Glaucoma

July 3, 2021Articles2

Glaucoma is a condition that damages your eye’s optic nerve.It is often linked to a buildup high of pressure inside your eye. Glaucoma tends to run in families.
The increased pressure in your eye, called intraocular pressure, can damage your optic nerve, which sends images to your brain.In worse damage condition glaucoma can cause vision loss or even total blindness within a few years.

Most people with glaucoma have no early symptoms or pain. If you lose vision, it can’t be brought back. But lowering eye pressure can help you keep the sight you have.
It is one of the leading cause of blindness for people over the age of 60. It can occur at any age but is more common in older adults.
Symptoms –
The signs and symptoms of glaucoma vary depending on the type and stage of your condition.

Open-angle glaucoma
• Patchy blind spots in your side (peripheral) or central vision, frequently in both eyes.
• Tunnel vision in the advanced stages.
Acute angle-closure glaucoma
• Eye pain
• Halos around lights
• Eye redness
• Severe headache
• Blurred vision
• Nausea and vomitting
It left untreated, glaucoma will eventually cause blindness. Even with treatment, about 15% of people with glaucoma become blind in at least one eye within 20 years.
Causes –
The back of your eye continuously makes a clear fluid called  aqueous humor. As this fluid is made, it fills the front part of your eye. Then, it leaves your eye through channels in your cornea and iris. If these channels are blocked or partially obstructed, the natural pressure in your eye, which is called the intraocular pressure (IOP), may increase. As your IOP increases, your optic nerve may become damaged. As damage of your nerve progresses, you may begin Iosing sight in your age.

The cause of increased pressure in your eye is not always known. Still following factors may contribute in increasing pressure of the eye –
• High blood pressure
• Reduced blood flow to your optic nerve
• Blocked or restricted drainage in your eye.
• Dilating eye drops
• Medications, such as corticosteroids.
Types –
Open angle glaucoma –
This is the most common type. It is also called wide-angle glaucoma. The drainage angle formed by the cornea and iris remain open, the drain structure in your eye (Called trabecular meshwork) looks fine, but fluid doesn’t flow out like it should be, as it gets partially blocked. This causes pressme in the eye gradually increase which damage the optic nerve.It happens so slowly that you may lose vision before you are even aware of a problem.
Angle-closure glaucoma –
It is also called closed-angle glaucoma, occurs when the iris bulges forward to narrow or block the drainage angle formed by the correa and iris. As a result, fluid can’t circulate through the eye and pressure increases. This type of glaucoma may occur suddenly or gradually. This is a medical emergency.
Normal-tension glaucoma –
In this type, your optic nerve becomes damaged even though your eye pressure is within the normal range.The exact reason for this is not known.You may have a sensitive optic nerve, or you may have less blood being supplied to your optic nerve.This limited blood flow could be caused by atherosclerosis- the build up of fatty deposits(plaque) in the arteries – or other conditions that impair circulation.
Glaucoma in Children –
Infants and children may have possibility of arousal of glaucoma.It may be present from birth or develop in the first few years of life. The optic nerve damage may be caused by drainage blockages or an underlying medical condition.
Pigmentary glaucoma –
In this type, pigment granules from your iris build up in the drainage channels, slowing or blocking fluid exiting your eye. Activities such as jogging sometimes stir up the pigment granules, depositing them on the trabecular meshwork and causing intermittent pressure elevations.
Risk Factors –
As because of chronic forms of glaucoma can destroy vision, therefore before any signs or symptoms are apparent, be aware of these risk factors –
• Being over age 60 years
• Having high intraocular pressure
• Family History
• Being black or Asian
• Having centrally thin corneas
• Had an eye injury or certain type of eye surgery
• Being extremely nearsighted or farsighted
• Taking corticosteroid medications, especially eyedrops, for a long time
• Having certain medical conditions, such as diabetes, heart disease, high blood pressure and sickle cell anaemia
Prevention –
These self-care steps can help you detect glaucoma in its early stages, which is important in preventing vision loss or slowing its progress.
• Get regular dilated eye examinations
• Know your family’s eye health history
• Exercise safely
• Take prescribed eyedrops regularly
• Wear eye protection When using power tools or playing high-speed racket sports.
Diagnosis –

Doctor will conduct a comprehensive eye examination.The tests to be performed includes –
• Meaning intraocular pressure (tonometry)
• Testing for option nerve damage with a dilated eye examination and imaging tests
• Checking for areas of vision loss (Visual field test)
• Measuring corneal thickness (pachymetry)
• Inspecting the drainage angle (gonioscopy)

Treatment –
Doctor may use prescription eye drops, oral medications, laser surgery or microsurgergy to lower pressure in your eye.

Eye Drops
These either lower the creation of fluid in your eye or increase its flow out, lowering eye pressure.
Prescription eyedrop medication include –
• Prostaglandins – e.g. latanoprost, travoprost, tafIuprost etc.
• Beta blockers – e.g. timolol, betaxolol
• Alpha-adrenergic agonists – e.g.- apraclonidine,brimonidine
Oral Medication
Oral medications such as
• Beta blocker
• Carbonic anhydrase
can improve drainage or slow the creation of fluid in the eye.
▪︎Laser surgery
This procedure can slightly raise the flow of fluid from your eye if you have open angle glaucoma. It can stop fluid blockage if you have angIe closure glaucoma. Procedures are –
• Trabeculoplasty
• Iridotomy
• Cyclophotocoagulation
▪︎Filtering surgery
▪︎Drainage tubes
▪︎Minimally invasive glaucoma surgery (MIGS)
Ayurvedic Perspective –
Glaucoma in best correlated with a condition described as Adhimantha , considered as a complication of chronic / untreated abhishyandi.
Vata regulates retinal nerve function, whereas Kapha specifically nourishes the eye and pitta acts to drain it. Vata symptoms usually relate to end stage conditions (Nerve damage), Kapha to retinal arterial occlusion and pitta to retinal vein occlusion, in context of fluid mechanics of the eye itself.
Helpful Procedures –
• Nasya

• Netradhara

• Netra tarpana

• Aschothana

• Pada Abhyanga

Effective Medications –
• Maha Triphla Ghrita
• Saptamrita Lauh
• Triphla Gugglu
• Amalaki Rasayan
• Decoction of Triphla Powder for eyes wash
• Anu Taila for nasya

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