is important to detect glaucoma early since late treatment cannot restore any vision that is already lost from damage to the optic nerve.  Medications can either be eye drops or oral tablets. 

Glaucoma cannot be prevented, so it is important to have early detection and treatment to prevent permanent visual loss.

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