Doctor's Notes on Adult Glaucoma Suspect
Glaucoma is a condition in which high pressure inside the eye damages the optic nerve and can result in permanent vision loss. Intraocular pressure (IOP), or elevated pressure inside the eye, is one of the main risk factors for glaucoma. Glaucoma suspect is an adult with one or more risk factors that may lead to glaucoma, including increasing IOP, but they do not yet have optic nerve damage or vision loss due to glaucoma. Regular eye examinations with an ophthalmologist are important to identify and treat people who are glaucoma suspects. Monitoring for the earliest signs of glaucomatous damage can often help preserve visual function.
People who are glaucoma suspected do not usually have any symptoms of glaucoma. Symptoms of possible angle-closure glaucoma may include
- intermittent headaches,
- seeing haloes, or
- blurred vision.
Once vision loss is apparent, significant amounts of optic nerve damage have already occurred. The optic nerve damage and vision loss are permanent.
What Is the Treatment for Adult Glaucoma Suspect?
The treatment for an adult glaucoma suspect is done with long-term monitoring, medications, and surgery to prevent optic nerve damage from glaucoma.
Close monitoring of intraocular pressure (IOP) and signs of damage to the retina or optic nerve is important in adult glaucoma suspects. Depending on a person’s age, medical problems, baseline IOP, and family history, close monitoring and starting preventative treatment will be done by an ophthalmologist.
Ocular hypertension or high IOP should be treated with medications to lower IOP. Common medications used to help lower IOP include:
- Alpha-adrenergic agonists
- Cholinergic agonists
- Rho-kinase inhibitors
- Carbonic anhydrase inhibitors
Combination products are available for several classes of drugs including most commonly:
In patients with certain types of early signs of adult glaucoma suspect, laser peripheral iridotomy can be a preventive measure in decreasing the risk of acute angle-closure glaucoma.
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Acute Angle-Closure GlaucomaAcute angle-closure glaucoma is caused by a rapid or sudden increase in pressure inside the eye, called intraocular pressure (IOP). Symptoms of acute angle-closure glaucoma severe eye pain, nausea and vomiting, headache, blurred vision and/or seeing haloes around lights, profuse tearing. The condition requires treatment by an ophthalmologist which may include medication, surgery, or a combination approach.
Angle Recession GlaucomaAngle recession glaucoma refers to a group of ocular disorders that occur after the eye undergoes trauma. Following this trauma, different mechanisms can cause an abnormal elevation of pressure inside the eye. An ophthalmologist diagnoses angle recession glaucoma using special instruments. Treatment may include eye drops, medication, laser surgery, or conventional incisional surgery. Taking steps to prevent traumatic eye injury is the best way to prevent angle recession glaucoma.
GlaucomaGlaucoma can be caused by a number of eye diseases that can damage the optic nerve, typically by elevating pressure inside the eye, which is called intraocular pressure (IOP) or ocular hypertension. Symptoms begin slowly and include vision loss and irregularities, eye pain, headache, nausea, and vomiting. Beta-blockers, Alpha-adrenergic agonists, and prostaglandin analogs are drugs used to treat glaucoma. Sometimes surgery is necessary, especially with congenital glaucoma. The disease is not curable but can be managed.
Glaucoma FAQsGlaucoma is usually high pressure inside the eye that damages the optic nerve and can result in permanent vision loss. While high pressure inside the eye, damage to the optic nerve and vision loss are common criteria for diagnosing glaucoma, glaucoma can be present without all three of these criteria. The two main types of glaucoma are open-angle and angle-closure glaucoma. Glaucoma may be symptomless until significant permanent vision damage has occured, but may show symptoms as well, including pain, redness, haloes, and blurred vision.
Glaucoma MedicationsGlaucoma is a disease characterized by increased intraocular pressure (IOP). (Intraocular means within the eye.) Increased intraocular pressure results from either increased production or decreased drainage of aqueous humor. Treatment for glaucoma can include medication and/or surgery to lower the intraocular pressure.
Lens-Particle GlaucomaLens-particle glaucoma is a form of glaucoma that occurs due to leakage of material from the inside of the lens of the eye. It may be caused be trauma, surgery, or inflammation. Signs and symptoms of lens-particle glaucoma may include blurred vision, sensitivity to light, eye pain, headache, redness, and tearing. The condition is diagnosed by ophthalmologic evaluation. Treatment may include eyedrops to control eye pressure and inflammation.
Normal-Tension GlaucomaNormal-tension glaucoma or low-tension glaucoma is a condition in which the optic nerve is damaged despite normal fluid pressure inside the eye (other types of glaucoma result vision loss because of abnormally high pressure inside the eye. Normal-tension glaucoma typically occurs in older adults and can be caused by congenital nerve defects and irregularities in blood flow to the eye. Eyedrops and surgery are treatments for this disorder.
Primary Congenital GlaucomaPrimary congenital glaucoma is present at birth and may be inherited. Blepharospasm, photophobia, and epiphora are symptoms. A cloudy whitish-gray cornea is a common sign. Treatment of primary congenital glaucoma typically involves surgery.
Primary Open-Angle Glaucoma (POAG)Glaucoma describes chronic high pressure within the eyeball. The pressure eventually causes nerve damage, though glaucoma can still occur without elevated pressure. Primary open-angle glaucoma is a subtype of the disease characterized by atrophy of the optic disc in the back oif the eye and other problems.
What Is Usually the First Sign of Glaucoma?Early glaucoma usually has few symptoms, but the buildup of pressure in the eye over time leads to slow vision loss starting with peripheral vision.
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.