Glaucoma
Glaucoma is a disease where optic nerve damage causes visual field loss. As the optic nerve is continuously damaged,
it requires ongoing treatment. Optic nerve damage causes visual field loss that gradually narrows, and if left untreated, can lead to blindness.
Once damaged, the optic nerve cannot recover, so early diagnosis and treatment are essential.
NormalNormal Vision
Damaged,
EnlargedEye with Glaucoma
Glaucoma Causes
Optic nerve damage from elevated intraocular pressure, or damage progression from impaired blood flow to the optic nerve.
Risk increases with age, high myopia, or family history. Not always inherited, but family history increases incidence 2-3x, so early screening is recommended.
Can occur with eye trauma, long-term steroid use, or systemic diseases like hypertension/diabetes/cardiovascular disease/atherosclerosis.
Once damaged, the optic nerve cannot recover. However, early detection can prevent blindness. Therefore, early diagnosis and treatment are best for this chronic condition.
Glaucoma Types
Glaucoma is a disease where optic nerve damage narrows the visual field, classified by cause and progression.
There are also secondary glaucoma from other eye or systemic diseases, and congenital glaucoma from structural abnormalities.
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| Category | Open-angle Glaucoma | Angle-closure Glaucoma | Acute Glaucoma | Chronic Glaucoma |
|---|---|---|---|---|
| Onset | Gradual, slow progression | Sudden, acute onset | Sudden, rapid IOP spike, acute attack | Slow progression, few early symptoms |
| IOP Change | Gradual rise | Rapid rise | Sharp rise in short time | Gradual rise or progression at normal IOP (includes normal-tension glaucoma) |
| Visual Field | Peripheral field narrows gradually | Rapid field loss, central vision may be affected | Acute field loss, blurred vision·rainbow halos, central vision may be affected | Chronic field loss, peripheral field narrows gradually |
| Symptoms | Mostly no early symptoms, silent progression | Severe eye pain, headache, blurred vision, rainbow pupils, possible vomiting | Extreme eye pain, headache, nausea·vomiting, redness, blurred vision, poor pupil response | No early symptoms, field loss·obstruction as it progresses |
| Cause | Normal drainage angle structure but reduced outflow function | Drainage angle suddenly blocked, outflow blocked | Sudden drainage pathway (angle) closure blocks aqueous flow | Angle open but poor outflow, optic nerve gradually damaged |
| Treatment | IOP control with medication, laser, surgery | Emergency medication, laser iridotomy, surgery if needed | Emergency medication, then laser iridotomy or surgical correction required | Long-term IOP control and optic nerve protection via medication·laser·surgery |
Glaucoma Symptoms
Normal Vision
Narrowed Vision in Glaucoma Patient
Difficulty focusing
Redness or vision decline
Blurred vision with pain
Heavy, easily tired eyes
Early morning headaches
Halos
Glaucoma Examination Equipment
Equipment
TOPCON NCT-800
Non-contact tonometer
Equipment
HUVITZ HOCT-1F
Optical coherence tomographer
Equipment
Optos Daytona
Non-mydriatic wide-angle fundus camera
Equipment
ZEISS Model 830
Automated perimeter
Equipment
ZEISS CIRRUS 5000
Non-contact tonometer
Equipment
Icare AIFLAME001
Wide-angle fundus camera
Glaucoma Treatment
Since damaged optic nerve cannot be restored, preventing further damage, not 'vision recovery', is key.
Treatment focuses on lowering IOP to prevent further optic nerve damage,
and selects appropriate method from medication, laser, or surgery based on patient condition and disease progression.
Regular exams and consistent management are the most reliable way to slow progression.
Point 01
Medication
Basic treatment, controls IOP with eye drops.
Reduces aqueous (eye fluid) production or aids drainage to relieve optic nerve pressure.
May combine two or more medications as needed.
Point 02
Laser Treatment
When medication fails or angle-closure glaucoma is present, laser widens drainage pathways
or creates new outflow routes to lower IOP.
Minimal pain, quick recovery.
Point 03
Surgery
When medication and laser are insufficient.
Surgery creates bypass for aqueous outflow
Trabeculectomy, drainage valve insertion are typical,
recently Minimally Invasive Glaucoma Surgery (MIGS) with faster recovery and fewer complications is also performed.
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