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USA National Eye Institute NEI USA

USA Glaucoma Foundation

Merk Manual Glaucoma

Glaucoma is one of the symptoms of Lowe Syndrome that is also a common eye problem. Glaucoma is a group of eye diseases which in most cases produce increased pressure within the eye. This elevated pressure is caused by a backup of fluid in the eye. Over time, it causes damage to the optic nerve. Early detection, diagnosis and treatment can help to preserve vision. In lowe syndrome, cataracts are normally removed from both eyes of the baby and Glaucoma may be due to complications of cataract surgery. This may be called Glaucoma following infantile lensectomy.

The fluid in the eye is called the aqueous humor. It is produced by a tiny gland, called the ciliary body, situated behind the iris. It flows between the iris and the lens and flows out through a very tiny spongy tissue, only one-fiftieth of an inch wide, called the trabecular meshwork, which serves as the drain of the eye. The trabecular meshwork is situated in the angle where the iris and cornea meet. When this drain becomes clogged, aqueous can not leave the eye as fast as it is produced, causing the fluid to back up. This causes increased pressure to build up within the eye and is called open (wide) angle glaucoma.

A specialist eye doctor is called an ophthalmologist. Pressure in the eye is measured as Intra Occular Pressure or IOP. There are three types of simple, painless tests that an eye specialist or optometrist can do.

• Look at the back of the eye using a special torch (ophthalmoscope). Damage to the optic nerve can be seen at the back of the eye.
• Measure the internal pressure of the eye (tonometry). This is done with a device that blows a small puff of air onto the eyeball.
• Measure the field of vision, by showing a sequence of spots of lights and asking which can be seen.

Treatment for glaucoma aims to lower the internal pressure of the eye and prevent any loss of vision, or any further deterioration in vision. Options include medicine given as eye drops, laser treatment and surgery.

A example eye drop treatment is Xalatan, an anti-glaucoma drug (agent) a latanoprost. Xalatan can influence the amount of fluid that the glaucomic eye would usually discharge (by increasing this amount of fluid, this drugs helps control the pressure of the patient’s eyes). The medicine’s action has proved to be helpful in the treatment of several types of glaucoma.

A laser can be used to open the holes in the trabecular meshwork. The procedure is usually quick and causes little discomfort. No general anaesthetic is required and there is no need for an overnight stay in hospital. The success of this type of treatment varies from person to person, and it may be necessary to continue using eye drops after laser treatment, though often at a lower dose.

The effectiveness of newer medications for glaucoma has reduced the amount of surgery for glaucoma. However, surgery is an option when medicines and/or laser treatment have failed to adequately lower pressure in the eye. The operation is straightforward and involves creating a tiny opening in the eye wall, which allows fluid to escape into the loose tissue under the conjunctiva (the clear membrane that covers the white of the eye).