Understanding and Managing Glaucoma: Diagnosis and Treatment

Glaucoma, a prevalent ailment and a leading cause of permanent blindness, poses significant public health implications.

1. Deciphering Glaucoma

Glaucoma is categorized into various types:

• Primary Glaucoma (Prominent): Includes primary angle closure glaucoma and primary open-angle glaucoma.
• Secondary Glaucoma: Develops post eye and systemic disorders, like trauma, uveitis, or vitreous pathology.

2. Recognizing Glaucoma's Indicators

• Acute Angle-Closure Glaucoma: Manifests suddenly with intense symptoms like severe eye pain, headache, eye tightness, redness, swollen eyelids, and vision deterioration. A blue-red halo around luminous objects might be observed.
• Subacute Angle-Closure Glaucoma: Mimics acute glaucoma but with milder symptoms that intermittently worsen, accompanied by transient blurred vision.
• Chronic Angle-Closure Glaucoma: Rare, usually asymptomatic, leading to severe vision loss.
• Open-Angle Glaucoma: Progresses silently without overt symptoms, often diagnosed at advanced stages. Patients may experience transient eye strain, blurred vision, and colored halos around bright lights.

3. Diagnostic Approaches for Glaucoma

• Assessing vision.
• Evaluating anterior chamber angle.
• Measuring intraocular pressure.
• Measuring optic disc parameters via ophthalmoscopy or posterior OCT.

4. Treating Glaucoma

• Acute Angle-Closure Glaucoma: An ophthalmic emergency warranting prompt and vigorous measures to alleviate intraocular pressure and pain. It might entail eye application of pilocarpine and acetazolamide administration.
• Chronic Glaucoma: Requires surgical intervention, tailored to disease stage.
• Laser Glaucoma Surgery: Non-invasive, employs lasers to create drainage channels.
• Open-Angle Glaucoma: Aims to lower intraocular pressure to prevent optic nerve damage. Medications like beta-adrenergic blockers, cholinergics, and prostaglandins are options. Surgical approaches might be considered if medication falls short.

5. Ensuring Follow-up and Monitoring

• Surgical patients require regular intraocular pressure checks.
• Open-angle glaucoma patients must adhere to prescribed eye drop regimens, routine pressure monitoring, visual field assessments, and ophthalmoscopy.