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Is Glaucoma Hereditary?

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An eye doctor using an eye dummy object to explain to a patient how glaucoma works.

Glaucoma is a group of eye conditions that damage the optic nerve. Though it mostly affects adults over 60, everyone, from infants to senior citizens, should have their eyes screened initially and then depending on an individual’s risk factors, then on a regular basis.

This is because early detection and treatment of glaucoma is the best and only way to prevent vision impairment and blindness. There are a few factors associated with this disease that put some people at a higher risk, including whether or not they have a family history of glaucoma.

What Is Glaucoma?

Glaucoma is a progressive disease that causes optic nerve damage. Your eye is constantly producing a fluid called aqueous humor. The same amount of aqueous humor should drain out as new fluid flows into your eye.

The fluid drains through a region known as the drainage angle. This process maintains stable intraocular pressure (IOP) in the eye. However, if the drainage angle isn’t working properly, caused by damage to the structures that allow aqueous humor to drain, fluid accumulates in the eye increasing the IOP.

The optic nerve is damaged as the pressure inside the eye rises. There are two drains for the aqueous humour:

Both structures are located behind the cornea and in front of the iris, near the front of the eye. 

There are many causes of glaucoma but two major types:

  • Open-angle glaucoma
  • Closed-angle glaucoma

The distinction between open-angle and closed-angle glaucoma is determined by which of the two drainage pathways is compromised.

Open-Angle Glaucoma

The most common form of the disease, chronic open-angle glaucoma, affects over 250,000 Canadians. When you first get glaucoma, you can do all of your normal daily activities, such as driving and reading because sight loss typically isn’t noticeable until irreversible vision damage has been done.

The normal drainage outflow mechanism in the eye becomes blocked in open-angle glaucoma, increasing fluid pressure inside the eye. However, some people may have normal-tension glaucoma, a type of open-angle glaucoma in which damage to the optic nerve occurs even when intraocular pressure isn’t elevated.

Some factors that increase your risk of open-angle glaucoma include:

  • Aging
  • Family history of glaucoma
  • Nearsightedness
  • High intraocular pressure
  • Low blood pressure

Open-angle glaucoma is usually asymptomatic until your optic nerve is damaged in the later stages. At this point, you can expect to encounter:

  • Blind spots in one or both of your eyes. Blind spots can appear in either your peripheral or central vision
  • Tunnel vision
  • Blindness

Closed-Angle Glaucoma

Closed-angle glaucoma occurs when an individual’s iris is very close to the drainage angle in their eye. The iris has the potential to obstruct the drainage angle, so when the drainage angle becomes completely blocked, eye pressure rapidly rises.

Closed-angle glaucoma can be classified as either acute or chronic. Acute cases are more common and occur more abruptly. Chronic closed-angle glaucoma develops gradually, making symptoms more difficult to detect. You are more likely to develop closed-angle glaucoma if you:

  • are older than 40 years of age, especially if you’re between 60 and 70 years old
  • are farsighted
  • are female
  • have a brother, sister, or parent with the disease

Acute angle-closure glaucoma develops quickly and can have serious consequences for your vision and health. You may be suffering from acute angle-closure glaucoma if you:

  • Have severe headaches
  • Experience pain in one or both eyes
  • Start feeling nauseous or vomiting
  • Get blurry vision
  • See halo effects around lights
  • Notice your eyes turning red
A close-up of a woman in the operating room during Laser Iridotomy.

How to Treat Glaucoma

Selective Laser Trabeculoplasty

Selective laser trabeculoplasty (SLT), which may be commonly used as a first-line treatment for open-angle glaucoma, can also be effective in patients who are already taking eye drops to treat their glaucoma.

Laser trabeculoplasty treats the drainage angle of the eye with a highly focused beam of light. This surgery allows fluid to flow more easily out of the front of the eye, lowering intraocular pressure.

For most eyes, improved drainage helps lower eye pressure, and the effect of a single treatment lasts 2 to 3 years, and sometimes longer. Because SLT doesn’t damage the drainage canals, it can be repeated if the first treatment was successful.

Laser Iridotomy

Another glaucoma treatment is laser iridotomy. A tiny hole is made in the iris during this procedure to allow the iris to fall away from the drainage area inside the eye. Think of this tiny hole to be like an escape valve, allowing the pressure in the front of the eye to equalize with the pressure in the back of the eye.  Laser iridotomy is used in patients with narrow drainage angles to decrease the risk of angle closure glaucoma.

Need More Information about Glaucoma Treatments?

If you have glaucoma and are interested in some of the treatments offered at Vector Eye Centre, contact our team. We can help you find an excellent treatment plan with a high quality level of care that will help you manage your glaucoma.

Written by Dr. Jamie Bhamra

Dr. Jamie Bhamra is an ophthalmologist with advanced training in cataract and corneal surgery, including refractive surgery, corneal cross-linking, external disease, ocular surface disease, and dry eye disease. He practices comprehensive ophthalmology in Calgary, Alberta.
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