For the Majority who have either been following me or visit my health blogs often, I am certain that the mention or talk of Glaucoma is nothing new to you because it is a condition I talk or write about a lot, mostly because it is a very silent and yet deadly condition, it is a leading cause of blindness in Ghana, in Africa and Globally, so you can understand why it is important to eye care professionals like myself.
So in the mention or talks of Glaucoma, you would realize that most often than not I am almost always talking about a rise in intraocular pressure which builds up and causes apoptosis of nerve cells resulting in a gradual decline in vision until absolute blindness occurs. Today I want to focus a little more on what this intraocular pressure is and what it is all about so that we can better appreciate it because I am sure many are painting it as the devil killing people's sight.
Let me hasten to add that glaucoma is not always a rise in intraocular pressure though, there are instances where the pressure can be normal, such as in low tension glaucoma, and yet still, death of nerve cells would progress, so let's be in the know. Ok so to today's discussion...
IOP
The Uvea tract lies behind the lenses within your eye and they include the ciliary body, the choroid, and the iris. The ciliary body is the seat of aqueous production in the eye. This aqueous plays a lot of significant roles within the eye which includes maintaining the tension within the eyeball so it doesn't collapse, carrying nutrition to different parts of the eye, and taking away some metabolic waste.
The process of production is made such that there is always a constant production of this fluid and there is also a constant drainage, the smooth process ensures that one's eye's pressure stays within the range of 10mmg and 20mmg always when something goes wrong then the system starts to fall and things go haywire.
So mostly with Glaucoma what happens is that either the drainage system where the constant flow is supposed to pass gets clogged either natural narrowing similar to the narrowing of arterioles in hypertension, or something clogs the pathway. When this happens then the laws of physics would let us understand that with more production and no drainage and a limited space then the pressure would build up.
In an acute close angle, there's no drainage at all and so the pressure builds up so quickly and within a short time such that when the pressure is not relieved and the pathway perhaps cleared the individual may suffer from permanent vision loss within the shortest possible time. In the other cases though the pathway may still be clear but narrowed affecting the flow and resulting in gradual buildup.
The other scenario is that the production goes overboard, when there is an overproduction of the aqueous it would have to be accompanied by over drainage and since this doesn't happen, the pressure would still get built up resulting in an increase in intraocular pressure. You Ophthalmologist may create tiny holes to enable more drainage when this is the case, it is best done for young adults though.
Depending on how well your eye responds to surgery or medication, your Optometrist may give you antiglaucoma medications that focus either on reducing the production of aqueous or one that facilitates the draining of the aqueous, both of which would inevitably result in a decrease in intraocular pressure.
Conclusion
As it stands now, Glaucoma doesn't have a cure yet however the management process does work and when patients are consistent and compliant with their medication, they get to enjoy the fullness of life without the complete loss of vision. There are however researches being done that seek to focus on identifying DNA markers and other biomarkers to predict glaucoma ahead of time and manage it even before it sets in.
@nattybongoMaybe, very shortly w,e would have a cure for the condition, until then, I urge all of us to take our eye health seriously, have regular checkups, it doesn't kill, avoid the use of over-the-counter medication and any other medication unsanctioned by your Optometrist, and remember that whenever you are in doubt you ought to speak to a professional don't just read. It was a pleasure serving you today and thanks for reading.
Further Reading
Killer, H. E., & Pircher, A. (2018). Normal tension glaucoma: review of current understanding and mechanisms of the pathogenesis. Eye (London, England), 32(5), 924–930. https://doi.org/10.1038/s41433-018-0042-2.
Sim, R. H., Sirasanagandla, S. R., Das, S., & Teoh, S. L. (2022). Treatment of Glaucoma with Natural Products and Their Mechanism of Action: An Update. Nutrients, 14(3), 534. https://doi.org/10.3390/nu14030534.
Chan, P. P., Pang, J. C., & Tham, C. C. (2019). Acute primary angle closure-treatment strategies, evidences and economical considerations. Eye (London, England), 33(1), 110–119. https://doi.org/10.1038/s41433-018-0278-x.
Razeghinejad, R., Lin, M. M., Lee, D., Katz, L. J., & Myers, J. S. (2020). Pathophysiology and management of glaucoma and ocular hypertension related to trauma. Survey of ophthalmology, 65(5), 530–547. https://doi.org/10.1016/j.survophthal.2020.02.003