Chapter 2: Diagnose It. Treat It.

Who does it affect?
Glaucoma does not discriminate. Infants, children, young adults, everyone can get it. Those who are 60 or older are more likely at risk. If someone has a family history of glaucoma, they are at a higher risk. Of course, having some type of trauma to the eyes also increases the chances as well. Other risk factors include being of African American descent and Hispanic descent, using corticosteroids, and having thicker corneas.

Diagnosis?
There are several tests used to diagnose.
Dilated eye exams in general will help to diagnose glaucoma. Visual fields test the peripheral which can indicate how far along the glaucoma is. Pachymetry measures the thickness of the cornea. Fundus photos are used to look at the optic nerve as well as the retina in detail and to see anything that can be suspicious or changing. Tonometry helps tremendously and it measures the intraocular pressure in mmHg. The two most common types used are:

Goldmann (applanation tonometry) - after putting the fluorescein  drops in the eyes, using a slip lamp and a small probe, the IOP and be measure by putting the small probe against your cornea; the force needed to flattened the cornea measures the IOP

Pneumotonometry (noncontact tonometry) - a puff of air is used to flatten the cornea which is usually distributed by a machine; this type is not the best or as accurate, but it is more ideal for children

Treatment?
Oral medications can be taken but usually, treatment for glaucoma is eye drops. The commonly used drops do one of the following: they increase the outflow of fluid, which typically lowers the pressure in the back of the eye or it reduces fluid formation so there is not of fluid trapped in the eye. It is also possible to have a surgical procedures done in order to open the angle to increase the drainage of the fluid. Types of surgery include:

Cyclophotocoagulation - the middle layer of the eye is treated with a laser, which reduces the production of fluid

Iridotomy - in the iris, a small hole is made in order to increase the outflow of fluid to prevent clogging

Trabeculoplasty - the trabecular meshwork (where the fluid is drained) is pulled open using a laser

Trabeculectomy - in order to drain the fluid, a new channel can be created









Sources:

http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/tests-diagnosis/con-20024042
http://www.webmd.com/eye-health/tonometry
http://www.webmd.com/eye-health/glaucoma-eyes?page=3#1
http://www.aoa.org/patients-and-public/eye-and-vision-problems/glossary-of-eye-and-vision-conditions/glaucoma?sso=y#2