I was in twice last week and today for an eye exam. The doctor said I have severe Glaucoma in my right eye. She showed me pictures of a perfect eye, an eye with a little bit of Glaucoma and an eye with severe Glaucoma and she said mine looked like that. She said overtime I could go blind.
So. now that I just found this out what do i do next? I'm only 27 she said I was probably born with it. I checked with my dad and he said that it has been frequent in our family.
I guess my questions are...
1. How is it treated?
2. Will I serisouly go blind?
3. How common is it?
4. Will I need surgery?
She referred me to a different type of doctor so I will have to go see him about it I just wanted to get a little educated. Glaucoma is damage to the optic nerve somehow related to pressure.
This a way you might look at it. The eyeball itself is a closed organ. It has that outer coat which is white, (sclera) than changes character a little in the front and becomes clear (cornea). When you look at someone's eyes you can see the color of their eyes. That part (iris) is connected at the edge of the clear and white part (limbus) to the ciliary body which has muscles that bend the lens. This second layer goes back next to the white part as the choroid.
So far we have the white part that's clear in the front. And the blood vessel layer that's colored in the front, has a hole in it (pupil) behind which sits the lens.
The third layer is the retina which can't be seen from the outside of the eye without certain types of lenses or instruments. It's the film and sends messages via the nerve to the brain. The nerve fibers have to pass through the white part to get out of the eye and into the optic nerve.
If the eyeball were just left as it is, it' would slowly leak fluid and collapse like a prune. On the surface of the ciliary body is a layer of cells that makes fluid (aqueous). This fluid is put into the eye and drifts around the lens next to the iris, into the anterior chamber, in front of the iris, then it moves to the side where there's a drain. The trabecular meshwork is sort of a spongy material that the fluid leaks through into a canal (canal of Schlemm) which empties into a series of veins into the blood.
Normal pressures are 10-22. 95% of people who have pressures in this range do not get glaucoma. 5% do. If the pressure is over 30, 95% get glaucoma, 5% don't. (I've never seen a patient with pressures over 25 that didn't have some type of glaucoma.
If for some reason the drain, the meshwork gets clogged up, the guys back there making the fluid don't know. They just keep on making fluid. The pressure goes up till it forces the fluid out at the same rate it's being produced. If that pressure, whatever it is, is too high for the nerve, the little nerve fibers get damaged and that atrophy goes back to the retinal ganglion cells and they die too. We can see this by looking at the retina and seeing certain types of streaking as bundles of nerve fibers atrophy or go away.
The type of glaucoma depends on the cause. If the eye fills with blood, hemorrhagic glaucoma. If pigment gets into and stops up the drain, pigmentary glaucoma. If the lens exfoliates like old paint falling off the wall, exfoliation glaucoma. If there are white cells from leukemia for instance, leukemic glaucoma. If the drain outside the eye, the veins are under some sort of high pressure such as a blood vessel tumor such as hemangioma or Sturge Weber syndrome, that can cause pressure problems too. If we can't figure it out, and the iris is not real closed as far as being near the cornea in a narrow angle, it's called Chronic Open Angle Glaucoma.
The treatment, assuming it is glaucoma and not spherical cupping which looks like glaucoma, or a tilted disc which also looks a lot like glaucoma (myopes get this more than the other 'opes...)....is to either increase the drain or decrease the production of fluid going into the eye. The drops do that one way or another. As the pressure gets lower, the damage stops or slows down.
The surgery is to make a new drain, or kill the cells that are making the fluid. Most don't like to do the destructive surgeries.
A trabeculoplasty is where they laser about 80 burns around the trabecular meshwork, which forms 80 little scars which pull on the meshwork and it opens the drain. The pressure goes down. That works for about 3 years or so. A trabeculectomy just opens the tissue to the outside under a covering that looks like a blister and filters the fluid out of the eye.
A newer and really NICE surgery is to place a suture inside the canal itself and tighten it so that it physically pulls the meshwork open. These people do really well and the IOP's drop to the low teens. (Intraocular pressures).
It's fairly rare to see someone blind from glaucoma in this country. but people that don't 'do' anything about it or have secondary problems such as diabetes, do have a worse prognosis.
The angle between the colored iris and the cornea is usually open wide. If it's narrow, the iris can get stuck up against the cornea and the pressure will go up a LOT....hurts. This is treated by opening a small hole in the colored iris, usually with a laser. The chamber deepens right away, fluid rushes into the front of the eye and the drain opens. This narrow angle glaucoma can later become open angle glaucoma from the chronic inflammation, but usually that one laser is all that's needed. Okay. The bad news is, glaucoma doesn't go away. The good news is, you can keep it under control. For most people, all you have to do is put eye drops in daily.
What glaucoma is, is pressure in your eye... that pressure can mess with the optic nerve if left untreated and cause blindness. I assume you were referred to a opthalmologist, right? They will most likely proscribe eye drops which you have to put in morning and night, and that should be it.
it is very common, and during the 6 months I worked for an eye doctor we had many patients with glaucoma or who were glaucoma suspects (they might get it later). http://www.glaucomafoundation.org/about_...
http://www.glaucomaconsultantsnorthwest....
These site tells you a lot of useful information.
1.Treatments, depend on the type you have, but can be treated with eye drops.
2. You can go blind
3. not sure about how common but it's not uncommon
4. Depends on what is causing your glaucoma as to if you need surgery.
ONE thing you need to do is to get to the other doctor ASAP. This is not something to mess around and if it's already affecting your vision than it is in an advanced stage. |
