Greetings to all and sundry,
It is another beautiful day today and the start of hopefully a wonderful weekend to come. I find great pleasure in coming your way today and I do hope that your week was great, well whatever the case was I am absolutely certain that the weekend will be full of fun and excitement.
As usual, I am here for us to learn and discuss health issues mostly about our eyes and what best can be done to help us make the most use of our eyes. Today's topic is quite a popular yet unpopular one and I do hope that you get to enjoy the read. Don't forget to ask a question and leave your thoughts below.
Introduction
Most of us if not all of us have heard of the ocular condition known as glaucoma and how it has become a global issue, especially among Africans since it has the highest prevalence here, and also in the Eastern part of the world having quite a high incidence.
Generally, when we preach about glaucoma most often than not we are focused on one particular type of Glaucoma and so individuals have come to know the condition in a particular light. However, there are different types of classification for the condition known as glaucoma although their etiology or pathophysiology may be the same the rate of damage may differ.
@nattybongoFor instance, the rate of damage in normal tension glaucoma may differ as compared to high tension glaucoma, whereas glaucoma as a result of subluxation of the lens may require more than the usual management protocol for glaucoma. Congenital glaucoma may require immediate surgery or risk permanent loss of vision due to cortical blindness whereas neovascular glaucoma may need things to be tackled differently with Anti-VEGF coming in.
Today we would be looking at one of the types or classifications of glaucoma, one that is quite common amongst those of Eastern descent, and how we may be able to tell when we find ourselves in that situation and what we ought to do to save our sight.
Acute Close Angle Glaucoma
Our eye produces something we call aqueous humor from the ciliary body, a part of the uvea, and when this liquid is produced it serves some functions of nourishing structures within the anterior chamber of the eye, however after because it is been continuously produced has to drain out of the eye. This is done through the trabecular meshwork and other structures to keep the balance and the pressure within the eye.
When this goes wrong with the drainage thus when pressure builds up and glaucoma sets in as the pressure built pushes against the optic nerve and forces the cells to undergo apoptosis and die off. When these damages are detected through routine examinations tests like checking the intraocular pressure, visual field tests, and ocular coherence tomography test help tell us if is truly glaucoma or something else resembling Glaucoma.
This is because conditions such as high myopia may also give a glaucomatous appearance within the eye. Once this is confirmed, the appropriate treatment protocols can be implemented. Now in the case of close-angle glaucoma, the passageway for the aqueous drainage tends to be narrow these individuals are prone to getting it and sometimes suddenly get the passage completely blocked off due to one or two things.
When the passage gets completely blocked the pressure builds up very quickly since there's still production but no drainage and no additional space within the eyeball to accommodate those coming. The pressure buildup results in symptoms such as pain in the eye, seeing haloes around light, nausea and vomiting, and headaches.
Acute Close Angle is an outlier when it comes to the Glaucoma condition because it is the only type that presents symptoms and it tends to be quite severe at that. The condition is considered to be an ocular emergency and should be dealt with as soon as possible to avoid irreversible vision loss since the acute pressure build-up kills the cells very quickly. This time is precious when it comes to this condition, time wasted is vision lost.
Management/Conclusion
Managing an Acute close angle demands surgical intervention to clear up the passageway or open up the angle to enable the drainage flow to continue accordingly. The pressure would also have to be tackled right away mostly with systemic medication as well as topical drugs. The combination of both works fasts to ease the pressure as well as the accompanying pain.
@nattybongoPain meds may also be given to help with the accompanying headaches. Your Optometrist may keep you for observation over some time or ask you to come in again within a specified time frame for a review to ensure that things have gotten better.
It is, however, important that if you notice any of these signs, especially with increasing pain in the eye then you should visit the nearest eye care facility for a checkup. Always do well to avoid over-the-counter medication without proper examination and remember to have regular eye exams. Early detection not only save lives but also sight. Stay safe, thanks for reading, and have a wonderful weekend.
Further Reading
Gastaud, P., Paoli, V., & Freton, A. (2012). Le vieillissement du vitré [Vitreous body aging]. Journal francais d'ophtalmologie, 35(5), 371–377. https://doi.org/10.1016/j.jfo.2012.02.007.
Milston, R., Madigan, M. C., & Sebag, J. (2016). Vitreous floaters: Etiology, diagnostics, and management. Survey of ophthalmology, 61(2), 211–227. https://doi.org/10.1016/j.survophthal.2015.11.008.
Sebag J. (2020). Vitreous and Vision Degrading Myodesopsia. Progress in retinal and eye research, 79, 100847. https://doi.org/10.1016/j.preteyeres.2020.100847.
Levin, M., & Cohen, N. (2021). The effects of aging on the mechanical properties of the vitreous. Journal of biomechanics, 119, 110310. https://doi.org/10.1016/j.jbiomech.2021.110310.