Glaucoma

By Charlie Gay
History of Glaucoma
● Term Glaucoma was used by Ancient Greeks and Romans

● Glaucoma is a series of eye diseases (not certain when first discovered)

● Richard Banister- devoted himself to eye diseases (credited with curing 24 blind people)

● Banister first to connect increased tension of eyeball and glaucoma in 1622 - given credit for initial discovery

of glaucoma

● 1850 - Von Helmholtz invented ophthalmoscope - key to diagnosing glaucoma

● 1862- Franciscus Donders discovered that pressure behind the eye caused blindness - key to how we now treat

glaucoma
Symptoms
● Two most common types of glaucoma - open angle and angle closure glaucoma

Open Angle Glaucoma - 3 million Americans:

● 90% of glaucoma cases

● Large open angle between iris and cornea
● No early warning signs
● Gradual vision loss
● Eye’s drainage canals become clogged
● Increased internal eye pressure and optic nerve damage
● Most people are not aware they have disease

Angle Closure Glaucoma:

● Angle between iris and cornea closing

● Symptoms more noticeable
● Blurred vision
● Rainbow colored circles around bright lights
● Extreme pain in eye and head with possible vomiting
● Sudden vision loss
● Damage/symptoms occur quickly - demand immediate medical attention
Cause of Glaucoma
● Not certain what genetically causes glaucoma
● Cases of variants of ABCA1 and PMM2 gene usually associated
with open angle glaucoma

- most common variant is the ABCA1 gene - involved in regulation

of cellular cholesterol and lipid metabolism

● Cases of change in the DNA sequences (near or in the genes

caveolin 1 and 2)
Diagnosis
● Important to have regular eye tests as get older
● Tonometer- measures the inner pressure of your eye
● Most patients with glaucoma have pressure exceeding 20 mmhg
● Regular glaucoma check up consists of a tonometry and ophthalmoscopy

Examining Name of Test

The shape and color of the optic nerve - see if looks Ophthalmoscopy (dilated eye exam) -
normal and normal pressure
The complete field of vision Perimetry (visual field test)

The angle in the eye where the iris meets the cornea Gonioscopy

Thickness of the cornea - tested because thickness can Pachymetry

thickness can influence pressure
Treatment
● If glaucoma is caught early can usually save vision

Eye drops- used to control eye pressure

Pills- can be taken with eye drops to lower the amount of eye fluid produced

Trabeculoplasty- laser surgery (for open angle) that alters the drainage system so fluid can pass through easier

Laser Peripheral Iridotomy- laser surgery (for closed angle) that makes an opening through the iris for fluid to flow
through

**If these treatments fail they will try traditional surgery

Identification of Glaucoma
People primarily at risk:

● African Americans - 6 to 8 times more likely

● Everyone over the age of 60 - 6 times more likely
● Hispanics and Asians
● Family history of disease - 4 to 9 times more likely

- Open angle glaucoma is an autosomal dominant trait

- Estimated 55.5 million people with open angle glaucoma in the world (.746 %)
Bioethical Considerations
● Not many ethical considerations necessary
● Only question is whether or not to treat glaucoma
● Dr. George L. Spaeth say, “Treatment should be offered only when the likelihood of
treatment making the patient worse is less than the likelihood of treatment preventing
the development or worsening of disability.
Spreadsheet
https://docs.google.com/spreadsheets/d/1CRR9TTRiTflXuXEIJs6qYHuBnUfS-
2lGSoX27ddGk-o/edit#gid=0
 Works Cited

"Early-onset Glaucoma - Genetics Home Reference." U.S. National Library of Medicine. National Institutes of Health, n.d. Web. 01

Mar. 2018.

"Facts About Glaucoma." National Eye Institute. U.S. Department of Health and Human Services, 01 Sept. 2015. Web. 01 Mar. 2018.

"Glaucoma." Wikipedia. Wikimedia Foundation, 28 Feb. 2018. Web. 01 Mar. 2018.

Grewe, R. "[The History of Glaucoma]." Klinische Monatsblatter Fur Augenheilkunde. U.S. National Library of Medicine, Feb. 1986.

Web. 01 Mar. 2018.

"Probability of Blindness From Glaucoma Has Nearly Halved." American Academy of Ophthalmology. N.p., 21 Jan. 2014. Web. 01

Mar. 2018.

"What Are the Symptoms of Glaucoma?" Glaucoma Research Foundation. N.p., n.d. Web. 01 Mar. 2018.