What is glaucoma?
Glaucoma is the name given to a set of diseases of eye diseases in which there is damage to the eye nerve (optic nerve) located at the back of the eye and resulting in decreased peripheral vision (peripheral) and ending with blindness.
In most people, the eye nerve damage is caused by increased pressure inside the eyeball as a result of barriers to the circulation or drainage of eye fluid (clear fluid that carries oxygen, sugars and nutrients / other essential nutrients to parts of the eye and also to maintain form of the eyeball). In most patients the nerve damage may be caused by poor blood supply to the vital optic nerve tissue, the structural weakness of the nerves or nerve tissue of health problems.
Glaucoma is one of the leading causes of blindness and vision damage in all parts of the world. Second most common type of glaucoma Primary Open Angle Glaucoma is (POAG) / open-angle glaucoma and acute / chronic closed angle glaucoma / angle-closure glaucoma. Another type of Normal Tension Glaucoma including, congenital glaucoma, pigmentary glaucoma and secondary glaucoma.
Different populations tend to suffer from different types of glaucoma. In general, the tribes of Africa and Asia higher risk for glaucoma and lost his eyesight than white men and glaucoma are the leading cause of blindness in Asia.
What happens in Glaucoma?
Increased pressure within the eye (intraocular pressure) is one cause of damage to the eye nerve (optic nerve) and indicates a problem with the fluid inside the eye that is too excessive. This could be caused by the eye that produces too much fluid, the fluid does not flow properly through the existing facilities for out of the eye (trabecular meshwork tissue) or the angle formed between the cornea and iris shallow or enclosed so that clogging / blocking the drainage of fluid than the eye.
Some people who suffer from glaucoma but still have pressure in normal eyes, the cause of such a type of glaucoma is estimated to an association with poor circulation in the area of nerve / optic nerve of the eye. Although glaucoma is more common with age, glaucoma can occur at any age. Risk for glaucoma include a history of glaucoma in the family (genetic), ethnicity, diabetes, migraine, could not see much (people with myopia), eye injuries, blood pressure, use of cortisone type drugs (steroids).
Kind / type of Glaucoma
Primary open angle glaucoma (open angle glaucoma)
This type is the most common / frequent in glaucoma and occurs primarily in elderly people (above 50 years). The cause is increasing the pressure inside the eyeball which occurs slowly. The average normal eye pressure is 14 to 16 millimeters of mercury (mmHg). Pressure to 20 mmHg was still within normal limits. Pressure above or equal to 22 mmHg is estimated to suffer from glaucoma suspect and requires further investigation.
There are no real symptoms / associated with open-angle glaucoma, so often goes undiagnosed. The patient does not feel any pain and often do not realize that her vision gradually worsened to the stage / advanced stage of disease. Therapy is needed to prevent the development of glaucoma and to prevent further destruction of vision.
Normal tension glaucoma (normal-pressure glaucoma)
Normal-pressure glaucoma is a condition in which there is progressive damage to the nerve / optic nerve and visual field loss occurs even though the pressure inside the eyeball remained normal. Type of glaucoma is estimated to have anything to do, though small, with a lack of blood circulation in the nerve / optic nerve, which resulted in the death of the cells in charge of carrying impulses / stimuli from the retina to the brain. In addition, the damage that occurs because of its relationship with the pressure in the eyeball can also occur in the still within normal limits (high normal), so a lower pressure than normal is also often needed to prevent further vision loss. Normal-pressure glaucoma is most common in people who have a history of vascular disease, the Japanese or the woman.
Angle closure glaucoma (angle-closure glaucoma)
Angle-closure glaucoma is most common in people of Asian descent and people who are poor eyesight away, there is also a tendency for the disease is inherited in the family, so we could be in the one family member suffering from this disease. In people with a tendency to suffer from this angle closure glaucoma, the angle is shallower than usual average. Due to the location of the trabecular meshwork tissue was located in the angle formed where the cornea and iris meet, the more shallow angle so the closer the iris of the network are the trabecular meshwork. The ability of the eye fluid to flow / through the space between the iris and lens becomes decreased, causing fluid pressure as it is formed behind the iris, and then make the angle shallower. If the pressure becomes higher making the iris blocking the trabecular meshwork tissue, it will block the flow. This condition can be acute or chronic. On the acute, there is a sudden increase in pressure within the eyeball, and this can occur within several hours and accompanied by severe pain in the eye. Eyes become red, swollen and dull cornea, blurred vision, etc. This situation is a situation that needs immediate attention because of damage to the optic nerve can occur quickly and cause permanent vision damage.
Not all patients with angle closure glaucoma will experience symptoms of acute attacks. In fact, some may develop into a chronic form. In this situation, the iris will gradually close the stream, so there are no obvious symptoms. If this happens, it will form scar tissue between the iris and flow, and press the eyeball does not increase until there is a lot amount of scar tissue. Acute attacks can be prevented by giving the medication.
Based on the results of epidemiological surveys, angle closure glaucoma is more common in East Asia, particularly Chinese.
Pigmentary glaucoma
Pigmentary glaucoma is a form derived from the form of open-angle glaucoma in which incidence is more common in men than women. People who miop (minus glasses) usually are more often affected. Anatomical shape of the eye is a key factor for the development of this form.
Congenital glaucoma
This form is a rare form occurs, the drainage system caused by the abnormal eye fluid. This can occur at birth or develop later in life. Parents can find out if their children suffer from this disorder by means of whether children are sensitive to light, large eyes and cloudy / dull or excessively watery eyes. Surgery is usually needed to handle it.
Secondary glaucoma
This form is as a result of other eye disorders such as trauma, cataracts, or eye inflammation. The use of steroid drugs (cortisone) also has a tendency to increase the pressure inside the eyeball.
How to detect glaucoma?
Routine eye examination and periodically is one way to detect glaucoma early as possible. All the tests for glaucoma include:
* Examination of the optic nerve by means of an ophthalmoscope
* Examination of the eye pressure with a tonometer
* If you need visual field examination
Can glaucoma be treated?
Although there is no cure for glaucoma, but the loss / damage to the view can be controlled or prevented.
Handling including:
* Eye drops: this is the most common and frequent and should be done regularly. Some patients can get a good response from a drug while others cannot get a response, but the selection of treatment should be tailored to the needs of patients and types of glaucoma.
* Laser (laser trabeculoplasty): this is done if the eye drops do not stop the deterioration of eyesight. In most cases, although this has laser action, eye drops should still be given. Laser action does not require the patient to be hospitalized.
* Surgery (trabeculectomy) is performed if eye drops and laser treatment fail to control the eye pressure. A channel is created to allow fluid to flow out of the eye. These actions may save remaining vision but did not fix the existing view. (Pfizerpeduli-Dr. Dedy Kartawidjaja)
References:
South East Asia Glaucoma Interest Group, http://www.seagig.org
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