Glaucoma is a medical condition of an eye disease as result of
the damage of the nerve of eye’s optic over time. If left untreated, it
can lead to permanently vision impair and blindness.
I. Types of glaucoma(a)
There are several types of glaucoma. The two main types are
(Chronically)open-angle and (Acutely)angle-closure both as a result of
increase of intraocular pressure (IOP), or pressure inside the eye.
A. Open-Angle Glaucoma affects about three million Americans.
Open-angle glaucoma is the most common form of glaucoma. According to the statistic, it effects over 90% in all glaucoma cases:
1. Open-Angle Glaucoma caused by the slow progesion of
clogging of the drainage canals, resulting in increased intraocular
pressure (IOP). In the study to investigate risk factors for primary
open-angle glaucoma (POAG) and pseudoexfoliative glaucoma (PEXG), showed
that intraocular pressure (IOP) was the only factor associated with
both POAG and PEXG, whereas moderate-to-high myopia showed borderline
significance in both. Vascular systemic diseases and their treatment
were associated only with POAG. The implications of these differences
for the pathogenesis between the 2 common types of OAG should be
explored further(1).
2. Open-Angle Glaucoma as a result of the area between the iris and cornea (The angle) widen.
3. Open-Angle Glaucoma develops slowly and is a lifelong condition
In the 6-year follow-up study of 118 control patients: 46 with
high-tension glaucoma (HTG), 57 with normal-tension glaucoma (NTG), and
15 with pseudoexfoliation glaucoma (PEXG)., the median untreated rate of
progression corresponded to advancing from normal visual function to
blindness in approximately 70 years, whereas on the basis of the mean
rate, visual function would show the same deterioration in approximately
25 years. Large differences existed among patients and different
glaucoma types, with PEXG progressing considerably faster than HTG, and
NTG progressing at the lowest rate(2).
4. Symptoms and Damage
The symptoms of gradually progressive visual field loss, and optic nerve
changes (increased cup-to-disc ratio on fundoscopic examination) has
not been noticed in the early stage of the diseases.
There is a report of 3 cases of ocular injuries were described in young
patients, due to accidental fall of durian fruit on the forehead and
face, while they were taking rest/sleeping /playing under the durian
tree. The ocular injuries observed were lacerating injury of cornea with
iris incarceration, hyphema, superficial penetrating injury of sclera
and angle recession glaucoma in the right eye of first patient;
lacerating injury of cornea with iris prolapse in the left eye of second
patient; subconjunctival haemorrhage, traumatic mydriasis and
superficial penetrating injury of sclera, commotion retinopathy and
macular edema in the left eye of third patient(3).
B. Angle-Closure Glaucoma
Angle-closure glaucoma is a less common form of glaucoma
1. Caused by Sudden rise in intraocular pressure due to blockage of drainage canals and Develops very quickly
Psychotropic agents may frequently be associated with ocular adverse
effects, which include angle-closure glaucoma. There is a report of a
case of pseudoexfoliation glaucoma in which intraocular pressure (IOP)
increased within hours after carbamazepine and gabapentin intake, with
no observable evidence of any angle closure(4)
2. Caused by a closed or narrow angle between the iris and cornea
In the study of 5,308 respondents to the Baltimore Eye Survey, a
cross-sectional, population-based survey conducted in a multiracial
urban community, of that 4,870 subjects whose eyes were dilated on
screening examination, none developed acute angle-closure glaucoma.
However, 38 patients of the 1,770 who were referred for definitive eye
examination were judged to have occludable angles on the basis of
gonioscopic methods(5).
3. Symptoms and damage that are usually very noticeable
Paience with Angle-closure glaucoma may be experience the symptoms
of sudden ocular pain, seeing halos around lights, red eye, very high
intraocular pressure (>30 mmHg), nausea and vomiting, suddenly
decreased vision, and a fixed, mid-dilated pupil, etc. as a result of
damage due to medication, etc.
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Sources
(a) tp://www.glaucoma.org/glaucoma/types-of-glaucoma.php
(1) http://www.ncbi.nlm.nih.gov/pubmed/21664597
(2) http://www.ncbi.nlm.nih.gov/pubmed/19854514
(3) http://www.ncbi.nlm.nih.gov/pubmed/22937520
(4) http://www.ncbi.nlm.nih.gov/pubmed/23429633
(5) http://www.ncbi.nlm.nih.gov/pubmed/8540544
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