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Glaucoma - Highlights

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of glaucoma.

Highlights:

Glaucoma

Glaucoma is one of the leading causes of blindness. While glaucoma can develop in anyone, people over age 60, who have a family history of glaucoma, or who are African-American are at especially high risk. Certain types of medical conditions, such as diabetes or extreme near-sightedness, can also increase the risk for glaucoma.

Glaucoma is actually a term used to describe several types of eye conditions that affect the optic nerve. In many cases, damage to the optic nerve is caused by increased pressure in the eye, also known as intraocular pressure (IOP).

Primary Open-Angle Glaucoma

Primary open-angle glaucoma is the most common type of glaucoma.
In primary open-angle glaucoma, poorly functioning drainage channels prevent fluid from being released from the eye at a normal rate. This in turn causes a rise in intraocular pressure.
People with primary open-angle glaucoma usually experience few or no symptoms until the later stages of the disease, when vision loss becomes apparent.

Treatment

There is no cure for glaucoma, but treatment can help reduce intraocular pressure thus preventing optic nerve damage and blindness. Glaucoma is usually treated with medications, although surgery may also be recommended for some patients.

Medication

Most glaucoma medications are usually given in the form of eye drops. Make sure your doctor or ophthalmologist explains to you the correct way to administer these drops.

A number of different medications are used to treat glaucoma. They include:

Beta-blockers, such as timolol (Timoptic, Betimol)
Prostaglandins, such as latanoprost (Xalatan)
Carbonic anhydrase inhibitors, such as dorzolamide (Trusopt) and brinzolamide (Azopt)
Adrenergic agonists, such as apraclonidine (Iopidine) and brimondidine (Alphagen)

Resources

www.glaucoma.org -- Glaucoma Research Foundation
www.nei.nih.gov -- National Eye Institute
www.glaucomafoundation.org -- The Glaucoma Foundation
www.aao.org -- American Academy of Ophthalmology
www.glaucomaweb.org -- American Glaucoma Society
www.lighthouse.org -- Lighthouse International

References

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Burr JM, Mowatt G, Hernández R, Siddiqui MA, Cook J, Lourenco T, et al. The clinical effectiveness and cost-effectiveness of screening for open angle glaucoma: a systematic review and economic evaluation. Health Technol Assess. 2007 Oct;11(41):iii-iv, ix-x, 1-190.

Chang R, Budenz DL. New developments in optical coherence tomography for glaucoma. Curr Opin Ophthalmol. 2008 Mar;19(2):127-35.

Cheng JW, Wei RL, Cai JP, Li Y. Efficacy and tolerability of nonpenetrating filtering surgery with and without implant in treatment of open angle glaucoma: a quantitative evaluation of the evidence. J Glaucoma. 2009 Mar;18(3):233-7.

Dueker DK, Singh K, Lin SC, Fechtner RD, Minckler DS, Samples JR, et al. Corneal thickness measurement in the management of primary open-angle glaucoma: a report by the American Academy of Ophthalmology. Ophthalmology. 2007 Sep;114(9):1779-87.

Gedde SJ, Schiffman JC, Feuer WJ, Herndon LW, Brandt JD, Budenz DL. Treatment outcomes in the tube versus trabeculectomy study after one year of follow-up. Am J Ophthalmol. 2007 Jan;143(1):9-22.

Hatt S, Wormald R, Burr J. Screening for prevention of optic nerve damage due to chronic open angle glaucoma. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD006129.

Hernández R, Rabindranath K, Fraser C, Vale L, Blanco AA, Burr JM; OAG Screening Project Group. Screening for open angle glaucoma: systematic review of cost-effectiveness studies. J Glaucoma. 2008 Apr-May;17(3):159-68.

Higginbotham EJ. Managing glaucoma during pregnancy. JAMA. 2006 Sep 13;296(10):1284-5.

Hodge WG, Lachaine J, Steffensen I, Murray C, Barnes D, Foerster V, et al. The efficacy and harm of prostaglandin analogues for IOP reduction in glaucoma patients compared to dorzolamide and brimonidine: a systematic review. Br J Ophthalmol. 2008 Jan;92(1):7-12.

Kwon YH, Fingert JH, Kuehn MH, Alward WL. Primary open-angle glaucoma. N Engl J Med. 2009 Mar 12;360(11):1113-24.

Lam DS, Tham CC, Lai JS, Leung DY. Current approaches to the management of acute primary angle closure. Curr Opin Ophthalmol. 2007 Mar;18(2):146-51.

Lemij HG, Reus NJ. New developments in scanning laser polarimetry for glaucoma. Curr Opin Ophthalmol. 2008 Mar;19(2):136-40.

Leske MC, Heijl A, Hyman L, Bengtsson B, Dong L, Yang Z; EMGT Group. Predictors of long-term progression in the early manifest glaucoma trial. Ophthalmology. 2007 Nov;114(11):1965-72. Epub 2007 Jul 12.

Rivera JL, Bell NP, Feldman RM. Risk factors for primary open angle glaucoma progression: what we know and what we need to know. Curr Opin Ophthalmol. 2008 Mar;19(2):102-6.

Rolim de Moura C, Paranhos A Jr, Wormald R. Laser trabeculoplasty for open angle glaucoma. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003919.

Rosenberg EA, Sperazza LC. The visually impaired patient. Am Fam Physician. 2008 May 15;77(10):1431-6.

Stewart WC, Konstas AG, Nelson LA, Kruft B. Meta-analysis of 24-hour intraocular pressure studies evaluating the efficacy of glaucoma medicines. Ophthalmology. 2008 Jul;115(7):1117-1122.e1. Epub 2008 Feb 20.

Vass C, Hirn C, Sycha T, Findl O, Bauer P, Schmetterer L. Medical interventions for primary open angle glaucoma and ocular hypertension. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003167.

Wishart MS, Dagres E. Seven-year follow-up of combined cataract extraction and viscocanalostomy. J Cataract Refract Surg. 2006 Dec;32(12):2043-9.

Reviewed last on: 6/23/2009
Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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