1. What Is Glaucoma?
Glaucoma is a group of eye diseases causing optic nerve damage and vacancy of visual field. It often appears without symptoms, causing damage to the eyes. When left untreated, glaucoma may lead to permanent blindness.
Glaucoma can be classified into the following kinds:
  • Primary glaucoma
    • Primary closed-angle glaucoma (common in Vietnam)
      • Primary closed-angle glaucoma with pupillary block
        • Acute closed-angle glaucoma
        • Semi-acute closed angle glaucoma
        • Chronic closed angle glaucoma
      • Primary closed-angle glaucoma without pupillary block
    • Primary open-angle glaucoma
  • Secondary glaucoma
glocom disease
2. Causes of Glaucoma
  • Hereditary factor
  • Aging – those of over 50 years old are at a higher risk of glaucoma.
  • Recorded eye diseases such as complications of diabetes, eye infections such as uveitis, etc.
  • Eye injuries
  • Side effects of frequent usage of corticosteroids
  • Complications after eye surgeries
  • Race – the Southeast Asian and the Afro-Caribbean are more susceptible to different forms of glaucoma than the others.
3. Symptoms of Glaucoma
The patients with different kinds of glaucoma have different symptoms as follows:
3.1 Primary glaucoma
3.1.1 Primary closed-angle glaucoma Primary closed-angle glaucoma with pupillary block
  • Acute primary closed-angle glaucoma
Acute primary closed-angle glaucoma occurs when the intraocular pressure (IOP) rises rapidly as a result of a sudden trabecular blockage when the peripheral iris presses against the front. It presents as a sudden onset, dizzying progression, usually occurs in the late evening, after a strong emotion, the patient suddenly has eye pain, ache on the fovea, then spreads to half of the head on the same side, blurred vision, rainbow-colored halos around bright lights, fear of light with watery eyes, possibly nausea or vomiting, stomach pain, sweating, fever, etc.
  • Semi-acute primary closed-angle glaucoma
Semi-acute angle closure glaucoma is waves of the IOP increase (at medium level) caused by angle closure manifested by waves of impaired vision, halo vision, mild eye pain and headache. It appears with almost no obvious subjective symptoms. When left untreated, those symptoms may disappear.
  • Chronic primary closed-angle glaucoma
It develops slowly and there are almost no symptoms such as pain or ache at first, or it sometimes comes with mild tightness in the eye or head. Primary closed-angle glaucoma without pupillary block
Those with this kind of glaucoma often have no subjective symptoms such as pain or ache. Patients usually visit the hospital when it is in the late stage with severe damage to the optic disc and optic nerve.
how glaucoma patient see


3.1.2 Primary open-angle glaucoma

It typically comes with no obvious symptoms, except in the case of severe damage on the visual field. Hence, it is often not detected in early stages. Many patients know their condition by accident.

Most patients only feel slightly tight eyes or a slight blurred vision when working involves too much eye use, nervousness or worrying.

3.2 Secondary glaucoma: appears after disorders in the eye and body, such as glaucoma caused by injuries, uveitis, lens pathology, etc.

4. Vulnerable Subjects
  • Those of over 40 years old
  • Those with family members having glaucoma
  • Those with refractive errors: nearsightedness of over 4 diopters, early presbyopia, quickly increased presbyopia level.
  • People with systemic diseases such as high blood pressure, nocturnal hypotension, spasm in coronary disease, Raynaud’s syndrome, cerebral circulation disorder, migraine, hyperlipidemia, diabetes, thyroid disease
5. Treatment

Glaucoma treatment is carried out to stop or slow down its progression, maintain the vision and the living quality for the patients. Depending on their condition, the patients with glaucoma may be treated in various ways, including:

  • Treatment with prescription eye drops, oral medications, infusion therapy to lower the eye pressure
  • Laser treatment: Laser Peripheral Iridotomy, Peripheral Iridectomy, iris shaping by laser, Laser Trabeculoplasty, Selective Laser Trabeculoplasty, laser photocoagulation of the ciliary body.
  • Surgery: Trabeculectomy, Fistulotomy, Non penetrating deep sclerectomy, Aqueous Shunt Implantation in the Anterior Segment.
6. Developments and Complications of Glaucoma

The prognosis depends on the glaucoma conditions and stages when the patients visit the hospital for examination and treatment. If not treated promptly, the damages of the optic disc and visual field may adversely progress to irreversible blindness. If detected and treated early, with proper regimen and regular monitoring, the risk of blindness can be avoided. Treatment of glaucoma requires a long process, and the patients should follow their prescribed treatment regimen to be able to control the disease progression and avoid dangerous complications.

7. Prevention of Glaucoma
Unfortunately, there has been no way to 100% prevent glaucoma yet. Hence, an early detection and treatment and regular monitoring are very important. Subjects at high risk such as people over 40 years old should have an eye exam once a year, and those with family member(s) having glaucoma should have an eye exam every 6 months.