Glaucoma is a relatively common eye disease. It may lead to a gradual deterioration of vision, pain and serious damage to the optic nerve.


Ciliary body located in the posterior eye chamber produces intraocular fluid. The fluid flows through the pupil into the anterior chamber and it is drained out of the eye by a space between the cornea and iris. There, the fluid is absorbed into surrounding blood vessels and enters the local bloodstream. Any fault of the fluid outflow can cause increase of the intraocular pressure and this is associated with glaucoma.


The risk of glaucoma increases with advancing age and it is more common in women than in men. There many genetic factors leading to glaucoma and the disease has even some congenital forms. In addition, glaucoma occurs more frequently in diabetics and after eye injuries and intraocular infections. Intraocular pressure may be increased by a number of drugs. Particularly important is the influence of certain medications on glaucoma’s development. Such medicines causing increase of the intraocular pressure include drugs expanding the bronchial tubes (used in the treatment of COPD and asthma), drugs against Parkinson's disease and some psychiatric drugs.


High intraocular pressure causes damage to the optic nerve. The disease can occur without any acute symptom with gradual deterioration of vision, occasional appearance of flashing lights and failures of the peripheral visual field. The centre of vision stays normal for a long time but the edges of the vision field lose sharpness and the peripheral vision is further disrupted by shadows and black spots. If left untreated, the disease may eventually result in utter blindness.


Glaucoma attack is a rare and sudden condition caused by a quick increase of intraocular pressure. It manifests with pain and redness of the affected eye, impaired vision and general symptoms like nausea and vomiting. It is important to immediately consult an ophthalmologist in such case.


When glaucoma is suspected, the patient should undergo an examination by ophthalmologist, who has the ability to investigate visual acuity, peripheral vision, and – most importantly – the value of intraocular pressure. The device measuring the intraocular pressure works noninvasively by calculating the resistance of examined eye to airflow.


Regular treatment should start as soon as the disease is diagnosed. It can stop the disease progression but already developed visual disorders can not be reversed. The therapy is based on medicines decreasing the intraocular pressure (such as acetylcholinesterase inhibitors) that are administered in form of eye drops. Local therapy allows ensuring full effect with reduction of potential side effects.


When the pharmacotherapy is not sufficient enough to solve the condition, laser therapy or even eye surgical intervention is necessary to provide better ocular fluid drainage.


Jiri Stefanek, MD  Author of texts: Jiri Stefanek, MD
 Sources: basic text sources