Glaucoma - body, causes, How Does Glaucoma Affect the Eye? Glaucoma Glaucoma Photo by: LightScribe Glaucoma (glaw-KO-ma) is a group of disorders that cause fluid pressure to rise inside the eye, which may result in vision loss. KEYWORDS for searching the Internet and other reference sources Ophthalmology Vision If a balloon is slowly filled with water, eventually it will burst. But if the same balloon has several pin-sized holes at one end, then it becomes possible to continue adding water to the balloon to maintain its round shape, without breaking the balloon, as long as the amount of water being added is equal to the amount escaping through the pinholes. The eye has a similar system of liquid that continuously flows in and out of a small chamber at the front of the eyeball. The problem for people with glaucoma is that the drainage out of the eye is blocked or not working properly. It is similar to the balloon that is filling with water. Without a way to make room for more liquid, pressure builds up. Although a pressure buildup will not cause the eye to burst, it may damage nerves at the rear of the eyeball that carry images to the brain.

Glaucoma is one of the leading causes of blindness in the United States. It affects more than 3 million people, especially the elderly and people of African ancestry. The disease also is one of the sneakiest eye disorders. Pressure can grow in the eye for years before the effects on vision are noticed. By then, often the damage has been done. Anatomy of the eye. The arrows show the flow of aqueous humor from behind the iris, through the pupil, to the front of the eye, where it drains through the canal of Schlemm. How Does Glaucoma Affect the Eye? The eye is about the same size as a ping-pong ball and is divided into two compartments. The larger compartment at the rear of the eye contains a gel-like substance called vitreous (VIT-re-us) humor, which helps to maintain the eyeball's shape and to transmit light. The front compartment, or anterior chamber, is smaller and is filled with a watery liquid called aqueous (AY-kwee-us) humor. This clear liquid brings in nutrients vital to the eye's health and carries out waste that can damage it. The aqueous humor flows from behind the front colored portion of the eye, which is called the iris.

It moves through the pupil, the opening in the center of the iris, into the front chamber of the eye. The liquid flows through the chamber and out a tiny drainage canal that has a fine, mesh-like covering. The small hole on the canal rests at an angle where the colored iris meets the cornea, the clear cup-shaped disc at the front of the eyeball. About 90 to 95 percent of people with glaucoma have a problem with this drainage system. The cause is unknown, as there is no visible blockage. It appears that the cells in the mesh covering the drainage canal do not do their job properly, or lose their ability to allow proper drainage over time. Glaucoma develops gradually, but there is a rarer acute * form of glaucoma that develops suddenly when the iris closes off the drainage canal. This causes a painful medical emergency that requires immediate treatment. The cause of most cases of glaucoma is not understood, although people of African ancestry, people who have diabetes or other family members with glaucoma, or those who have suffered eye injuries are at greater risk. Aging is another risk factor for glaucoma. How Is Glaucoma Diagnosed?

Except for the rare cases of acute glaucoma that develop suddenly, most people do not realize they have glaucoma. As pressure is building in the eye, many of the millions of nerve cells at the rear of the eye are destroyed. The nerves that die first affect peripheral (pe-RIF-er-al) vision, or how well people see out of the sides of the eyes. When the loss of vision becomes severe enough for a person to notice, the damage is so great that little can be done. The best way to diagnose glaucoma is through an eye exam that uses an instrument called a tonometer (to-NOM-e-ter) to measure the pressure in the eye. One type of tonometer registers eye pressure by lightly touching the eye's surface. Eyedrops are used to make this procedure painless. Another tonometer uses a puff of air to measure eye pressure. The doctor or eye specialist (ophthalmologist or optometrist) also may use a scope that shines light in the eye to look for damage to the optic nerve. Peripheral vision can be checked as part of the eye exam. * acute means sudden, short, and severe. Why Are Early Diagnosis and Treatment Important?

Diagnosis Early diagnosis of glaucoma is the key to preventing vision loss. If glaucoma is discovered before the increased eye pressure has destroyed many nerves, vision can be saved in many cases. Routine eye exams, including tests for glaucoma, are important, especially as adults pass age 35. Such eye exams are especially important for people at greatest risk for glaucoma, including people of African ancestry, people with relatives who have glaucoma, people with diabetes, and people with previous eye injuries. Treatment The most common treatment involves eyedrops that reduce pressure. Sometimes surgery is necessary either to open the drainage canal or to create a new one. No Mountain Too High Glaucoma rarely occurs in young people, but Erik Weilenmayer was born with an eye disease that caused glaucoma. By age 13, he was totally blind. Erik did not let glaucoma prevent him from becoming a teacher and a mountain climber. He has scaled some of the toughest peaks, including Alaska's Mt. McKinley, the highest in the United States. "When I first went blind, I wondered what I could do," Weilenmayer said in 1998.

"It's really a kick to do extreme activities and do them well—and no more dangerously than anyone else." Erik's accomplishments are a reminder that physical challenges and differences do not have to prevent people from participating in life's most difficult and demanding activities. See also 3 Main Causes Of Glaucoma By Marilyn Haddrill ; contributions and review by Charles Slonim, MD Like This Page? Please Share! The cause of glaucoma generally is a failure of the eye to maintain an appropriate balance between the amount of internal (intraocular) fluid produced and the amount that drains away. Underlying reasons for this imbalance usually relate to the type of glaucoma you have. Just as a basketball or football requires air pressure to maintain its shape, the eyeball needs internal fluid pressure to retain its globe-like shape and ability to see. But when something affects the ability of internal eye structures to regulate intraocular pressure (IOP), eye pressure can rise to dangerously high levels  causing glaucoma. Recommended For You Learn how Optometry Giving Sight helps 670 million people to see again Unlike a ball or balloon, the eye can't relieve pressure by springing a leak and "deflating" when pressure is too high.

Instead, high eye pressure just keeps building and pushing against the optic nerve until nerve fibers are permanently damaged and vision is lost. The aqueous humor is produced behind the iris, flows into the anterior chamber through the pupil, and exits the eye via the drainage angle between the iris and cornea. Too much aqueous production or obstruction of its outflow from the eye causes a rise in intraocular pressure (IOP) that can lead to glaucoma. In most types of glaucoma, elevated intraocular pressure (IOP) is associated with damage to the optic nerve in the back of the eye. Glaucoma and Eye Anatomy When glaucoma progresses, injury to neurons ultimately leads to eye damage in the form of peripheral vision loss. However, eye damage appears to begin first in the brain as connectivity is lost. This discovery reported in early 2010 is a major breakthrough that could lead to improved early diagnosis and treatments of the eye disease, according to Vanderbilt Eye Institute (VEI) researchers in Nashville. "If you followed the disease long enough, eventually the optic nerve, then the retina, show signs of degeneration," said VEI research director David Calkins, PhD. "So the degeneration works in reverse order.

It starts in the brain and works its way back to the retina..." To understand what causes glaucoma, you first must know something about the human eye's anatomy and how intraocular fluid moves through the eye: The clear fluid inside the eye is produced by the ciliary body , which is a small, circular structure found behind the iris or colored portion of the eye. This fluid, known as the aqueous humor , flows behind the iris and through the pupil or central opening in the middle of the iris. The aqueous humor (or "aqueous") then fills the anterior chamber, a space between the back of the clear cornea and the front of the iris. The aqueous exits the eye through a structure known as the drainage angle , which is the angle formed inside the anterior chamber between the iris and the peripheral cornea. The aqueous filters through this angle and through the sclera or white part of the eye and then joins with the network of veins outside the eye. Any disruption of this outflow of aqueous  including from certain eye injuries  can result in an increase in IOP. Anatomically, the eye's drainage angle is referred to as being either "open" or "closed" (narrow).

The narrower the angle, the more difficult it is for the aqueous to flow through it. An open angle also can hinder the outflow of aqueous, if structural damage exists within the ocular tissues of the angle itself. What is more important than your vision? Find local eye doctor to get an eye exam Other Glaucoma Causes: Poor Blood Flow, Optic Nerve Damage While high IOP often is associated with glaucoma, this eye disease also can occur when internal eye pressure is normal (normal-tension glaucoma). People with this condition have highly pressure-sensitive optic nerves that are susceptible to irreversible damage from what ordinarily would be considered "normal" IOP. Conversely, certain people with elevated intraocular pressure known as ocular hypertension may never develop glaucoma. Most conventional methods of screening for glaucoma involve testing eyes for the presence of high IOP. But because glaucoma can occur even without high IOP, direct examination of the optic nerve and visual field testing are essential in making (or ruling out) the diagnosis of glaucoma. Watch this video that explains what glaucoma is and who is at risk for the disease.

(Video: National Eye Institute) Though the exact cause of normal-tension glaucoma is unknown, many researchers believe decreased blood flow to the optic nerve may be a factor. This could be caused by narrowing of blood vessels that nourish the optic nerve or constrictions of these vessels (vasospasms). Some studies also indicate that poor blood flow within the eye is associated with blind spots (scotomas) that develop within the visual field, similar to those that occur in glaucoma.* An intriguing study reported in August 2007 indicates a potential common cause of both glaucoma and Alzheimer's, which creates brain lesions and accompanying memory loss. Researchers in the UK who conducted the study found that buildup of a protein known as beta-amyloid in the eye's retina and in brain tissue appears to be associated with development of both glaucoma and Alzheimer's. However, abnormal accumulation of beta-amyloid proteins does not mean that someone with Alzheimer's will have glaucoma or vice versa. Researchers said similarities between certain eye and brain tissue could explain why the buildup of beta-amyloid proteins can affect both the eye and the brain.

Increasingly, glaucoma treatments now are being investigated for their ability to protect nerve cells in the eye from damage. How does glaucoma affect the body? - Living With Glaucoma - Sharecare Living With Glaucoma How does glaucoma affect the body? A Honor Society of Nursing (STTI) answered Glaucoma is a disease that, for the most part, affects only the eyes. Along with acute angle-closure glaucoma, also known as closed-angle glaucoma, comes severe eye pain, which result from of a rapid increase in pressure of the eye. The pain can be intense, causing nausea and vomiting. With all other types of glaucoma there is unlikely to be any other effect on the body besides the eyes and their loss of vision. Glaucoma Symptoms, Treatment, Causes - What is glaucoma? - MedicineNet Medical Author: Andrew A. Dahl, MD, FACS Andrew A. Dahl, MD, FACS Andrew A. Dahl, MD, is a board-certified ophthalmologist. Dr.

Dahl's educational background includes a BA with Honors and Distinction from Wesleyan University, Middletown, CT, and an MD from Cornell University, where he was selected for Alpha Omega Alpha, the national medical honor society. He had an internal medical internship at the New York Hospital/Cornell Medical Center. Medical Editor: William C. Shiel Jr., MD, FACP, FACR William C. Shiel Jr., MD, FACP, FACR Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology. What is glaucoma? Quick GuideCommon Eye Problems and Infections What is glaucoma? Glaucoma is a disease of the major nerve of vision, called the optic nerve. The optic nerve receives light-generated nerve impulses from the retina and transmits these to the brain, where we recognize those electrical signals as vision.

Glaucoma is characterized by a particular pattern of progressive damage to the optic nerve that generally begins with a subtle loss of side vision (peripheral vision). If glaucoma is not diagnosed and treated, it can progress to loss of central vision and blindness. Glaucoma is usually, but not always, associated with elevated pressure in the eye (intraocular pressure). Generally, it is this elevated eye pressure that leads to damage of the eye (optic) nerve. In some cases, glaucoma may occur in the presence of normal eye pressure. This form of glaucoma is believed to be caused by poor regulation of blood flow to the optic nerve. How common is glaucoma? Worldwide, glaucoma is the second leading cause of irreversible blindness. In fact, as many as 6 million individuals are blind in both eyes from this disease. In the United States alone, according to one estimate, more than 3 million people have glaucoma. As many as half of these individuals with glaucoma may not know that they have the disease. The reason they are unaware of the presence of the disease is that glaucoma initially causes no symptoms, and the subsequent loss of side vision (peripheral vision) is usually not recognized.

Medically Reviewed by a Doctor on 10/20/2016 Glaucoma | University of Maryland Medical Center If left untreated, blindness results. Symptoms of Closed-Angle Glaucoma In acute closed-angle glaucoma, the pressure inside the eye increases quickly, and the symptoms are dramatic. Intense pain in the eyebrow area and blurred vision develop usually in one eye, and the patient often feels like the eye will burst (although it won't). The eye usually reddens. A person may see rainbow-like halos around lights. Sometimes nausea and vomiting occur. These symptoms may occur on and off and not appear as a full attack. In either case, they indicate a medical emergency. In chronic closed-angle glaucoma, the process is gradual and painless. Symptoms of Congenital Glaucoma Although congenital glaucoma is usually present at birth, symptoms generally don’t develop in the infant for a few months. If parents notice that an infant’s eyes are enlarging, becoming cloudy, often watering, or tending to close in the presence of light, they should have an ophthalmologist examine the child’s eyes.

Port-wine stains on an infant’s face could indicate Sturge-Weber syndrome, a disorder that occasionally causes glaucoma. Diagnosis Early diagnosis is the key to successful treatment of glaucoma and prevention of blindness. Because chronic glaucoma has no warning symptoms, half of patients are unaware they have the condition. A diagnosis of glaucoma does not depend solely on the presence of increased pressure within the eye. Optic nerve damage or a strong indication of damage must also be present. The optic nerve carries the information of vision from the eye to the brain. Recommendations for Glaucoma Screening There has been debate about the relative benefits and risks of routine glaucoma screening in adults. Glaucoma screening can help identify signs of increased intraocular pressure (IOP) and the early stages of primary open-angle glaucoma (POAG). However, treatment of IOP and early POAG can potentially result in harmful effects, such as eye irritation and increased risk for cataracts. Because of this uncertainty, the United States Preventive Services Task Force has not found sufficient evidence to recommend for or against routine screening for glaucoma in adults.

In contrast, the American Academy of Ophthalmology strongly supports glaucoma screening, with the following specific recommendations: Everyone over age 65 and African-Americans over 40 years old should have periodic eye exams, including tests for glaucoma, every other year. African-Americans ages 20 - 39 should have eye examinations every 3 - 5 years. Other people at higher risk (people with diabetes, history of eye injuries, a family history of glaucoma, or those taking corticosteroid medications) should have eye examinations every year after age 35. People with known glaucoma should have frequent examinations to check peripheral vision and to be sure treatment is maintaining a safe eye pressure. After such examinations, the ophthalmologist will assess current treatment and make necessary adjustments. Tonometry and Pressure Tests Doctors determine IOP using a painless procedure called tonometry, which measures the force necessary to make an indentation in the eye. They may use a tonometer (small smooth instrument). There are several methods, and the doctor may apply anesthetic eye drops to first numb the eye: The applanation (Goldman) method, uses a blue-light filter and slit-lamp, which is moved forward toward the patient's face.

Electronic indentation tonometry uses an electronic pen with a digital read-out. The noncontact approach does not use a tonometer. It applies a puff of air to measure the force needed to indent the eye. In the Schiotz method, the doctor presses very lightly against the eye with the tonometer. IOP is measured by the weight needed to flatten the cornea. This method is not considered as accurate as the others. In general, normal IOP is usually maintained at measurements of 10 - 21 mmHg. Intraocular pressure over 21 mmHg indicates a potential problem. The test is not completely accurate, however. Only about 10% of people with IOP levels of 21 - 30 mmHg will actually develop glaucoma and optic nerve damage. On the other hand, many people with glaucoma have normal pressure, at least for part of the time. Measurement of Cornea Thickness (Pachymetry) Cornea thickness is an important indicator of disease progression in patients with elevated IOP. The doctor first applies numbing drops to the eye and then uses an ultrasonic wave instrument to measure cornea thickness.

Tests for Optic Nerve Damage To check for damage in the optic nerve, the doctor first uses eye drops to dilate (widen) the pupils and then examines the eyes with a magnifying lens instrument such as an ophthalmoscope, which has a light on one end. Damaged nerve fibers may be indicated by: An asymmetrical or elongated cupped optic nerve. (The cup of the optic disc is the center portion, which enlarges as nerve damage progresses.) The optic nerve color may be pale or an unhealthy pink. Visual Field Tests The doctor will conduct tests of the visual fields (the areas that the patient can see). In most people with glaucoma, the first areas to become noticeably impaired are the peripheral visual fields (areas of sight that are not directly in front of a person but around the edges, or periphery). Tests for Closed-Angle Glaucoma Using an instrument called a gonioscope, ophthalmologists can inspect the front of the eyes and assess the drainage angle between the cornea and the iris and the channels in the trabecular meshwork. This test can help differentiate between closed- and open-angle glaucoma. Treatment Glaucoma cannot be cured, but treatment may help delay disease progression.

Most treatments for glaucoma aim to reduce ocular pressure and its fluctuations. Early treatment with medications, surgery, or both can nearly always maintain safe pressure of the aqueous humor, thus preventing optic nerve damage and blindness. Decision to Start Treatment Many people have high IOP but no sign of nerve damage. Over the course of 20 years, only 10 - 30% of these people will actually develop glaucoma. Nevertheless, once glaucoma has destroyed optic nerve fibers, no treatment can reverse the damage. However, not all people with high eye pressure develop optic nerve damage and serious vision problems. Nor does treatment prevent progression in some patients. Medications used for glaucoma also can carry side effects and risks. Some doctors recommend delaying treatment for people with borderline or early signs of glaucoma until they begin to show risk factors for progressive disease and vision loss (thinner corneas, larger cup to optic disc ratio, older age, and rising pressure). Considerations for Drug Treatments There are many different drugs for treating glaucoma. The drugs reduce pressure in the eye but all have a number of side effects that affect other parts of the body. Occasionally, some side effects can be severe.

Many of the drugs used for glaucoma can interact with common medications for other conditions. And, many patients require two or more drugs. If your doctor prescribes more than one medication, be sure you understand when you should take each drug and how long you should wait between applying each drop. Ask your doctor to write down a schedule for you. Let your doctor know if you experience any side effects. To prevent optic nerve damage, it is very important to take your medication on a regular basis and not skip doses. Most glaucoma medications are given as eye drops. These drugs decrease eye pressure by reducing the production of aqueous humor or by helping the fluid drain more efficiently: Prostaglandin-like drugs are generally the first-line treatment for glaucoma. They include latanoprost (Xalantan), bimatroprost (Lumigan), travaprost (Travatan), and tafluprost (Zioptan). Beta-blockers such as timolol (Timoptic, generic) and other brands are a second choice. Alpha agonists, carbonic anhydrase inhibitors (CAIs), and miotics are other drug therapies. Some drugs are available are available as combination eye drops.

For example, Cosopt combines the beta blocker timolol and CAI dorzolamide. Combigan combines timolol and the alpha agonist brimonidine. Treating Pregnant Patients. Considerations for a pregnant woman with glaucoma can be complicated. All of the drugs used for glaucoma are absorbed by the body, cross the placenta, and are excreted in breast milk. Many have effects that can interfere with or adversely affect pregnancy. Women should discuss going off medication, particularly during the first trimester, and be monitored during that time for increasing eye pressure. IOP tends to drop during pregnancy, although usually not to a significant degree. In addition, changes in IOP and visual loss vary greatly. Some women have no IOP change or visual loss during pregnancy, while others may experience an increase in IOP or worsening of visual loss. Your ophthalmologist must carefully consider your individual case and talk with you about the risks and benefits of continuing glaucoma medication during pregnancy. If women need to take medications, they should try to take the lowest effective dose possible. Considerations for Surgery The goal of standard glaucoma surgery is to reduce pressure in the eye by increasing the outflow of the aqueous fluid.

Two methods are commonly used: Filtration surgery (trabeculectomy). This uses standard surgical instruments to open a passage in the eye for draining fluid. Laser trabeculoplasty. This procedure uses a laser to burn tiny holes in the drainage area. In general, surgery is used for patients who have not been helped by medications. However, in some cases doctors may recommend surgery before or in place of drug treatment. Surgery does not cure glaucoma, and over half of patients will need medication or a repeat surgical procedure within 2 - 5 years. Medications Nearly all glaucoma medications are prescribed to reduce eye pressure. They generally work by reducing the production of aqueous humor and increasing fluid outflow (drainage). In most cases, these drugs are taken as eye drops. If drops alone do not work, your doctor may also prescribe a medication to be taken by mouth. Prostaglandins Prostaglandins are hormone-like substances that help widen blood vessels. Drugs that mimic natural prostaglandins increase the drainage of aqueous humor to help reduce intraocular pressure. Prostaglandin-like drugs are the first-line treatment for glaucoma.

Latanoprost (Xalatan, generic) is the standard brand. Latanoprost was the first prostaglandin to be approved as first-line treatment for elevated eye pressure. Three newer prostaglandins are travoprost (Travatan), bimatoprost (Lumigan),and tafluprost (Zioptan). These drugs are used to reduce eye pressure in patients with open-angle glaucoma and high ocular pressure. Side effects include itching, redness, and burning during administration. Muscle and joint pain may also occur. All of these drugs may permanently change eye color from blue or green to brown. Beta-blockers Topical beta-blockers lower the pressure inside the eye by inhibiting the production of aqueous humor. Timolol (Timoptic, Betimol, generic) is the standard brand. Other examples of beta-blockers used for glaucoma treatment are levobunolol (Betagan, generic), carteolol (Ocupress, generic), metipranolol (OptiPranolol, generic), and betaxolol (Betoptic, generic).

After a beta-blocker is administered, only a tiny amount of the drug is absorbed by the cornea. Most of it enters in the bloodstream. These drugs, therefore, can cause side effects in parts of the body other than the eyes ("systemic" side effects). Beta-blockers may: Cause reduced sexual drive, fatigue, depression, anxiety, and breathing difficulties. Lower heart rate and reduce blood pressure. Worsen severe asthma or other lung diseases. Cause a sudden rise in eye pressure, particularly if a patient has switched to a beta-blocker from another type of glaucoma medication. It is important that IOP be checked shortly after the other drug has been withdrawn. When beta-blockers are used to treat one eye, the other (contralateral) eye also experiences a lesser, but still significant reduction in IOP. Topical beta-blockers can interact with oral medications, such as other beta-blockers, calcium-channel blockers, or the antiarrhythmic drug quinidine. People with diabetes who take insulin or hypoglycemic medications should be aware that beta-blocker side effects may mask the symptoms of hypoglycemia (low blood sugar).

Carbonic Anhydrase Inhibitors Carbonic anhydrase inhibitors (CAIs) are used for glaucoma when other drugs do not work. They may be combined with other medications. In addition to reducing aqueous humor production, CAIs may improve blood flow in the retina and optic nerve (beta-blockers do not). Improving blood flow can keep the disease from getting worse. CAIs are available in the following forms: Eye-drop CAIs include dorzolamide (Trusopt, generic) and brinzolamide (Azopt). Side effects may include stinging in the eye, watery or dry eyes, or bitter taste. Brinzolamide is a newer medication that may cause less stinging than dorzolamide. Oral forms include acetazolamide (Diamox, generic) and methazolamide (Neptazane, generic). Although pill forms are more effective than eye drops, they have significantly more side effects and are rarely used for long-term treatment. Unpleasant side effects include frequent urination, stomach problems, and tingling in fingers and toes. People who are allergic to sulfa drugs or who have a history of kidney stones should not use these drugs.

CAIs can also produce a toxic reaction when taken with large doses of aspirin. Alpha Agonists Alpha agonists, also called adrenergic agonists, reduce the production of aqueous humor and increase drainage. Apraclonidine (Iopidine, generic) and brimonidine (Alphagan, generic) are the alpha agonists used for glaucoma treatment. They are generally used before glaucoma surgery, but may be useful as primary therapy when used in combination with beta-blockers or other standard drugs. The most common side effects are dry mouth and altered taste. Alpha agonists may also trigger an allergic reaction that causes red and itching eyes and lids. Brimonidine causes less of an allergic response than apraclonidine. Unlike apraclonidine, however, it can cause lethargy and mild low blood pressure. Miotics Miotics, also called cholinergic agonists, narrow the iris muscles and constrict the pupil. This action pulls the iris away from the trabecular meshwork and allows the aqueous humor to flow out through the drainage channels, reducing the pressure inside the front of the eye.

Pilocarpine (Isoptocarpine, other brands, generic) was the most widely used anti-glaucoma drug before timolol was introduced. It is the preferred miotic. However, it has to be taken several times a day and many people have difficulty complying with this regimen. Carbachol (Isopto) is another miotic. Epinephrine and its derivatives are the older therapies. Epinephrine is now rarely prescribed because of side effects. Dipivefrin (Propine), a newer form of epinephrine, is effective in low doses and causes few systemic side effects. Side Effects. Side effects may include: Teary eyes, brow-aches, eye pain, and allergic reactions. A miotic narrows the pupil and so can cause nearsightedness. Vision can become dim and it may be difficult to see in darkened rooms or at night, making driving difficult. Miotics increase the risk of cataract development and are therefore used mostly in patients in whom cataracts have already been removed. Retinal detachment is an uncommon but dangerous side effect in susceptible individuals.

Managing Drug Regimens Many patients skip doses of their glaucoma medications, sometimes because of side effects and sometimes because of confusing or time-consuming regimens. Skipping even a few doses can greatly increase the risk of visual loss. It is essential that you inform your doctor if you are not regularly taking your medication. Otherwise, your doctor may increase the dosage, thereby causing unwelcome side effects. Patients who do not regularly take their glaucoma medication are at high risk for blindness. If you have problems taking your medications or sticking to the dosing regimen, talk with your doctor. Hints for Managing a Regimen. Pharmaceutical manufacturers use colored tops, yellow for timolol, for example, and green for pilocarpine, to help prevent mix-ups. Creating a chart scheduling each drug by color can be helpful. Small electronic timers are available that will signal times for taking the medications. The timing of these combinations is important. Some patients may be candidates for single medications that combine two drugs, such as Cosopt, which contains both dorzolamide and timolol. This medication requires only one drop twice per day. Patients who need additional glaucoma drugs, however, will need to take these two drugs separately.

When using any drug for a long period of time, side effects are a potential problem. If they become severe, ask your doctor about reducing the dosage or trying other drugs. Administering Eye Drops. A common reason that glaucoma medicine does not work is that patients do not take it correctly. Patients should ask the ophthalmologist to watch while they place the drops in their own eyes to make sure they are doing it correctly. The following are some recommended steps: If you use both ointments and eye drops, take the eye drops first. Wash your hands before applying eye drops. Hold the bottle upside down. Tilt your head back and, with one hand, pull the lower eyelid down to form a pocket. With your other hand, hold the bottle as close as possible to your eye. Don’t let the bottle directly touch your eye or eyelid. After you have placed the drop, close your eye or press your index finger against the corner of the eye near your nose. Gently move the lower lid upward until the eye is closed. Keep your eye closed for at least 1 minute. This prevents the drop from draining out.

Wait at least 5 minutes before applying another drop or a different medication Drug Therapy for Acute Closed-Angle Glaucoma Acute closed-angle glaucoma is an emergency situation. Doctors may administer a combination of two or more medications to reduce eye pressure quickly before it can damage the optic nerve and cause visual loss. Apraclonidine (Iopidine, generic) is a powerful drug used before and after laser surgery to prevent an increase in fluid pressure and is more effective than other medications. In addition to standard drugs, doctors may also administer glycerin by mouth or mannitol or acetazolamide intravenously. Surgery is almost always performed once the pressure is reduced. Surgery If medications do not control eye pressure, or if they create severe side effects, surgery may be necessary. The standard procedures are usually one of the following: Laser surgery (trabeculoplasty). This procedure partially opens the drainage area. It does not reduce pressure as much as filtering surgery (trabeculectomy) but it has fewer adverse effects. Filtration surgery (trabeculectomy). This conventional surgery procedure opens the full thickness of the drainage area.

Laser Surgery (Trabeculoplasty) Laser trabeculoplasty is used to treat open-angle glaucoma. It involves the following steps: The procedure uses a laser to burn 80 - 100 tiny holes in the drainage area. The two main types of surgery are argon laser trabeculoplasty (ALT) and selective laser trabeculloplasty (SLT). A tiny scar forms, which increases fluid outflow. The procedure is performed on an outpatient basis, takes 15 minutes, causes almost no discomfort, and has very few complications. Laser surgery is not a cure. Although it reduces intraocular pressure, patients still need to take medications every day. Within 2 - 5 years eye pressure increases and most patients require either additional surgery or new medications. Filtration Surgery (Trabeculectomy) Filtration surgery has been used for more than 100 years with only minor modifications. It uses conventional surgical techniques known as full-thickness filtering surgery or guarded filtering surgery (trabeculectomy). The surgeon creates a sclerostomy, a passage in the sclera (the white part of the eye) for draining excess eye fluid.

A flap is created that allows fluid to escape without deflating the eyeball. The surgeon may also remove a tiny piece of the iris (called an iridectomy) so that fluid can flow backward into the eye. A small bubble called a bleb nearly always forms over the opening, which is a sign that fluid is draining out. Although surgeons aim for a thick bleb, which poses less risk than a thin one for later leakage, the ideal operation would have no bleb at all. The procedure is usually performed on an outpatient basis but some patients may need to stay overnight in the hospital. For many patients, trabulectomy eliminates the need for medications. In some patients, eye pressure eventually increases again and patients may need to go back on medication or undergo a second trabeculectomy. A newer instrument called a trabectome allows for a less invasive type of trabulectomy surgery. The trabectome procedure uses an electrosurgical pulse to remove a small section of the trabecular meshwork. Side Effects. Many of the serious side effects or complications that occur with filtration surgery involve blebs (blister-like bumps). Bleb Leaks and Infections. Blebs, particularly thin ones, commonly leak.

Leakage can occur early on or sometimes as late as months or years after surgery. Untreated, leaks can be serious and even cause blindness. Surgical repair is the most effective way of managing leaking blebs, although drug therapies, pressure patching, and other nonsurgical techniques may be tried first. Due to the dangers of leaking blebs, doctors recommend lifelong monitoring after surgery. Scarring. In some cases, scars form around the incision, closing up the drainage channels and causing pressure to rebuild. Scarring is a particular problem in young patients, African-Americans, and patients who have taken multiple drugs, have had an inflammatory disease, or have had cataract surgery. Releasing the surgical stitches used in the procedure may help prevent scarring and pressure build-up. A second procedure called bleb needling can sometimes open up the scarred area and restore drainage. With this technique, the tip of a very fine hypodermic needle is used to carefully cut loose the particles closing off the drainage area. Drugs may also be used to prevent scarring. Cataracts. The procedure is highly associated with the development of cataracts over time.

Because cataracts are associated with glaucoma anyway, it is not entirely clear whether the cataracts are caused by the surgery or would develop in any case. Glaucoma affects which part of the body? Glaucoma affects which part of the body? +1 vote posted Aug 4, 2016 by Anuradha Tabyal Share this question Your comment on this question: Email me at this address if a comment is added after mine:Email me if a comment is added after mine Privacy: Your email address will only be used for sending these notifications. Anti-spam verification: To avoid this verification in future, please log in or register . 1 Answer +1 vote Glaucoma is a disease that, for the most part, affects only the eyes. Along with acute angle-closure glaucoma, also known as closed-angle glaucoma, comes severe eye pain, which result from of a rapid increase in pressure of the eye. The pain can be intense, causing nausea and vomiting. With all other types of glaucoma there is unlikely to be any other effect on the body besides the eyes and their loss of vision.

early-onset glaucoma - Genetics Home Reference early-onset glaucoma Description Glaucoma is a group of eye disorders in which the optic nerves connecting the eyes and the brain are progressively damaged. This damage can lead to reduction in side (peripheral) vision and eventual blindness. Other signs and symptoms may include bulging eyes, excessive tearing, and abnormal sensitivity to light (photophobia). The term "early-onset glaucoma" may be used when the disorder appears before the age of 40. In most people with glaucoma, the damage to the optic nerves is caused by increased pressure within the eyes (intraocular pressure). Intraocular pressure depends on a balance between fluid entering and leaving the eyes. Usually glaucoma develops in older adults, in whom the risk of developing the disorder may be affected by a variety of medical conditions including high blood pressure (hypertension) and diabetes mellitus, as well as family history. The risk of early-onset glaucoma depends mainly on heredity. Structural abnormalities that impede fluid drainage in the eye may be present at birth and usually become apparent during the first year of life.

Such abnormalities may be part of a genetic disorder that affects many body systems, called a syndrome. If glaucoma appears before the age of 5 without other associated abnormalities, it is called primary congenital glaucoma. Other individuals experience early onset of primary open-angle glaucoma, the most common adult form of glaucoma. If primary open-angle glaucoma develops during childhood or early adulthood, it is called juvenile open-angle glaucoma. Frequency Primary congenital glaucoma affects approximately 1 in 10,000 people. Its frequency is higher in the Middle East. Juvenile open-angle glaucoma affects about 1 in 50,000 people. Primary open-angle glaucoma is much more common after the age of 40, affecting about 1 percent of the population worldwide. Related Information Genetic Changes Approximately 10 percent to 33 percent of people with juvenile open-angle glaucoma have mutations in the MYOC gene. MYOC gene mutations have also been detected in some people with primary congenital glaucoma. The MYOC gene provides instructions for producing a protein called myocilin.

Myocilin is found in certain structures of the eye, called the trabecular meshwork and the ciliary body, that regulate the intraocular pressure. Researchers believe that myocilin functions together with other proteins as part of a protein complex. Mutations may alter the protein in such a way that the complex cannot be formed. Defective myocilin that is not incorporated into functional complexes may accumulate in the trabecular meshwork and ciliary body. The excess protein may prevent sufficient flow of fluid from the eye, resulting in increased intraocular pressure and causing the signs and symptoms of early-onset glaucoma. Between 20 percent and 40 percent of people with primary congenital glaucoma have mutations in the CYP1B1 gene. CYP1B1 gene mutations have also been detected in some people with juvenile open-angle glaucoma. The CYP1B1 gene provides instructions for producing a form of the cytochrome P450 protein. Like myocilin, this protein is found in the trabecular meshwork, ciliary body, and other structures of the eye.

It is not well understood how defects in the CYP1B1 protein cause signs and symptoms of glaucoma. Recent studies suggest that the defects may interfere with the early development of the trabecular meshwork. In the clear covering of the eye (the cornea ), the CYP1B1 protein may also be involved in a process that regulates the secretion of fluid inside the eye. If this fluid is produced in excess, the high intraocular pressure characteristic of glaucoma may develop. The CYP1B1 protein may interact with myocilin. Individuals with mutations in both the MYOC and CYP1B1 genes may develop glaucoma at an earlier age and have more severe symptoms than do those with mutations in only one of the genes. Mutations in other genes may also be involved in early-onset glaucoma. Inheritance Pattern Early-onset glaucoma can have different inheritance patterns. Primary congenital glaucoma is usually inherited in an autosomal recessive pattern , which means both copies of the gene in each cell have mutations. Most often, the parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but do not show signs and symptoms of the condition.

Juvenile open-angle glaucoma is inherited in an autosomal dominant pattern , which means one copy of the altered gene in each cell is sufficient to cause the disorder. In some families, primary congenital glaucoma may also be inherited in an autosomal dominant pattern. Related Information 19 Effects of Diabetes on the Body Cataracts and Glaucoma The Effects of Diabetes on the Body After you eat or drink, your body breaks down the sugars in your blood and turns it into glucose. The glucose travels through your bloodstream and provides your body with energy. To accomplish this, your pancreas needs to produce a hormone called insulin. In a person with diabetes (diabetes mellitus), the pancreas either produces too little insulin or none at all, or the insulin can’t be used effectively. This allows blood glucose levels to rise while the rest of your cells are deprived of much needed energy. This can lead to a wide variety of problems affecting nearly every part of your body. There are two main types of diabetes. Type 1, also known as juvenile diabetes or insulin-dependent diabetes, is an immune system disorder. In Type 1 diabetes, the patient’s own immune system attacks the insulin-producing cells in the pancreas, destroying the ability to manufacture insulin.

People with Type 1 diabetes must take insulin to live. Most people with Type 1 diabetes are diagnosed as children or young adults. The main problem in Type 2 diabetes is the presence of what is called insulin resistance. In this sort of diabetes, the pancreas starts off robust in its production of insulin. However, cells that need energy don’t respond normally to the usual amounts of insulin. The pancreas has to produce much higher levels of the hormone in order to manage blood glucose levels. Over time, the insulin-producing cells in the pancreas can burn themselves out due to this overproduction. At this point a person with Type 2 diabetes begins to require insulin medication. However, in earlier phases of this more common type of diabetes, the illness can be effectively managed with diet, exercise, and careful monitoring of blood sugars. Some people with Type 2 diabetes may require a variety of oral medications and eventually, as described above, some will eventually need insulin. Gestational diabetes is high blood sugar that develops during pregnancy. Most of the time, gestational diabetes can be controlled through diet and exercise, and it typically resolves after the baby is delivered. Common symptoms of diabetes include excessive thirst, frequent urination, and sluggishness.

Blood tests will reveal high sugar levels. Endocrine, Excretory, and Digestive Systems Your pancreas produces and releases insulin to help make energy out of sugars. If your pancreas produces little or no insulin, or if your body can’t use it, alternate hormones are used to turn fat into energy. This can create high levels of toxic chemicals, including acids and ketone bodies, which may lead to a condition called diabetic ketoacidosis. This is a serious complication of the disease. Symptoms include extreme thirst, excessive urination, and fatigue. Your breath may have a sweet scent that is caused by the elevated levels of ketone bodies in the blood. High blood sugar levels and excess ketones in your urine can confirm diabetic ketoacidosis. Untreated, the condition can lead to loss of consciousness or even death. Diabetes can damage your kidneys, affecting their ability to filter waste products from your blood. Elevated amounts of protein in your urine (microalbuminuria) may be a sign that your kidneys aren’t functioning properly. Kidney disease related to diabetes is called diabetic nephropathy. This condition doesn’t show symptoms until it advances to later stages.

People with diabetes should be evaluated for nephropathy in order to avoid irreversible kidney damage and kidney failure. Diabetic hyperglycemic hyperosmolar syndrome (HHS) occurs in Type 2 diabetes. It involves very high blood glucose levels but without ketones. Symptoms also include dehydration and loss of consciousness. It usually happens to people whose diabetes is undiagnosed or who have not been able to control their diabetes. It can also be caused by heart attack, stroke, or infection. High blood glucose levels can make it hard for your stomach to completely empty (gastroparesis). In turn, the delay causes blood glucose levels to rise. Diabetes is the leading cause of gastroparesis. Symptoms include nausea, vomiting, bloating, and heartburn. Circulatory System High blood glucose levels can contribute to the formation of fatty deposits in blood vessel walls. Over time, that can restrict blood flow and increase the risk of hardening of the blood vessels (atherosclerosis). Lack of blood flow can affect your hands and feet. Poor circulation can cause pain in the calves while you’re walking (intermittent claudication).

People with diabetes are particularly prone to foot problems due to narrowed blood vessels in the leg and foot. Your feet may feel cold, and you may be unable to feel heat due to lack of sensation. A condition called diabetic neuropathy causes decreased sensation in the extremities, which may prevent you from noticing an injury or infection. Diabetes increases your risk of developing infections or ulcers of the foot. Poor blood flow and nerve damage increase the likelihood of having a foot or leg amputated. If you have diabetes, it is critical that you take good care of your feet and inspect them often. Diabetes raises your risk of developing high blood pressure, putting strain on the heart. According to the National Diabetes Information Clearinghouse , people with diabetes have double the risk of heart disease or stroke than people without diabetes. Monitoring and controlling your blood glucose, blood pressure, and cholesterol can lower that risk. So can good eating habits and exercise. Diabetes and smoking are a very bad mix, increasing risk of cardiovascular problems and restricted blood flow. Integumentary System Diabetes can affect your skin. Lack of moisture can cause the skin on your feet to dry and crack. It is important to completely dry your feet after bathing or swimming.

You can use petroleum jelly or gentle creams, but be careful: creams or oils left between your toes can become so moist that it can lead to infection. High-pressure spots under your foot can lead to calluses. If you don’t take good care of them, they can become infected or develop ulcers. If you get an ulcer, see your doctor immediately to lower your risk of losing your foot. You may also be more prone to boils, infection of the hair follicles (folliculitis), sties, and infected nails. People with diabetes have a higher incidence of bacterial infections, including staph (Staphylococcus), than the general population. Moist, warm folds in the skin are susceptible to fungal or yeast infections. You’re most likely to develop this type of infection between fingers and toes, the groin, armpits, or in the corners of your mouth. Symptoms include redness, blistering, and itchiness. A condition called diabetic dermopathy can cause brown patches on the skin. There’s no cause for concern and no treatment is necessary. Eruptive xanthomatosis causes hard yellow bumps with a red ring. Digital sclerosis causes thick skin, most often on the hands or feet.

Both of these skin conditions are signs of unmanaged diabetes. They usually clear up when you get your blood sugar under control. Central Nervous System Diabetes causes damage to the nerves (peripheral neuropathy), which can affect your perception of heat, cold, and pain, making you more susceptible to injury. This also makes it more likely that you’ll ignore an injury, especially if it’s in a difficult place to see, such as between your toes, on your heels, or the bottoms of your feet. Swollen, leaky blood vessels in the eye (diabetic retinopathy) can damage your vision and even lead to blindness. Symptoms include floaters or spots in your field of vision. People with diabetes tend to develop cataracts at an earlier age than other people. They are also more likely to develop glaucoma. Symptoms of eye trouble can be mild at first, so it’s important to see your eye doctor regularly. Reproductive System The hormones of pregnancy can cause gestational diabetes. This also increases the risk of high blood pressure (preeclampsia or ecclampsia). In most cases, gestational diabetes is easily controlled, and glucose levels return to normal after the baby is born.

Symptoms are the same as other types of diabetes, but may also include repeated infections affecting the vagina and bladder. Women with gestational diabetes may have babies with higher birth weight, making delivery more complicated. Women who have had gestational diabetes should be monitored, as there’s an increased risk of developing diabetes within ten years. Recommended for You The Not-So-Sweet Facts of Diabetes Get an up-close look at the increasing impact type 2 diabetes has on everything from pregnancy to healthcare costs. Controllable risk factors – diabetes. (n.d.). Retrieved from Diabetes, heart disease, and stroke. (2014, February 19). Retrieved from Facts about diabetic retinopathy. (2012, June). Retrieved from Foot complications. (2014, May 22). Retrieved from Gastroparesis. (2012, June 15). Retrieved from High blood pressure. (2014, January 4). Retrieved from Kidney disease (Nephropathy). (2013, December 10). Retrieved from Mayo Clinic Staff. (2012, October 23). Diabetic ketoacidosis: Complications.

Retrieved from Mayo Clinic Staff. (2012, October 23). Diabetic ketoacidosis: Definition. Retrieved from Mayo Clinic Staff. (2012, October 23). Diabetic ketoacidosis: Symptoms. Retrieved from Skin complications. (2014, March 31). Retrieved from What is diabetes?. (n.d.). Retrieved from

Question: Glaucoma affects which part of the human body?
Answer: Eyes