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Glaucoma

Open-angle glaucoma; Chronic glaucoma; Chronic open-angle glaucoma; Primary open-angle glaucoma; Closed-angle glaucoma; Narrow-angle glaucoma; Angle-closure glaucoma; Acute glaucoma; Secondary glaucoma; Congenital glaucoma

Glaucoma is a group of eye conditions that can damage the optic nerve. This nerve sends the images you see to your brain.

Most often, optic nerve damage is caused by increased pressure in the eye. This is called intraocular pressure.

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Glaucoma

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Causes

Glaucoma is the second most common cause of blindness in the United States. There are 4 major types of glaucoma:

The front part of the eye is filled with a clear fluid called aqueous humor. This fluid is made in an area behind the colored part of the eye (iris). It leaves the eye through channels where the iris and cornea meet. This area is called the anterior chamber angle, or the angle. The cornea is the clear covering on the front of the eye that covers the iris, pupil, and angle.

Anything that slows or blocks the flow of this fluid will cause pressure to build up in the eye.

Open-angle glaucoma is the most common type of glaucoma.

Closed-angle glaucoma occurs when the fluid is suddenly blocked and cannot flow out of the eye. This causes a quick, severe rise in eye pressure.

Secondary glaucoma occurs due to a known cause. Both open- and closed-angle glaucoma can be secondary when caused by something known. Causes include:

Congenital glaucoma occurs in babies.

Symptoms

OPEN-ANGLE GLAUCOMA

ANGLE-CLOSURE GLAUCOMA

Symptoms may come and go at first, or steadily become worse. You may notice:

CONGENITAL GLAUCOMA

Symptoms are most often noticed when the child is a few months old.

SECONDARY GLAUCOMA

Exams and Tests

The only way to diagnose glaucoma is by having a complete eye exam.

Eye pressure is different at different times of the day. Eye pressure can even be normal in some people with glaucoma. So you will need other tests to confirm glaucoma. They may include:

Treatment

The goal of treatment is to reduce your eye pressure. Treatment depends on the type of glaucoma that you have.

OPEN-ANGLE GLAUCOMA

If drops alone do not work, you may need other treatment:

ACUTE ANGLE GLAUCOMA

An acute angle-closure attack is a medical emergency. You can become blind in a few days if you are not treated.

CONGENTIAL GLAUCOMA

SECONDARY GLAUCOMA

If you have secondary glaucoma, treating the cause may help your symptoms go away. Other treatments also may be needed.

Outlook (Prognosis)

Open-angle glaucoma cannot be cured. You can manage it and keep your sight by following your provider's directions.

Closed-angle glaucoma is a medical emergency. You need treatment right away to save your vision.

Babies with congenital glaucoma usually do well when surgery is done early.

How you do with secondary glaucoma depends on what is causing the condition.

When to Contact a Medical Professional

If you have severe eye pain or a sudden loss of vision, get immediate medical help. These may be signs of closed-angle glaucoma.

Prevention

You cannot prevent open-angle glaucoma. Most people have no symptoms. But you can help prevent vision loss.

If you are at risk for closed-angle glaucoma, your provider may recommend treatment before you have an attack to help prevent eye damage and vision loss.

Related Information

Tonometry
Vision problems
Blindness and vision loss
Retina
Peripheral
Iris
Anterior
Uveitis
Systemic
Diabetes
Nearsightedness
Farsightedness

References

Anderson DR. The optic nerve in glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 48.

Giaconi JA, Law SK, Caprioli J. Primary angle-closure glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 53.

Gross RL. Current medical management of glaucoma. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 10.24.

Kwon YK, Caprioli J. Primary open-angle glaucoma. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 52.

Mandelcorn E, Gupta N. Lens-related glaucomas. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:chap 54A.

Rhee DJ. Which therapy to use in glaucoma? In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 10.23.

Saheb H, Ahmed II. Micro-invasive glaucoma surgery: current perspectives and future directions. Curr Opin Ophthalmol. 2012;23(2):96-104. PMID: 22249233 www.ncbi.nlm.nih.gov/pubmed/22249233.

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Review Date: 8/11/2015  

Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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