Glaucoma (cont.)

Primary open-angle glaucoma cannot be prevented, given our current state of knowledge. However the optic-nerve damage and visual loss resulting from glaucoma can be prevented by earlier diagnosis, effective treatment, and compliance with treatment.

Secondary types of glaucoma can often be prevented by avoidance of trauma to the eye and prompt treatment of eye inflammation and other diseases of the eye or body that may cause secondary forms of glaucoma.

Most cases of visual loss from angle-closure glaucomas can be prevented by the appropriate use of laser iridotomy in eyes at risk for the development of acute or chronic angle-closure glaucoma.

New eyedrops will continue to become available for the treatment of glaucoma. Some drops will be new classes of agents. Other drops will combine some already existing agents into one bottle to achieve an additive effect and to make it easier and more economical for patients to take their medication.

Many researchers are investigating the therapeutic role of neuroprotection of the optic nerve, especially in patients who seem to be having progressive nerve damage and visual field loss despite relatively normal intraocular pressures. Animal models have shown that certain chemical mediators can reduce injury or death of nerve cells. Proving such a benefit for the human optic nerve, however, is more difficult because, for one thing, biopsy or tissue specimens are not readily available. Nevertheless, if any of these mediators in eyedrops can be shown to protect the human optic nerve from glaucomatous damage, this would be a wonderful advance in preventing blindness.

In other studies, new surgical methods are being evaluated to lower the intraocular pressure more safely without significant risk of damage to the eye or loss of vision.

Finally, increased efforts to enhance public awareness of glaucoma, national free screenings for those individuals at risk, earlier diagnosis and treatment and better compliance with treatment are our best hopes to reduce vision loss from glaucoma.

• Glaucoma is a disease that is often associated with elevated intraocular pressure, in which damage to the eye (optic) nerve can lead to loss of vision and even blindness.
• Glaucoma is the leading cause of irreversible blindness in the world.
• Glaucoma usually causes no symptoms early in its course, at which time it can only be diagnosed by regular eye examinations (screenings with the frequency of examination based on age and the presence of other risk factors).
• Intraocular pressure increases when either too much fluid is produced in the eye or the drainage or outflow channels (trabecular meshwork) of the eye become blocked.
• While anyone can get glaucoma, some people are at greater risk.
• The two main types of glaucoma are open-angle glaucoma, which has several variants and is a long duration (chronic) condition, and angle-closure glaucoma, which may be a sudden (acute) condition or a chronic disease.
• Damage to the optic nerve and impairment of vision from glaucoma are irreversible.
• Several painless tests that determine the intraocular pressure, the status of the optic nerve and drainage angle, and visual fields are used to diagnose glaucoma.
• Glaucoma is usually treated with eyedrops, although lasers and surgery can also be used. Most cases can be controlled well with these treatments, thereby preventing further loss of vision.
• Much research into the causes and treatment of glaucoma is being carried out throughout the world.
• Early diagnosis and treatment is the key to preserving sight in people with glaucoma.

Previous contributing authors and editor:

Medical Authors: Lawrence J. Schwartz, MD, and Camille Hylton, MD
Medical Editor: Leslie J. Schoenfield, MD, PhD

REFERENCES:

American Academy of Ophthalmology. "Primary Angle Closure, Preferred Practice Pattern." Oct. 2010.

American Academy of Ophthalmology. "Primary Open-Angle Glaucoma, Preferred Practice Pattern." Oct. 2010.

American Academy of Ophthalmology. "Primary Open-Angle Glaucoma Suspect, Preferred Practice Pattern." 2005.

Last Editorial Review: 11/5/2010

Source: MedicineNet.com
http://www.medicinenet.com/glaucoma/article.htm