Different Types of Glaucoma

Primary Open-Angle Glaucoma: What is it? 

The most prevalent kind of glaucoma, known as Primary Open-Angle Glaucoma (POAG), affects around three million Americans. It takes place when the drainage canals in the eye clog up over time. 

Because the appropriate volume of fluid cannot drain out of the eye, the inner eye pressure (also known as intraocular pressure or IOP) increases. The drainage canal openings are visible and ought to be functioning properly in open-angle glaucoma. Similar to a clogged pipe underneath the drain in a sink, the clogging issue develops farther inside the drainage canals. 

The majority of folks don’t exhibit any symptoms or warning signals. Undiagnosed and untreated open-angle glaucoma can result in a progressive loss of vision. This particular form of glaucoma develops gradually, sometimes without any obvious vision loss for many years. When treated early on, it typically responds favorably to medicine. 

Glaucoma is typically brought on by higher eye pressure. The amount of fluid generated and the amount of fluid leaving the eye are in balance in a healthy eye. When the drainage channels are open but do not effectively drain fluid, primary open-angle glaucoma develops. Our eyes have built-in drainage systems to maintain a healthy balance. 

A deeper problem that affects the natural drainage system of the eye is the cause of primary open-angle glaucoma. The drainage system of the eye functions like a sink. An overflow will happen if a clog forms or if fluid is produced more quickly than it can be expelled. This overflow raises the pressure inside the eye. The part of the eye most susceptible to harm from high pressure is the optic nerve. The optic nerve can start to atrophy by sustained high pressure or pressure spikes. Glaucoma has the potential to cause permanent blindness if untreated.

Types of Open-Angle Glaucoma

Primary Open-Angle Glaucoma 

Primary open-angle glaucoma is characterized by an open drainage angle of the eye but insufficient aqueous humor drainage. As a result, the drainage system of the eye slowly becomes clogged over time, gradually raising intraocular pressure. This particular form of glaucoma is painless and frequently goes unreported until the optic nerve damage gets worse, sometimes leading to blindness before a person even realizes there is a problem. Primary open-angle glaucoma is more prevalent in African Americans and can run in families. 

Low-Pressure Glaucoma

Low-pressure glaucoma, also known as normal-tension glaucoma, is distinguished by damage to the optic nerve and visual loss even while intraocular pressure is not elevated over the usual range. Lack of Poor blood flow to the optic nerve is also known to cause low-pressure glaucoma, which has been linked to a number of illnesses such as migraines, Raynaud’s disease, and sleep apnea. 

NORMAL-TENSION GLAUCOMA: WHAT IS IT? 

Normal-tension glaucoma (NTG), also known as low-tension or normal-pressure glaucoma, is a condition in which the optic nerve is harmed without the eye pressure rising over the normal range (usually between 12-21mm Hg). Whether NTG is a distinct condition from primary open angle glaucoma (POAG) or merely another type of POAG is up for dispute among glaucoma specialists. 

What differs in normal-tension glaucoma? 

There are a few characteristics that seem to be more prevalent in NTG than in POAG, whether or not NTG is a distinct entity from POAG. Visual field abnormalities in NTG patients typically occur closer to the center of vision. Additionally, patients with NTG frequently experience hemorrhages in the tiny blood capillaries of the optic nerve. NTG has been linked to both low blood pressure and migraines. 

Normal-tension glaucoma: What causes it?? 

It is thought that NTG is more likely than POAG to be caused by reasons unrelated to ocular pressure. These include structural weaknesses in the optic nerve tissue as well as irregularities in the blood flow to the optic nerve. Why some optic neurons are harmed by relatively modest eye pressure levels is still being researched. 

Diagnosing Normal-Tension Glaucoma

The same tests that are used to diagnose POAG are also utilized to diagnose NTG. In order to confirm that the eye pressure is within the normal range, your doctor may also take repeated readings of your eye pressure during the day. Your doctor could advise brain and optic nerve imaging in some circumstances if the optic nerve appearance is unusual for glaucoma in order to rule out other potential causes of optic nerve damage. 

The Management of Normal-Tension Glaucoma 

Similar to POAG, normal-tension glaucoma is treated by lowering the ocular pressure using a medication, laser therapy, and surgery. Although there is presently no medication that may directly alter blood flow to the optic nerve, it may play a significant role in NTG. The optic nerve blood flow may be impacted by over-medicating for high blood pressure. Your ophthalmologist might advise speaking with your primary care physician about changing your medication regimen in order to keep your blood pressure at a healthy level.

Congenital Glaucoma 

Congenital glaucoma is a type of condition that affects infants and very young children as a result of improper eye drainage angle development. Congenital glaucoma signs and symptoms frequently involve light sensitivity, runny eyes, or a propensity to want to keep the eyes closed. Additionally, the eyes may have hazy corneas and enlarge more than usual.

Angle-Closure Glaucoma: What is it? 

Acute glaucoma and narrow-angle glaucoma are other names for this form of glaucoma. It differs greatly from open-angle glaucoma in that the ocular pressure typically rises very quickly. It is significantly more uncommon. 

Angle-Closure Glaucoma develops when the drainage canals become blocked or obscured, similar to a sink with a blockage in the drain. 

The iris is not as open and wide as it should be with angle-closure glaucoma. When the pupil dilates too quickly or too dramatically, the outer margin of the iris gathers over the drainage canals. This may occur when entering a dimly lit space. 

You can determine whether your angle is normal and wide or irregular and narrow with a quick test. 

Angle-closure glaucoma symptoms can include nausea, headaches, rainbows surrounding lights at night, and extremely blurry vision. 

Types of Angle-Closure Glaucoma

Chronic Angle-Closure Glaucoma

Chronic angle-closure glaucoma is distinguished by a steady, progressive constriction of the eye’s drainage angle, unlike an acute episode. It takes more extensive damage or an acute attack for this type of glaucoma to show symptoms. In people who are farsighted, chronic angle-closure glaucoma is more common. 

Secondary Angle-Closure Glaucoma 

Trauma or underlying diseases that obstruct the angle frequently lead to secondary angle-closure glaucoma. Secondary angle-closure glaucoma can be acute or chronic, just like primary angle-closure glaucoma. 

Secondary Open-angle Glaucoma Types 

Secondary open-angle glaucoma can take many distinct forms. These types of glaucoma typically develop as a result of trauma, drugs (particularly steroids), irregular material deposits in the drainage angle, or both. 

Pseudoexfoliative Glaucoma

The buildup of a fibrillary protein substance in the drainage angle and other eye structures results in pseudoexfoliative glaucoma. This hinders the eye’s ability to drain fluid properly. The majority of adults with pseudoexfoliative glaucoma are of northern European ancestry. 

What is pigmentary glaucoma and pigment dispersion syndrome? 

Pigment dispersion syndrome is a disorder where the colored component of the eye, the iris, releases pigment that becomes caught in the drainage system of the eye. The pigment can obstruct the drain, which might therefore raise ocular pressure. 

Pigmentary Glaucoma

In pigmentary glaucoma, a pigment that has flaked off from the iris slowly accumulates in the drainage tracts of the eye and produces sporadic rises in intraocular pressure. Granules of pigment can become loose during a vigorous activity like jogging. One of the few kinds of glaucoma that affects young people, it most frequently affects nearsighted young men. 

During an eye exam, it is possible to spot the signs of pigment dispersion syndrome, including areas of iris pigment loss and an abundance of pigment in the drainage area. 

Blurred vision and rainbow-colored haloes around lights are only two signs of these eye pressure surges. Although there is less pigment dispersion as people get older, glaucoma is still a possibility for them. 

How Does Glaucoma Develop From Pigment Dispersion Syndrome? 

Elevated eye pressure and lasting damage to the drain can result from pigment dispersion syndrome. The optic nerve may be harmed over time by the increased eye pressure, leading to pigmentary glaucoma. Glaucoma that is not treated can cause visual loss and finally blindness. 

How is pigmentary glaucoma managed by doctors? 

The goal of pigmentary glaucoma treatment is to reduce eye pressure by the use of drugs, lasers, or surgery. Unfortunately, it is challenging to stop or significantly slow down the release of iris pigment. As a result, efforts are concentrated on lowering eye pressure. 

Medication to lower eye pressure either result in less fluid entering the eye or more fluid exiting the eye. Surgery options might range from outpatient laser therapy to incisional surgery in the operating room, depending on the disease’s severity. 

What to know?

Patients with pigment dispersion syndrome should undergo routine monitoring because it is a risk factor for glaucoma development. Treatment for patients with pigmentary glaucoma can be effective. Thankfully, many individuals can keep their good vision thanks to innovative treatments.

Angle-Recession Glaucoma

Physical damage to the drainage angle reduces its capacity to drain fluid from the eye in angle-recession glaucoma. After the initial eye injury, this kind of glaucoma might appear years or even decades later. 

Glaucoma Induced by steroids   

Intraocular pressure might rise as a result of topical or systemic steroid therapy, such as prednisone. Sometimes the pressure increase is significant enough or lasts long enough to damage the optic nerve and result in visual loss due to glaucoma. Steroid-induced glaucoma is the term for this condition.

Uveitic Glaucoma 

Uveitis, or swelling and inflammation of the uvea, the central layer of the eye, is referred to as uveitic glaucoma. The majority of the retina’s blood supply is provided by the uvea. In cases of uveitis, either the inflammatory reaction itself or the steroid medicine used to treat it might cause elevated ocular pressure.

Neovascular Glaucoma

Blood vessels can increase in number on the iris and in the drainage structures of the eye as a result of a number of diseases, including diabetes. The drainage angle may get blocked by this buildup of blood vessels, which can cause neovascular glaucoma.

Treatment for different types of glaucoma

Angle-closure glaucoma is typically treated with laser surgery or traditional surgery, which includes removing a small part of the iris’s outer edge which blocks the drainage. In order for the additional fluid to flow, surgery helps clear the drainage channels. 

As a precaution, doctors might treat the second eye if you have angle-closure glaucoma in one. 

Angle-closure glaucoma surgery is typically effective and long-lasting. Though a chronic type of glaucoma could still develop, routine checks are still crucial. 

The iris may bow forward so far in acute angle closure glaucoma cases that it totally obstructs your eye’s angle. Acute angle closure glaucoma prevents any fluid from draining from the eye, in contrast to narrow-angle glaucoma, which still permits some drainage. It progresses swiftly, and some of its symptoms include nausea, red eyes, and excruciating pain. An urgent medical situation is acute angle closure glaucoma. The excessive pressure could permanently harm your vision if it is not lowered within a few hours. A hospital emergency department or your eye doctor should be visited right away if you notice any of these signs.

FAQ’s for different types of glaucoma

Which types of glaucoma is the most severe? 

Secondary glaucoma is a disease that can be brought on by specific medications and eye conditions. Closed-angle glaucoma, however, is most likely the disease’s most severe variation. It happens when the angle is suddenly blocked, which causes a quick increase in eye pressure. 

Do all glaucoma sufferers eventually lose their vision? 

Glaucoma is a serious, chronic eye condition that, if left untreated, can cause vision loss. However, glaucoma generally does not result in blindness. Because there are various options available to assist prevent glaucoma from further harming your eyes, glaucoma can be controlled with current treatment. 

What should people with glaucoma avoid? 

It has been established that high trans fat diets harm the visual nerve. It’s time to stop eating fried foods, baked products, and anything whose ingredient list contains hydrogenated or partially hydrogenated oils. Additionally, saturated meals like red meat, steak, lard, shortening, and oils might make glaucoma worse.