What are the main causes of traumatic glaucoma. How can blunt trauma and penetrating injuries lead to glaucoma. What are the symptoms and treatment options for traumatic glaucoma. How can you prevent glaucoma after an eye injury.

Understanding Traumatic Glaucoma: A Comprehensive Overview

Traumatic glaucoma is a serious eye condition that can develop following an injury to the eye. It occurs when damage to the eye’s structures interferes with the normal drainage of aqueous humor, leading to increased intraocular pressure (IOP) and potential optic nerve damage. This condition can result from both blunt trauma and penetrating injuries, each with its own set of challenges and treatment approaches.

The Mechanisms Behind Blunt Trauma-Induced Glaucoma

Blunt trauma is a common cause of traumatic glaucoma. This type of injury occurs when a forceful impact affects the eye without penetrating its surface. Sports-related accidents, such as those involving baseball or boxing, are frequent culprits. When blunt trauma occurs, it can damage the eye’s internal structures, particularly the ciliary body and drainage system.

How does blunt trauma lead to glaucoma? The impact can cause the ciliary body to tear, resulting in internal bleeding. The accumulation of blood, plasma, and cellular debris can clog the eye’s drainage canals, impeding the outflow of aqueous humor. This obstruction leads to a rise in IOP, which, if left untreated, can damage the optic nerve and potentially cause vision loss.

Angle Recession Glaucoma: A Long-Term Complication

In some cases, blunt trauma can cause a specific type of glaucoma known as angle recession glaucoma. This condition may develop years after the initial injury due to scarring of the damaged drainage canals. The scarring process gradually blocks fluid outflow, leading to a chronic increase in IOP. Angle recession is characterized by a tear at the base of the iris where the drainage canals are located, which can be observed during a comprehensive eye examination.

Penetrating Eye Injuries and Their Glaucomatous Consequences

Penetrating eye injuries, caused by sharp objects or flying debris, can also result in traumatic glaucoma. Unlike blunt trauma, these injuries involve a breach of the eye’s outer layers. Initially, the eye pressure may drop due to fluid leakage from the wound. However, once the injury is closed, several factors can contribute to elevated IOP:

• Tissue swelling and inflammation
• Internal bleeding
• Formation of scar tissue
• Damage to drainage structures

The risk of glaucoma following a penetrating injury emphasizes the importance of proper initial treatment and long-term monitoring.

Recognizing the Symptoms of Traumatic Glaucoma

Identifying traumatic glaucoma early is crucial for preventing vision loss. While some cases may develop without immediate symptoms, patients should be aware of potential warning signs:

• Blurred or decreased vision
• Eye pain or discomfort
• Redness of the eye
• Sensitivity to light
• Seeing halos around lights
• Headaches

It’s important to note that these symptoms can vary depending on the severity and type of injury. Any noticeable changes in vision or eye comfort following an injury should prompt immediate medical attention.

Treatment Approaches for Traumatic Glaucoma

The management of traumatic glaucoma focuses on controlling IOP and preventing further damage to the optic nerve. Treatment strategies may include:

1. Medications: Eye drops or oral medications to reduce aqueous humor production or improve outflow
2. Laser therapy: Procedures such as selective laser trabeculoplasty (SLT) to improve drainage
3. Surgical interventions: In severe cases, filtering surgery or drainage implants may be necessary

The choice of treatment depends on the specific cause of the glaucoma, the extent of damage, and the patient’s overall health. In cases of acute elevation of IOP following trauma, the primary goal is to quickly lower the pressure to prevent optic nerve damage.

Specialized Approaches for Different Types of Trauma

Treatment strategies may differ based on whether the glaucoma resulted from blunt trauma or a penetrating injury:

For blunt trauma:

• Initial management focuses on controlling IOP while the eye clears excess blood and debris
• Long-term monitoring for angle recession glaucoma is essential

For penetrating injuries:

• Immediate wound closure and prevention of infection are priorities
• Corticosteroid therapy may be used to reduce inflammation and scarring
• Early intervention to manage tissue swelling and bleeding is crucial

Preventing Glaucoma After Eye Injuries

While not all cases of traumatic glaucoma can be prevented, certain measures can reduce the risk of its development following an eye injury:

1. Seek immediate medical attention for any eye injury, no matter how minor it may seem
2. Follow your doctor’s instructions carefully regarding medication use and follow-up appointments
3. Wear protective eyewear during sports and hazardous activities
4. Attend regular eye check-ups, especially if you’ve had a previous eye injury
5. Be aware of the symptoms of glaucoma and report any changes in vision promptly

Can early intervention make a difference in preventing traumatic glaucoma? Absolutely. Prompt treatment of eye injuries can significantly reduce the risk of developing glaucoma or minimize its severity if it does occur.

Long-Term Monitoring and Management

Patients who have experienced eye trauma should be prepared for long-term monitoring of their eye health. This is particularly important because some forms of traumatic glaucoma, such as angle recession glaucoma, may not develop until years after the initial injury.

What does long-term management involve?

• Regular comprehensive eye exams, including IOP measurements
• Periodic visual field tests to assess any changes in peripheral vision
• Imaging studies to monitor the optic nerve and retinal nerve fiber layer
• Ongoing adjustments to treatment plans as needed

By maintaining vigilant follow-up care, patients and their eye care providers can detect and address any signs of glaucoma development early, potentially preserving vision and quality of life.

Advances in Traumatic Glaucoma Research and Treatment

The field of ophthalmology continues to evolve, bringing new hope for patients with traumatic glaucoma. Recent advancements include:

• Improved surgical techniques with minimally invasive glaucoma surgery (MIGS)
• Enhanced imaging technologies for earlier detection of optic nerve damage
• Novel drug delivery systems for more effective and convenient treatment
• Stem cell research aimed at regenerating damaged ocular tissues

These innovations offer the potential for better outcomes and improved quality of life for those affected by traumatic glaucoma.

The Role of Genetic Factors in Traumatic Glaucoma

Emerging research suggests that genetic predisposition may play a role in an individual’s susceptibility to developing glaucoma following eye trauma. Studies are underway to identify genetic markers that may indicate a higher risk of post-traumatic glaucoma. This knowledge could lead to more personalized prevention strategies and treatment approaches in the future.

The Importance of Patient Education and Support

Living with traumatic glaucoma or its risk can be challenging. Patient education and support are crucial components of effective management. Eye care professionals should provide comprehensive information about:

• The nature of traumatic glaucoma and its potential progression
• The importance of adherence to treatment regimens
• Lifestyle modifications that may help manage the condition
• Available support groups and resources for patients and their families

By empowering patients with knowledge and support, healthcare providers can improve treatment outcomes and help individuals maintain a high quality of life despite their diagnosis.

Coping Strategies for Patients with Traumatic Glaucoma

Patients diagnosed with traumatic glaucoma may face emotional and practical challenges. Developing effective coping strategies is essential for maintaining mental health and overall well-being. Some helpful approaches include:

• Joining support groups to connect with others facing similar challenges
• Engaging in stress-reduction techniques such as meditation or yoga
• Exploring assistive technologies for vision impairment if necessary
• Maintaining open communication with healthcare providers about concerns and difficulties

By addressing both the physical and emotional aspects of traumatic glaucoma, patients can better navigate the complexities of their condition and maintain a positive outlook.

The Future of Traumatic Glaucoma Care

As research continues and technology advances, the future of traumatic glaucoma care looks promising. Anticipated developments include:

• More sophisticated diagnostic tools for earlier detection
• Personalized treatment plans based on genetic and molecular profiles
• Advanced neuroprotective therapies to preserve optic nerve function
• Innovative surgical techniques with faster recovery times and fewer complications

These advancements hold the potential to significantly improve outcomes for patients with traumatic glaucoma, potentially reducing the incidence of vision loss and enhancing quality of life.

In conclusion, traumatic glaucoma presents unique challenges in both its prevention and management. By understanding its causes, recognizing its symptoms, and adhering to appropriate treatment and monitoring protocols, patients and healthcare providers can work together to minimize the impact of this condition. As research progresses and new technologies emerge, the outlook for those affected by traumatic glaucoma continues to improve, offering hope for better outcomes and preserved vision in the years to come.

Traumatic Glaucoma | glaucoma.org

It can be caused by injuries that “bruise” the eye (called blunt trauma) and injuries that penetrate the eye.

Conditions such as severe nearsightedness, previous injury, infection or prior surgery may also make the eye more vulnerable to a serious eye injury.

BLUNT TRAUMA

As a result of an immediate injury, traumatic glaucoma is most commonly caused by blunt trauma, which is an injury that doesn’t penetrate the eye, such as a blow to the head or an injury directly on the eye.

The most common cause is from sports-related injuries, such as baseball or boxing. Normally, the eye fluid flows out of the front part of the eye through the pupil and then is absorbed into the bloodstream through a meshwork of drainage canals around the outer edge of the iris.

When a blunt trauma occurs, damage to this system can occur. The most common cause is the ciliary body, the part of the eye that produces eye fluid, inside the eye tearing. This can cause bleeding inside the eye.

The excess amount of blood, plasma and debris can accumulate and clog the drainage system. This can lead to an increase in eye pressure, which can damage the optic nerve.

Elevated eye pressure due to blunt trauma is treated by keeping the eye pressure at safe levels while the eye drains the excess blood out. Glaucoma medications to control the eye pressure are usually tried first. If this is not sufficient to control the eye pressure, surgery may be necessary.

The elevated eye pressure following blunt trauma is temporary in most cases. It is important, however, to make sure to get regular follow-up eye exams.

In some cases, the damaged drainage canals in the eye can build up excess scarring. This scarring blocks fluid flow and can lead to glaucoma. This type of glaucoma, called angle recession glaucoma, can occur many years after the initial injury.

The angle recession is seen on an exam as a tear at the base of the iris where the drainage canals are. Angle recession glaucoma can be difficult to treat. Treatments can include medications that reduce fluid production in the eye, laser surgery or filtering surgery.

PENETRATING EYE INJURY

Traumatic glaucoma can also be caused by penetrating injuries to the eye, such as those caused by a sharp instrument or flying debris. The eye pressure is usually lower right after the injury occurs. Once the wound is closed, tissue inside the eye can become swollen and irritated, and bleeding can occur, causing the eye pressure to rise.

Short term rises in eye pressure are controlled in ways similar to cases of blunt trauma. However, damaged tissue and scarring from a penetrating eye injury can lead to blocked drainage canals.

Glaucoma due to a penetrating eye injury is best treated by preventive measures when the initial wound occurs. Corticosteroid therapy to help prevent tissue damage and scarring and antibiotics are an important component of initial treatment. Initial treatment can also include surgery to remove excess eye fluid or reduce swollen tissue.

If glaucoma does develop over the long term, medications that reduce the production of eye fluid are usually the first method of treatment, followed by filtering surgery.

Article by Ruth D. Williams, MD. Last reviewed on January 1, 2022.

Ruth Williams, MD

Ruth D. Williams, MD is a glaucoma specialist at the Wheaton Eye Clinic in Wheaton, Illinois. She is a past president of the American Academy of Ophthalmology and a national spokesperson on ophthalmic issues.

How to Prevent Glaucoma After an Eye Injury: Retina Specialists: Retinal Ophthalmologists

How to Prevent Glaucoma After an Eye Injury: Retina Specialists: Retinal Ophthalmologists

Eye injuries are remarkably common, especially among young people, and they’re a significant cause of preventable vision loss. While most of these injuries may be minor or superficial, not requiring a hospital admission, some ocular trauma is serious — and even potentially fatal. In addition, certain types can develop into secondary glaucoma, also known as traumatic glaucoma.

Retina Specialists has five locations, in Dallas, DeSoto, Plano, Mesquite, and Waxahachie, Texas. Our team of ophthalmologists provides the expert care you need when you’ve sustained eye trauma, helping to save your eyesight and prevent the potential glaucoma that may follow. 

Here’s what you need to know about glaucoma prevention and how we can help.

Glaucoma — the basics

Glaucoma is a group of eye conditions that damage the optic nerve, which is critical for sight. The condition is one of the leading causes of lost vision in those over age 60. Usually the damage is caused by high intraocular pressure (IOP), measured at over 21 mm Hg (normal is around 14-15). 

Many forms of glaucoma produce no warning signs, and vision loss is so gradual you might not notice it until the condition reaches an advanced stage. Whatever vision you lose can’t be recovered with treatment, which is why it’s important to get regular eye exams to detect glaucoma early on.

Traumatic glaucoma is an elevated IOP that results from an injury or damage to the eye. It may result from:

• Impaired drainage, leaving elevated fluid levels
• Hyphema, a pool of blood in the anterior chamber
• Injury to and inflammation of the lens or iris

Adhesions (growths) may also form between the peripheral iris and the structures of the anterior chamber, which reduces the outflow of fluid (aqueous humor) and leads to increased IOP. This condition is called peripheral anterior synechiae (PAS). 

If any of these conditions aren’t treated promptly, the increased pressure damages the optic nerve over time, leading to vision loss.

Symptoms of traumatic glaucoma

In addition to whatever symptoms you may have from the injury itself, such as torn tissues, a broken orbit, bruising, and swelling, if you suffer an eye injury, you need to watch out for signs of traumatic glaucoma:

• Aching pain in the eye which appears soon after the injury
• Sensitivity to light
• Blurred vision (possible retinal detachment)
• Hyphema (blood collecting in the front of the eye) 
• Swelling in the eye
• Elevated eye pressure: eye canals blocked with blood and inflammatory cells

If you experience any of these, get in to see our eye doctors as soon as possible.

Treating and preventing glaucoma after an eye injury

The treatment goal for glaucoma, no matter what the form, is to lower the IOP to less than 21 mm Hg, and to do so without inadvertently damaging the optic nerve further. Treatment for injuries and traumatic glaucoma focuses on repairing any eye damage, decreasing fluid pressure, and preserving what vision remains.

In the case of traumatic glaucoma, treatment and prevention are essentially the same thing. By treating the eye immediately after an injury, you prevent the pressure from building and causing any further damage to the optic nerve. Time = vision, so if there’s any question about whether you should see an ophthalmologist or not, go!

Treatment for traumatic glaucoma involves using medications, either with or without surgery.

Medications

Your doctor may start you on a preventive course of corticosteroids and antibiotics to reduce inflammation and pressure in the eye, especially if your pressure is over 21 mm Hg.

For medications, the first class is the beta-blockers, often used for lowering high blood pressure. These drugs work by reducing the aqueous fluid entering the eye, thereby decreasing IOP.

The next class is composed of the prostaglandin analogues. These medications relax the eye muscles to facilitate fluid outflow, which reduces IOP.

The third and fourth classes are the alpha-adrenergic agonists and carbonic anhydrase inhibitors, both of which decrease the rate of aqueous humor production.

Surgery

At Retina Specialists, we always start with conservative treatments, only recommending surgery when those methods have failed, and the risk of increasing visual loss outweighs the risk of surgery. Some options include argon laser trabeculoplasty, laser procedures, and filtration surgery. 

In addition, we sometimes need to perform surgery to repair badly damaged inner-eye structures after a traumatic event. One example is repairing the retina, the light-sensitive tissue at the back of the eye that allows you to see. It can become detached during a trauma, necessitating repair to preserve your vision.

If you’ve had an eye injury, get it checked out as soon as possible, even if you don’t think there’s any damage. Give Retina Associates a call at any of our offices to schedule a consultation with one of our ophthalmologists, or book online with us today. Detecting glaucoma early may help preserve your sight.

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Secondary glaucoma – causes, symptoms, classification, treatment and prevention

Contents

1. Causes of secondary glaucoma
2. Pathogenesis of the disease
3. Classification of secondary glaucoma
4. Symptoms and signs
5. Complications
6. Diagnosis
7. Treatment of secondary glaucoma
8. Prognosis and prevention

Secondary glaucoma is a disease that occurs against the background of an existing pathology of the organ of vision. It is accompanied by an increase in intraocular pressure, which leads to damage to the optic nerve and subsequent blindness. Secondary glaucoma can be manifested by a spasm of accommodation, pain syndrome, steadily occurring decrease in vision. To establish the diagnosis, the following studies are necessary: ​​tonometry, tonography, gonioscopy, visometry, ophthalmoscopy, perimetry, biomicroscopy. The tactics of treatment is directly related to the etiology of the disease and, as a rule, includes antihypertensive therapy, surgery, laser coagulation of the retina.

The incidence of secondary glaucoma is up to approximately 22% of all detected cases of glaucoma and, on average, out of 100 patients in 1-2 it causes urgent hospitalization. Quite often, the disease becomes a disability factor, because in 28% of cases it ends in irreversible blindness. In 20-45% of cases, a long-term increase in IOP leads to serious consequences in the form of damage to the optic nerve, which may require enucleation (removal) of the eyeball. Almost half of the cases are uveal glaucoma. It is equally often diagnosed in women and men. The prevalence of the disease has no geographical features. You can learn more about glaucoma on this page.

Causes of secondary glaucoma

There are quite a lot of factors that cause an increase in IOP in secondary glaucoma. According to available information, the pathology is polyetiological, but there are also the main reasons for its development:

• Inflammatory processes. The most common causes include uveitis, recurrent episcleritis, and scleritis. These inflammatory processes, including those that affect the drainage system of the eye, increase IOP due to the lack of the possibility of outflow of intraocular fluid.
• Chronic keratitis. In this case, IOP rises due to inflammation of the cornea, which leads to its severe degenerative changes, the formation of a walleye and anterior synechia. In addition, reflex hypertonicity causes constant irritation of the membrane.
• Lens ectopia. Violation of intraocular hydrodynamics develops when the lens dislocates into the anterior chamber of the eye or into the vitreous body.
• Cataract. The cause of secondary glaucoma can only be age-related immature cataracts, traumatic or overripe cataracts, which are accompanied by a lens block, which causes an increase in IOP.
• CVD thrombosis. This condition leads to ischemia, which leads to neovascularization of the iris, which subsequently spreads to the anterior chamber of the eye.
• Injuries. A contusion or injury to the eye, which is accompanied by an ingrowth of the epithelium in the optic canal, increases intraocular pressure. If the traumatic eye injury has a burn character, IOP rises due to excessive production of intraocular fluid
• Ocular media dystrophy. Dystrophic changes that affect the APC create difficulties for the outflow of intraocular fluid.
• Tumor formations inside the orbit. If a volumetric formation is localized in the eye cavity, this causes an increase in IOP. Retinoblastoma and melanoma are the most common malignant pathologies of the organ of vision.

Pathogenesis of the disease

The mechanism of development of secondary glaucoma is associated with impaired outflow of intraocular fluid. This can be caused by a mechanical block of the anterior chamber angle due to edema of the trabecular meshwork. True, in 20% of cases, the cause of the development of secondary glaucoma is pathological hypersecretion of aqueous humor, with the accumulation of excessive volume of exudate. An additional stimulation of the development of ocular hypertension, as one of the symptoms of the disease, is an increase in the permeability of the vascular wall of the venous bed, as well as spasm of arterioles.

Dislocation of the lens is accompanied by compression of the cornea into the angle of the anterior chamber of the eye. In the case of secondary damage to the vitreous body, a pupillary block occurs, in addition, it is often obturated with masses of intertrabecular fissures.

If the disease proceeds for a long time, functional changes in the drainage system are supplemented by organic ones along the outflow path. The formation of goniosynechia progresses, exudate appears in the trabecular zone, which, with increased angiogenesis, leads to increased manifestations of visual dysfunction.

If the cause of the pathology is neoplastic factors, the degree of intensification of clinical symptoms directly depends on the growth rate of these neoplasms in the orbital cavity.

In case of bleeding into the anterior chamber or into the vitreous cavity, the increase in IOP is related to the extent of the hemorrhage. With its resorption, there is a gradual decrease in pressure, however, due to the clots that have arisen and some obstruction of the trabecular network, it is capable, after a time of imaginary well-being, to begin to increase again.

Classification

Secondary glaucoma is an exclusively acquired disease. Experts distinguish its one- and two-sided forms. The classification of the disease is based on its etiology:

• Uveal post-inflammatory. It develops as a result of a long course of inflammation processes or the occurrence of post-inflammatory changes.
• Phacogenic. Its cause is traumatic damage to the lens, or a complication of cataract.
• Vascular. The occurrence of this form is due to a persistent increase in pressure in the episcleral veins or their thrombosis.
• Degenerative. The presence of degenerative-dystrophic changes becomes the cause of the disease in people with uveopathy, iridocorneal endothelial syndrome and Fuchs anomaly.
• Traumatic. In this case, glaucoma occurs due to traumatic damage to the eye under the influence of mechanical, chemical, thermal, ionizing agents.
• Neoplastic. This variant of the disease occurs due to the occurrence in the orbit of some neoplasms – benign or malignant, which cause an increase in ophthalmotonus.

Symptoms and signs

Features of the underlying pathology are the leading factor in the clinical manifestations of secondary glaucoma. As a rule, only one eye is affected. If the form of glaucoma is bilateral, there is an asymmetric development of changes. Symptoms of the disease are absent for a long time, with the exception of cases when the pathology occurs due to trauma or postoperative complications. In the uveal form, patients often feel an increase in IOP in the evening. In addition, with it there is a rapidly progressive decrease in visual acuity. Within a year, complete blindness can often occur.

When secondary glaucoma develops due to cataract or ectopia of the lens, patients report pain in the orbit, redness of the eye, decreased vision. Attacks may be accompanied by dizziness, nausea and vomiting. A distinctive feature in this form of the disease is the trembling of the lens (phacodonez), which occurs during the movements of the eyeballs. A feature of glaucoma in people with neoplastic neoplasms is a slow increase in clinical symptoms.

Common to all forms of secondary glaucoma are the appearance of iridescent circles before the eyes when looking at a light source, headache radiating to the superciliary arches, blurred vision. The accommodative ability, at the same time, is often disturbed and accommodation spasm prevails. Asthenopic complaints are not uncommon even with a short eye strain.

Complications

Blindness is considered the most severe complication of secondary glaucoma, as people with this pathology have a high risk of optic nerve atrophy. The vascular and wound form of the disease is often complicated by vitreous hemorrhages and hyphema. Quite often, rubeosis of the iris and the growth of newly formed vessels in the cornea occur. For uveal glaucoma, characteristic complications are inflammatory and infectious diseases – blepharitis, keratitis, conjunctivitis. With contusion of the eye, due to the rapid increase in IOP, subconjunctival bleeding often occurs. In the phacolytic form of glaucoma, in the event of a rupture of the lens capsule, plastic iridocyclitis may develop.

Diagnosis

Diagnosis of secondary glaucoma requires careful history taking to identify the underlying cause of increased IOP. Conducting an external examination is uninformative and often leads to a belated diagnosis. The complex of specific ophthalmological examinations includes:

• Gonioscopy. With its help, it is possible to determine the state of the anterior chamber and identify the prerequisites for impaired outflow of intraocular fluid of a morphological nature (closing of the APC, reduced chamber volume, disturbances in the structure of the corneal-scleral trabecula).
• Tonometry (non-contact). It reveals an increase in intraocular pressure, above the tolerable values ​​(exceeding 20-22 mm Hg). Daily tonometry is also advisable, for greater detail of changes in IOP during the day.
• Eye ultrasound. Its purpose is to identify organic changes that contribute to an increase in ophthalmotonus. In addition, with the help of ultrasound, it is possible to detect existing neoplasms and signs of dislocation of the lens.
• Ophthalmoscopy. It is performed to study the state of the fundus and identify atrophic changes in the optic nerve head and damage to the choroid, which are characteristic of a long-lasting increase in IOP.
• Biomicroscopy of the eye. This is a detailed revision of the anterior part of the eye in order to identify ulcers and leukomas on the cornea.
• Electronic tonography. Secondary glaucoma occurs with an inverted type of pressure increase, which rises in the evening. Tonography makes it possible to determine the volume of intraocular fluid and calculate the index of its outflow through the trabecular meshwork.
• Visometry. It reveals a progressive decline in visual function. When conducting additional refractometry, the myopic type of refraction is usually detected.
• Perimetry. Its execution reveals a concentric narrowing of the visual fields.

Treatment of secondary glaucoma

The prescribed etiotropic therapy is aimed at eliminating the disease that led to the occurrence of secondary glaucoma. With concussions, therapeutic tactics include taking analgesics, desensitizing and sedative drugs. Therapeutic treatment of the disease includes the following complex:

Antihypertensive therapy. It is prescribed in case of increased IOP, due to excessive production of aqueous humor. A decrease in the level of intraocular pressure is achieved through the use of drugs from the groups of adrenergic blockers, M-cholinomimetics, carbonic anhydrase inhibitors, prostaglandins, alpha-2-agonists.

Surgery. If the pathology arose as a result of bombing of the cornea due to a decrease in the volume of the anterior chamber, trepanation of the cornea should be performed. If a pupillary block due to ectopia of the lens is detected, its extraction is required. When glaucoma is complicated by persistent pupil dilation, a purse-string suture is performed along the cornea. In case of narrowing of the corneal-scleral angle, laser iridectomy is prescribed.

Laser retinal coagulation. Treatment is advisable only in the case of persistent high pressure in the episcleral vessels. Total laser coagulation of the retina is very effective even with the initial signs of blood stasis in the whirlpool veins and anterior ciliary arteries.

Prognosis and prevention

With timely detection of secondary glaucoma and treatment of the disease in the early stages, the prognosis for the patient’s life and ability to work is favorable. The peculiarity of the disease is that timely treatment is able to restore partially lost visual functions.

The absence of specific methods for the prevention of secondary glaucoma places certain responsibilities on the individual. Indeed, to prevent the disease, regular visits to the ophthalmologist are necessary to control the level of IOP. It is recommended to regularly measure intraocular pressure in patients in the postoperative period (within a year) after surgical interventions on the eyes, with traumatic eye injuries or with an unfavorable ophthalmic history (cataract, ocular migraine, intraocular hemorrhage).

What is glaucoma? Causes, symptoms, diagnosis and treatment of glaucoma | Blog

Glaucoma – is a group of ophthalmic diseases in which the outflow of aqueous humor from the eye is disturbed. The aqueous fluid fills the anterior chamber of the eye and functions to nourish the lens and cornea, and removes toxic metabolic products from the eye.

The main symptom of glaucoma in the early stages is an increase in intraocular pressure. Without effective treatment, the outflow of aqueous humor is impaired and intraocular pressure rises, leading to retinal damage, occlusion, and damage to the optic nerve.

Classification of glaucoma types

Glaucoma can be congenital or acquired. Congenital occurs in children and is a pathology of newborns. Acquired is divided into primary and secondary glaucoma. The secondary form is acquired and affects adults.

Types of acquired glaucoma:

1. Primary form – occurs as a primary disease.

• Open-angle glaucoma is the most common form of pathology in which the outflow of aqueous humor through the filtering open angle of the intraocular chamber is impaired.
• Angle-closure glaucoma – a form of the disease with complete closure of the edge for the outflow of intraocular fluid.
• Pigmentary glaucoma – pigment is deposited on the iris of the eye, which closes the angle for the outflow of aqueous humor.
• Normotension glaucoma is a type of pathology in which nerve damage occurs without an increase in intraocular pressure.

2. Secondary form – occurs due to other diseases.

• Inflammatory glaucoma is a pathology that occurs as a result of inflammatory processes in the vascular system of the eye.
• Phacogenic glaucoma is a pathology that occurs due to a change in the shape, displacement or violation of the integrity of the lens.
• Neovascular glaucoma – a form that occurs due to the germination of blood vessels from the iris into the corner for the outflow of intraocular fluid.
• Pseudoexfoliative glaucoma – is the result of deposits in the form of flakes around the perimeter of the back of the cornea, on the iris and front of the eye, which block the outflow of intraocular fluid;
• Postoperative glaucoma is a form of the disease that is a postoperative complication of cataract treatment.
• Traumatic glaucoma is the result of an injury to the eye.
• Dystrophic glaucoma is a disease associated with dystrophy (tissue death) of the retina, Fuchs syndrome and other processes.
• Neoplastic glaucoma is a type of pathology in which a tumor grows and blocks the angle for the outflow of intraocular fluid.
• Iridocorneal endothelial syndrome is the rarest type of disease in which cells from the cornea grow into the filtering canal of the anterior chamber of the eye.

What are the causes of glaucoma?

Unfortunately, modern science has not yet identified the exact causes of glaucoma.

Glaucoma in children occurs against the background of harmful factors of intrauterine development:

• chemical poisoning;
• radioactive poisoning;
• intrauterine infections (mumps, rubella, toxoplasmosis).

Statistically proven that secondary glaucoma occurs more often in older people. The theory that intraocular pressure and blood pressure are related has been refuted.

However, there are patients who are more prone to developing secondary glaucoma. Among the risk factors :

• Hereditary factor (someone in the family had previously suffered from glaucoma).
• Age 35 and older.
• Diabetes mellitus.
• High blood pressure (hypertension).
• Low blood pressure (hypotension).
• Atherosclerosis.
• Moderate to high myopia.
• Migraines and frequent headaches.

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What are the symptoms of glaucoma?

The disease often develops for a long time – for years it does not make itself felt, and the first signs of glaucoma appear in the later stages of the disease. That is why it is important to undergo a comprehensive eye examination once a year. This is especially true for older people, who have a higher risk of developing the disease.

Main symptoms of glaucoma:

• Frequent headache and migraine in the morning.
• Iridescent circles before the eyes and iridescent outlines around objects.
• Gradual loss of vision.
• Pain inside the eye.
• Blurred vision.
• Narrowing of the visual field.
• Nausea, vomiting.
• Dizziness.
• Poor adaptation of the organs of vision when changing light to dark lighting.

Diagnosis and treatment of glaucoma

For the timely diagnosis of this pathology, it is necessary to undergo a comprehensive examination of the organs of vision. People over 35 years of age and patients with risk factors are additionally required to undergo an examination every few years with an emphasis on the detection of glaucoma.

The clinic usually conducts primary complex diagnostics, and then the patient gets an appointment with an ophthalmologist, with whom further treatment of glaucoma and its methods are agreed. You may also need to consult narrow specialists, for example, a pediatric ophthalmologist and a retinologist.

Treatment of glaucoma is carried out by three main methods:

• Conservative method.
• Laser method.
• Surgically.

The conservative method is used in the early stages of glaucoma and in cases where the treatment has a noticeable effect on the patient. In other cases, a low-traumatic laser procedure or surgical intervention is used.

The laser procedure is used as an alternative method to surgery and allows you to create alternative ways of outflow of intraocular fluid. This procedure is less traumatic and does not require long rehabilitation. If necessary, it can be performed several times.

Surgical methods – non-penetrating deep sclerectomy and trabeculectomy. The first method is the main choice in the treatment of open-angle glaucoma. It has the shortest possible rehabilitation period – 1-2 days. The second type is used in advanced cases or with repeated surgical intervention.