Glaucoma is a term subsuming several disorders of the eye accompanied by damage of the optic nerve. This damage is often caused by an increased intraocular pressure (ocular hypertension) or a disorder of the optic nerve blood flow.
Different forms of glaucoma
Is no result of another general or eye disorder/disease.
- Closed-angle glaucoma: In case of the closed-angle glaucoma, the intraocular pressure (pressure inside the eye) increases. This can happen very suddenly, which is called acute angle closure.
- Open-angle glaucoma: The open-angle glaucoma is the most common glaucoma with 90%. This insidious disorder is often not detected.
- Normal tension glaucoma: The normal tension glaucoma is a variant of the primary open-angle glaucoma. Although the intraocular pressure is normal, the optic nerve is damaged.
Secondary glaucoma are the consequence of other diseases and disorders, e.g., inflammations, injuries, diabetes, obstructions of blood vessels, cortisone treatment, surgical procedures, eye bleedings, etc.
Developmental glaucoma can be traced back to a malformation of the anterior chamber angle.
Glaucoma is an insidious danger because it does not cause any symptoms for a long time. A typical sign of glaucoma is gradual loss of peripheral vision. But there are also cases with loss of central vision. If not treated, it can result in blindness.
There are several diverse causes of glaucoma, having in common to increase the intraocular pressure and, thus, damaging the optic nerve.
Within the course of glaucoma, the nerve cells of the retina and optic nerve are gradually damaged. Glaucoma have different causes, but the most important risk factor is an elevated intraocular pressure. If not treated, glaucoma can lead to visual field obstruction, severe decrease of visual acuity and, eventually, blindness.
The first therapeutic step is to decrease the intraocular pressure by the administration of eye drops. Subject to the kind of medication, it reduces the fluid production or increases drainage.
Laser and surgical treatment
If medication does not yield optimal results, different laser procedures can help drain intraocular fluid. If these measures are not enough, surgery is indicated.
Selective laser trabeculoplasty (SLT)
Selective laser trabeculoplasty decreases the intraocular pressure. It is a painless outpatient procedure without side effects, done in only a few minutes. It selectively targets pigment cells of the chamber angle of the eye by using laser impulses of a low energy level. Our body replaces this cells by new ones while healing the small damage caused by the laser. SLT improves the drainage and normalizes the intraocular pressure.
In order to improve drainage, a kind of valve is built into the scleral wall during trabeculectomy.
Basal iridectomy and laser iridotomy
During basal iridectomy and laser iridotomy, a part of the iris is removed either surgically or by laser to enable the intraocular fluid to flow between front and rear areas of the iris.
During cyclophotocoagulation (CPS), the production of intraocular fluid is decreased by partially ablating the secretory ciliary epithelium.