glaucoma

Glaucoma is a group of eye disorders characterized by damage to the optic nerve, often associated with elevated intraocular pressure (IOP). It leads to progressive, irreversible peripheral vision loss. While high IOP is a major risk factor, glaucoma can occur with normal IOP, in which case it is called normal-tension glaucoma.

Most common forms are open-angle glaucoma, in which drainage of aqueous humor through the trabecular meshwork is reduced gradually, and angle-closure glaucoma, in which the drainage angle becomes blocked, causing a rapid rise in IOP and potential acute symptoms. Secondary glaucomas result from another eye condition or medication.

Symptoms vary. Open-angle glaucoma is typically asymptomatic in early stages; as vision narrows, blind spots appear. Acute angle-closure glaucoma presents with eye pain, headache, nausea, blurred vision, halos, and a red eye and is a medical emergency.

Diagnosis consists of a complete eye examination, including measurement of IOP (tonometry), assessment of the optic nerve head, retinal nerve fiber layer imaging, and visual field testing. Regular screening is recommended for people at risk (older adults, family history, certain ethnic groups).

Treatment aims to lower IOP to prevent further optic nerve damage. First-line therapy often includes prescription eye drops, sometimes oral medications. Laser therapies such as laser trabeculoplasty or laser peripheral iridotomy may be used. Surgical options include trabeculectomy, drainage implants, and minimally invasive glaucoma surgeries (MIGS).

Prognosis and management: There is no cure, and vision loss is irreversible. Ongoing treatment and adherence, along with regular monitoring, can slow progression and preserve vision. Prevention focuses on regular eye examinations and controlling risk factors.