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Exploring the Rare & Common Types of Glaucoma

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Glaucoma is a deadly eye disease, not just because of the irreversible damage to the optic nerve but because it sneaks up silently and takes away your sight. As if that was not enough, there are so many types of glaucoma and they all come with different causes and treatments.

So, without further ado, let us explore these common and rare types of glaucoma.

Glaucoma and the normal eye

Glaucoma and the normal eye

Open-Angle Glaucoma

Also known as chronic glaucoma, open-angle glaucoma normally shows up when the drainage channel is blocked. This usually happens because of the aging of the drainage channel, it slowly becomes clogged and the eye fluid (aqueous humor) starts to accumulate, causing an increase in eye pressure. This is not something that happens overnight, it takes time and develops slowly, but once started, it becomes a lifelong condition.

Even though open-angle glaucoma is more common in older people, there have been cases of it affecting younger people as well.
Open-angle glaucoma (one of the most common types) accounts for at least 90% of all glaucoma cases

Normal Tension Glaucoma

This is another form of open-angle glaucoma, but it differs by cause. As the name suggests, people with this type of glaucoma tend to be unusually sensitive to even normal levels of eye pressure. Eye doctors may refer to it as ‘Normal Pressure or Low Tension Glaucoma’. The underlying cause is still being looked into but plausible reasons include abnormally low blood pressure or an over sensitive optic nerve. Poor blood flow may also attribute to normal tension glaucoma.

You should watch out for this type of glaucoma if you have:

  • A family history of glaucoma
  • Are of Japanese ethnicity
  • Have some heart disease

Acute Angle-Closure Glaucoma

Unlike other types of glaucoma, this one is not that common. People of Asian and Native American heritage are at higher risk of acute glaucoma. It occurs when the drainage system of the eye becomes blocked.

Now, how does that happen?

The drainage canals or channels that you will hear a lot about in this article are present between the iris and cornea. If the iris and cornea move too close, it restricts the ‘angle’ between them. When the angle becomes closed, pressure builds up and causes damage. Hence, the name ‘angle-closure’ glaucoma. The symptoms show up suddenly and often painfully with blurred vision, severe headaches, nausea or even seeing rainbow halos around lights. Acute angle-closure glaucoma requires immediate medical care or it may cause permanent damage and loss of sight.

Secondary Glaucoma

This type of glaucoma shows up as the result of some other eye condition or disease, such as inflammation in the eye (Uveitis), trauma, eye injury, tumor or a side effect of some drug.

Learn more about what is uveitis, the causes, symptoms,and treatments

The type of glaucoma resulting from eye pressure change is termed as primary glaucoma. Just like primary glaucoma, secondary glaucoma can also be open-angle or angle-closure type and can occur in one or both eyes.

Since the cause can be from a number of different things mentioned above, the treatment of different kinds of glaucoma also varies. Although, in most cases, medications or eye surgery may help.

Exfoliation Glaucoma

Exfoliation glaucoma, also abbreviated as XFG or termed as pseudoexfoliative glaucoma, is one of the most common identifiable types of secondary open-angle glaucoma. It is categorized as a gene abnormality in which a white flaky, dandruff-like material peels off the outer layer of the lens and starts to collect in the angle between the cornea and iris, in turn clogging the drainage system of the eye.

XFG is known to affect certain racial groups such as people from Russia, the Nordic countries, Greeks, Mediterranean populations and Indians more commonly than people from other ethnic backgrounds.

This type of glaucoma shows higher eye pressures and faster disease progression than patients with primary open-angle glaucoma.

Glaucoma diagnosis detection and protection: The sooner you start, the better!

Eye exam: Glaucoma diagnosis and detection

Eye exam: Glaucoma diagnosis and detection

Neovascular Glaucoma (NVG)

Another form of secondary glaucoma, Neovascular glaucoma occurs when new blood vessels start to form on the iris and the eye’s drainage channels. This abnormal blood vessel formation causes the blockage of drainage channels. NVG is often related to diabetes and proliferative diabetic retinopathy. It never occurs on its own, meaning if you have diabetes, there are high chances you may experience Neovascular glaucoma. According to the findings of a research study,

Normally hypotensive topical drops can help patients with NVG. However, if these do not suffice, laser or surgical procedures may help to control the intraocular pressure.

Pigmentary Glaucoma

Pigmentary glaucoma is known to be more common in men as compared to women. When the pigment granules, present at the back of the iris, start to break and collect in the eye fluid, they block the drainage canals of the eye. The intraocular pressure begins to rise and the symptoms begin.

This pigment deposit can be detected via an eye exam, so there is a good chance you can prevent disease progress on time, given you get regular eye checkups. As stated earlier, pigmentary glaucoma is more likely to affect the male population including young Caucasians, who are near-sighted.

As patients with pigmentary glaucoma age, the pigment dispersion may lessen but not stop. Therefore, patients will still be at risk for developing glaucoma and thus, need to take the correct precautionary measures.

Traumatic Glaucoma

The most common cause of traumatic glaucoma is blunt trauma. Traumatic glaucoma can occur from a blow to the head or the eye. People who play sports such as baseball or boxing need to be more careful and aware of this type of glaucoma because it may develop immediately after an injury or may take years to show up. Other than blunt trauma, injuries that penetrate the eye can also contribute to traumatic glaucoma.

One common occurrence in traumatic glaucoma is damage to the ciliary body. Due to trauma, the ciliary body, the part of the eye responsible for producing the aqueous fluid, is damaged and begins to tear. This tearing can often cause bleeding inside the eye and raise complications, adding to glaucoma.

Treatments include keeping the eye pressure in control so the excess blood leaks out of the eye. Glaucoma medications come as the first step, but surgeries can also help if they do not work.

Uveitic Glaucoma

As evident from the name, this form of glaucoma stems from Uveitis, a common eye condition. Uveitis or ocular inflammatory disorders occur when the pigmented layer in the eye, comprising of the iris, choroid and the ciliary body, becomes inflamed. This inflammation can block the drainage pathways and cause an increase in intraocular pressure IOP, causing glaucoma. This happens when uveitis becomes chronic.

Fighting with uveitic glaucoma is not easy. There can be various causes to uveitis alone, so first identifying and treating the underlying cause of uveitis is necessary and then treatment for lowering the IOP may begin.

As you may know, some uveitis treatments such as corticosteroid treatment can also cause an increase in IOP, so there is a lot you need to take into account before jumping to any conclusions.

Congenital Glaucoma

A rare condition known to affect babies and young children, congenital glaucoma has many names such as childhood glaucoma, pediatric or infantile glaucoma. This occurs when the eye’s drainage canals do not develop properly, during the prenatal period. An inherited condition, usually diagnosed within the first five years of a child’s life, it can be treated via microsurgery and medications.

Symptoms include enlarged eyes, cloudy corneas, and sensitivity towards light.

Irido Corneal Endothelial Syndrome (ICE)

ICE is a rare form of glaucoma, which mostly affects only one eye. In this condition, the eye’s drainage tissues become blocked because of the cells on the back surface of the cornea start to spread over these tissues and across the surface of the iris. These cells also form adhesion, binding the iris to the cornea, further blocking the drainage channels. A blocked drainage system gives rise to an increase in eye pressure, which damages the optic nerve.

This type of glaucoma is commonly found in females with light skin. Symptoms may include hazy or blurry vision upon waking up and seeing halos around lights. Treating ICE is a bit difficult, as conventional laser therapies do not work as effectively. Best treatment options include medications or filtering surgery.

Concluding Thoughts

If you or a loved one is fighting with glaucoma of any type, follow the given instructions from your optometrist and get regular eye checkups and eye exams.

Any damage incurred by glaucoma cannot be reversed by present medical advancements. That makes it even more important to go the extra mile and protect your vision. Relying on certain healthy habits, low vision aids, and adopting a generally healthy lifestyle, will be a great head start to help you improve your quality of life.


This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

Comments

Umesh Chandra Bhatt from Kharghar, Navi Mumbai, India on April 19, 2019:

Exhaustive and informative. Thanks.

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