Glaucoma is a group of diseases of the optic nerve involving loss of retinal ganglion cells in a characteristic pattern of optic neuropathy. Although raised intraocular pressure is a significant risk factor for developing glaucoma, there is no set threshold for intraocular pressure that causes glaucoma. One person may develop nerve damage at a relatively low pressure, while another person may have high eye pressures for years and yet never develop damage. Untreated glaucoma leads to permanent damage of the optic nerve and resultant visual field loss, which can progress to blindness.
Types
The most common type,
primary open angle glaucoma (POAG) (), frequently has no symptoms and has been nicknamed "the sneak thief of sight". One factor may be a relative obstruction on the outflow of
aqueous humour from the eye. Aqueous humour is produced by the
epithelium lining the eye's
ciliary body which then flows through the
pupil and into the anterior chamber. The
trabecular meshwork then drains the humour to
Schlemm's canal, and ultimately to the
venous system. All eyes have some intraocular pressure, which is caused by some resistance to the flow of aqueous through the trabeculum and Schlemm's canal. If the intraocular pressure (IOP) is too high, (>21.5 mm Hg), the pressure exerted on the walls of the eye results in compression of the ocular structures. However, other factors such as disturbances of blood flow in the optic nerve head may interact with IOP to affect the optic nerve. In one third of cases of POAG there is statistically normal IOP. This is called
normal tension glaucoma (NTG). Because optic nerve examination and
perimetry testing are not always done in addition to IOP measurement in those at risk, NTG is underdiagnosed and the condition presents late.
Pigmentary glaucoma, caused by
pigment dispersion syndrome, is a form of POAG.
Another type, acute angle-closure glaucoma (AACG) (), is characterized by an acute rise in the intraocular pressure. This occurs in susceptible eyes when the pupil dilates and blocks the flow of fluid through it, leading to the peripheral iris blocking the trabecular meshwork. Acute angle-closure glaucoma can cause pain and reduced visual acuity (blurred vision), and may lead to irreversible visual loss within a short time. This is an ocular emergency requiring immediate treatment. Many people with glaucoma experience halos around bright lights as well as the loss of sight characterized by the disease.
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Glaucoma - Explains how this eye disease affects people of all ages, and shows what things look like to someone who has it.
Glaucoma - Discusses how this disease affects the eye, the different forms, symptoms and diagnosis, and treatment and prevention.
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