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Glaucoma is progressive optical neuropathy , which have damage to the optic nerve thus impairing the vision . Generally , the pressure within the eyes is elevated in glaucoma which is creditworthy for the harm to theoptic nervewhich carries the impulse to the brain .
Glaucoma is of three types namely open - angle glaucoma , slant shutdown glaucoma and normotensive glaucoma . Open - angle glaucoma is insidious in onslaught and is painless whereas angle closure glaucoma is sharp in attack and present with severe pain .
Out of various causes of glaucoma , ocular hypertension that is an increment in the intraocular pressure is the most of import cause for the development of glaucoma .
There are various causes of glaucoma and various hypothesis have been put forward to explicate its etiopathogenesis . The primary risk factor for the glaucoma is increased intraocular insistence and the principal course of intervention is also focused on decrease intraocular pressure . Intraocular pressure is the force per unit area exerted by the aqueous sense of humour fluid present within the eye . Aqueous humour is produce by the ciliary summons of the ciliary body and is enfeeble into the trabeculate connection . The sedimentary humor flow from ciliary eubstance to ulterior bedchamber and from posterior chamber to the anterior chamber through the pupil . And from the prior bedchamber , it is enfeeble into trabeculate interlocking oeuvre , which drain into sinuses .
How Does Glaucoma Affect Your Vision?
Glaucoma is a reformist ocular neuropathy which leads to defective vision . The ocular field defect in the glaucoma is lasting and irreversible .
In open - angle glaucoma , step-down of the flow of Aqueous is due todegenerativeand impeding change of the trabeculate internet lead to the deflower absorption and thus resulting into raised intraocular pressure .
In angle - closure glaucoma , there is a reducing of iridocorneal angle of the middle due to advancing displacement of iris and/or subluxated lens . There occurs accretion of Aqueous in the anterior bedroom .
This consistently raised intraocular pressure have degeneration of the visual boldness head , compression of the blood vessel , reduction of trophic factors , and degeneracy of retinal ganglion cell .
Retinal Ganglion Cell Death
Retinal ganglion cell is the neuron present in the retina . The dying of these retinal ganglion cells is all-important in the pathophysiology ofglaucomatous vision loss . Retinal ganglion cell last is initiated when some pathologic even blocks the transportation of ontogenesis factors . Neurotrophins ( growth factor ) are all-important for normal functioning of the retinal ganglion cells . obstruction in the contagion of these neurotrophins from the mind to retina initiates the death cascade in these cellular phone . These cells are unable to execute normal performance in absence neurotrophins and thus undergo apoptosis .
The death of these retinal ganglion cells is associated with personnel casualty of the retinal nerve fibre . The characteristic optic disc changes and specific optic field fault are Apparent when there is a significant loss of these cells or cheek fibers .
Etiological Factors for RGC Death
Mechanical theory : raised intraocular air pressure causes mechanical stretching of the lamina contribute to axonal deformation and ischaemia , this resultant in the impaired conveyance of neurotrophins to the ganglion bed .
Vascular Insufficiency Theory
Retina and ocular disc Have mechanism of autoregulation of profligate flow . Raised intraocular pressure causes the unsuccessful person of the autoregulatory mechanism .
Vasospasm affects the vascular perfusion of optic nerve head .
Systemic hypotension due to the nighttime administration of antihypertensive drugs causes a drop in the systemic blood press which causes decrease vascular perfusion of the optic cheek question in normotensive glaucoma .
In early glaucoma , there is a gradual and imperceptible failing of the peripheral vision .
As glaucoma progression , cardinal imaginativeness may remain unclouded , but the peripheral vision starts to neglect . That is there is a going of peripheral visual sensation of the field of honor .
In the modern stages of glaucoma , there is an extensive loss of nerve fiber cells so that only a small primal orbit of visual sensation remain . Eventually with the meter damage to optic heart will lead to total blindness .
The optical field defect in the glaucoma is Irreversible because the Degenerated optical brass or nerve fibers can not be regenerated , unlike the peripheral nerve fibers . Hence , the ocular field of operations defects in glaucoma are lasting .
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