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Types Of Glaucoma

Glaucoma is a group of eye diseases that can damage the optic nerve, which connects the eye to the brain and carries images to it. The most common cause is increased pressure inside the eye, known as intraocular pressure. This pressure can gradually damage the optic nerve. However, it is important to note that glaucoma can also occur even with normal eye pressure

Glaucoma is a group of eye diseases that can damage the optic nerve, ... Read More

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Different Types Of Glaucoma

There are different types of glaucoma:

  • Open-Angle Glaucoma: This is the most common type. It occurs when fluid buildup gradually increases eye pressure, damaging the optic nerve over time.
  • Angle-Closure or Acute Glaucoma: This type is characterised by a sudden blockage of fluid drainage, which causes a rapid and severe increase in eye pressure. This is a medical emergency needing immediate attention.
  • Normal-Tension Glaucoma: Here, optic nerve damage and vision loss occur despite normal eye pressure. The cause for this remains uncertain.
  • Congenital Glaucoma: This occurs in infants from birth due to improper development of the eye’s drainage system.
  • Secondary Glaucoma: This type of glaucoma is caused by another condition like an eye injury, inflammation, or the use of certain medications.

Glaucoma is a leading cause of blindness worldwide but early detection and treatment can help prevent or slow vision loss. Regular eye exams are crucial for detecting glaucoma in its early stages.

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Types of Eye Tests for Glaucoma

There are multiple tests that your doctor may recommend to diagnose and monitor glaucoma:

  • Tonometry to Measure Eye Pressure: This test can be done using an air-puff test, where a puff of air is blown into the eye., Applanation tonometry is where eye drops numb the eye before a tool gently presses on it to measure pressure.
  • Ophthalmoscopy to Examine the Optic Nerve: Eye drops are used to dilate the pupil, enabling the doctor to examine the optic nerve’s shape, colour, and any signs of damage.
  • Visual Field Test (Perimetry) to Map the Field of Vision: During this test, you look straight ahead and press a button when you see spots of light in your peripheral vision. This test can detect vision loss caused by glaucoma.
  • Gonioscopy to Examine the Drainage Angle of the Eye: After numbing the eye with drops, a special lens is gently placed on it. This allows the doctor to check if the angle where the iris meets the cornea is open or closed.
  • Pachymetry to Measure Corneal Thickness: A probe gently touches the eye to measure the thickness of the cornea. Thin corneas are a risk factor for glaucoma.
  • Optical Coherence Tomography to Image the Optic Nerve: Laser light is used to directly measure the thickness of the nerve fiber layer.

These tests help diagnose glaucoma, determine its severity, and monitor for progression over time. A comprehensive eye exam including several of these tests is the most reliable way to definitively diagnose glaucoma.

Are you going through any of these symptoms?

Open-Angle Glaucoma

Open-angle glaucoma is the more prevalent variety, making up roughly 90% of the cases. In this type, the angle between the iris and cornea, which is an essential component of the eye’s drainage system, remains open. However, the trabecular meshwork, another crucial part of the drainage system, does not function correctly or gets blocked. This dysfunction leads to fluid accumulation inside the eye, causing a gradual increase in internal eye pressure. This pressure can cause damage to the optic nerve over time.

Some important points to note about open-angle glaucoma are:

  • Progresses Slowly: Open-angle glaucoma is a slow-progressing disease which makes it even more dangerous as one may not realise its presence until significant damage has occurred.
  • No Early Warning Signs: There are no early warning signs of this disease. The vision loss associated with it often goes unnoticed until the disease is considerably advanced.
  • Common Treatment Options: The most commonly used treatment options include eye drops that lower eye pressure and laser procedures aimed at improving drainage. In certain severe cases, surgery may be required.

Regular visits to your doctor for eye exams are crucial for the early detection and management of this condition.

Angle-Closure Glaucoma

Angle-closure glaucoma, on the other hand, occurs when the iris is pushed against the cornea, blocking the drainage angle and preventing fluid from exiting the eye. This blockage can cause a sudden spike in eye pressure, which can lead to a medical emergency.

Here are a few vital characteristics of angle-closure glaucoma:

  • Rapid Progression: Unlike open-angle glaucoma, angle-closure glaucoma progresses rapidly and requires immediate medical attention.
  • Noticeable Symptoms: Symptoms of angle-closure glaucoma are not subtle and include intense eye pain, nausea, redness in the eyes, and blurred vision.
  • Risk of Blindness: If not treated promptly, angle-closure glaucoma can lead to blindness within just a few days.

Similar to open-angle glaucoma, the treatment for this type also includes eye drops for reducing pressure, laser procedures, and in some cases, surgery. Regular eye check-ups are the key to early detection, and hence effective management of both types of glaucoma.

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Congenital Glaucoma

Congenital glaucoma is a rare but serious condition that is present at birth or manifests shortly after. This condition arises from an abnormal development of the eye’s drainage system which ultimately leads to an increase in eye pressure. The signs to watch out for include enlarged or cloudy corneas, light sensitivity, excessive tearing, and irritability in the eyes.

Identifying this condition early is crucial. A comprehensive eye exam carried out by a paediatric ophthalmologist is typically the first step towards diagnosis. Treatment often necessitates surgical measures such as a trabeculotomy, goniotomy, or drainage implants. These procedures help to improve fluid drainage, thus reducing the pressure in the eyes. The main aim of these interventions is to preserve vision and prevent further complications.

Secondary Glaucoma

In contrast to the congenital form, secondary glaucoma refers to glaucoma that occurs as a result of other congenital ocular or systemic abnormalities. These may include conditions such as aniridia, Peters anomaly, Sturge-Weber syndrome, and Lowe syndrome.

The prognosis for secondary glaucoma is generally guarded due to its association with other medical conditions. Patients often require multiple procedures and may face associated problems such as amblyopia (lazy eye), damage to the optic nerve, and corneal or lens issues that can deteriorate their visual outcome.

Medical therapy remains the first line of treatment for secondary glaucoma. However, surgical interventions such as goniotomy and trabeculotomy may also be required for adequate control of the intraocular pressure which is elevated in glaucoma.

Types of Secondary Glaucoma

When it comes to secondary glaucoma, there are various types that you need to be aware of. These are conditions that develop as a result of an existing eye or health problem. Let us explore some of these types:

  • Neovascular Glaucoma: This form is caused by abnormal blood vessel growth on the iris, the coloured part of your eye, that blocks the drainage of fluid. It often occurs due to diabetes or high blood pressure.
  • Pigmentary Glaucoma: In this type, pigment granules from the iris clog the drainage angle, obstructing fluid outflow.
  • Exfoliation Glaucoma: Here, flaky material peels off the lens and clogs up the drainage system.
  • Uveitic Glaucoma: This form is triggered by inflammation of the uvea, the middle layer of your eye, or steroid medications used to treat it.
  • Traumatic Glaucoma: As the name suggests, this type is caused by eye injuries that can either occur immediately or develop years later.
  • Steroid-Induced Glaucoma: Regular use of corticosteroid medications can lead to this form of secondary glaucoma.
  • Lens-Induced Glaucoma: This type is caused by an advanced cataract or swelling of the lens.
  • Glaucoma Associated With Retinal Disorders: Certain retinal disorders such as retinopathy of prematurity, Coats disease, and posterior scleritis can also lead to secondary glaucoma.

FAQs

What is glaucoma?

Glaucoma is a group of eye conditions that damage the optic nerve, which is crucial for good vision. Damage is usually caused by an abnormally high pressure in your eye and can lead to vision loss if not treated properly.

How many types of glaucoma are there?

There are primarily four types of glaucoma: Open-Angle (Chronic) glaucoma, Angle-Closure (Acute) glaucoma, Secondary glaucoma, and Congenital glaucoma. Each type has different causes and treatment options.

Is blindness inevitable with glaucoma?

Not necessarily. With early detection and appropriate treatment, you can protect your eyes against severe vision loss or blindness from glaucoma. Regular check-ups with your eye doctor can help catch any potential issues early on.

How often should I get tested for glaucoma?

For those over 40 and with a family history of glaucoma, it is advised to have an eye examination from your family doctor every two years. If you have health problems like diabetes or a history of glaucoma in your family, you may need an eye exam more often.

What treatment options are available for glaucoma?

Treatment options for glaucoma include prescription eye drops, oral medications, laser therapy, or surgery. The choice of treatment depends on the type and severity of your glaucoma.

Can glaucoma be prevented?

While glaucoma cannot be prevented, its progression can be slowed down with early detection and treatment. Regular eye examinations are crucial, especially if you have risk factors like family history, diabetes or high blood pressure.

What are the symptoms of glaucoma?

Symptoms can vary depending on the type of glaucoma. For example, Open-Angle glaucoma is often symptomless in the early stages, whereas Angle-Closure glaucoma can cause sudden symptoms such as blurry vision, halos around lights, intense eye pain, nausea and vomiting.

How is glaucoma diagnosed?

The diagnosis of glaucoma includes a comprehensive eye examination: visual acuity test, visual field test, dilated eye examination, pressure measurement (tonometry), and imaging tests to create a detailed picture of your optic nerve for future comparison.

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Medically Reviewed By
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Dr. Piyush Kapur
28 Years Experience Overall
Last Updated : February 26, 2025