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  3. Glaucoma: Open Angle and Narrow-Angle?

Glaucoma: Open Angle and Narrow-Angle?

Glaucoma Background:

Glaucoma: Narrow-Angle Vs. Open-Angle
Glaucoma: Narrow-Angle Vs. Open-Angle

What is Glaucoma: Open Angle and Narrow-Angle? The eyeballs are soft structures with a liquid inside, called aqueous humor. This liquid is produced by a structure called the ciliary body. Furthermore, it’s drained by a structure called the trabecular network. Although the cause of Glaucoma has not been totally understood, it is thought to be caused by either too much production or not enough drainage of this aqueous humor, building up to much Intraocular Pressure (IOP) in the eyeball referred to as glaucoma. Therefore, A buildup of this IOP may lead to damage of the optic nerve and result in blindness. Glaucoma affects about 2 million people in the United States. After cataracts, glaucoma is the second most common cause of blindness.

There are two types of Glaucoma:

There are two known types of glaucoma, Open-angle glaucoma which is much more common, and Closed-angle glaucoma, which is less common.

Who is at risk for Glaucoma?

Ethnicity:

African-American, East Asian, and people of South Asian descent have an Increased risk for glaucoma. Inuit people, have also been found to have a greater risk of glaucoma.

African-Americans Risk

According to the Bright Focus Foundation, Glaucoma is the leading cause of irreversible blindness amongst African Americans. More then 500,000 African Americans are affected by Glaucoma.

Family History

Genetics: A family history of glaucoma increases the risk of glaucoma in siblings.

Glaucoma is thought to be due to “ocular hypertension,” which is, as was mentioned, and increased pressure in the eyeball, resulting in pressure on the optic nerve.

Symptoms: Open Angle Glaucoma vs Narrow-Angle Glaucoma:

Open-angle glaucoma

Patients with Open-angle glaucoma often have no idea they have glaucoma at it has a slow onset that is painless, with progressive vision loss in most cases.

Narrow-angle glaucoma

Narrow-angle glaucoma may present with sudden eye pain, red-eye, even nausea or vomiting. The pupil becomes dilated and fixed, and the eyeball may feel hard. These symptoms represent an emergency and must be treated quickly.

Diagnosis

Glaucoma Test
Glaucoma Test in progress

Diagnosis is made by a physical exam by an ophthalmologist or optometrist. The patient’s eye pressure will be measured by Tonometry. Tonometry is the measure of intraocular pressure with a puff of air, and a fundoscopic exam using a special light to look inside the eye to see the vessels and retina. Other methods include measuring the angle between the iris and the cornea, called gonioscopy.

Treatment Options for Glaucoma: Open Angle and Narrow-Angle?

The treatment of glaucoma depends on the type: Open-angle vs Closed-angle. For patients who have had a high intraocular pressure measured, there are medications that can lower the pressure, either by increasing the outflow or by decreasing the production of aqueous humor.

Medications for glaucoma include but are not limited to:

Glaucoma drops
Glaucoma drops

Prostaglandin analogs (Latanoprost, Bimatoprost, etc.) which increase the drainage of the aqueous humor. Beta-blockers (Timolol and others) work by inhibiting aqueous humor production.

Gluacoma Surgery is another option:

Glaucoma Surgery
Glaucoma Surgery

By making a hole in the drainage system (the trabecular meshwork), aqueous humor is allowed to drain, decreasing the intraocular pressure. Another surgical technique is a trabeculectomy which involves creating a hole in the sclera to decrease the pressure build-up.

Laser therapy has been performed as well and does not involve puncturing the sclera.

Medical Marijuana (aka medical weed):

Marijuana-and-Glaucoma.
Green cannabis leaf with figures of the two eyes lies on a white medical table. The use of cannabis (Medical marijuana) in ophthalmology (for treatment of glaucoma and other diseases)

For consideration, Medical Marijuana (aka medical weed), has been touted as a cure for glaucoma. This is a controversial subject, as recent research showed the THC, one of the components of Marijuana that causes the “high,” may lead to decreased intraocular pressure, while CBD, another component that supposedly has more medical properties, may increase intraocular pressure and even work against the THC effect. This is still being researched.

Updated on March 24, 2019

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