Abnormal high blood ocular blood pressure
Open-angle glaucoma
Angle-closure glaucoma
Glaucoma is a serious eye disease usually caused by excessive pressure inside the eye, although it can occur with normal eye pressure as well. This damages the retinal nerve fibres, causing permanent deterioration of vision.

Glaucoma usually develops in the middle-aged or elderly and is the most common cause of blindness. Visual loss usually starts at the periphery and gradually encroaches upon central vision. Damage to the nerve fibers can begin up to six years before symptoms become noticeable, by which time the damage can be significant. While there is no known cure, glaucoma can be managed through early detection and treatment with eyedrops.

Fluid normally moves into and out of the eyeball to keep it nourished and maintain its shape. When this flow becomes blocked the intra-ocular pressure (IOP) can build and cause glaucoma. The common forms of glaucoma start painlessly and without symptoms, but the uncommon forms can produce symptoms like hazy vision, pain in the eye, headache, nausea, vomiting, rainbow halos around lights, or a sudden loss of vision in one eye. Other visual problems due to glaucoma include diminished sensitivity to contrasts, oversensitivity to light, problems with glare and a loss of ability to see fine details.

A gene has been discovered for one of the rarer forms of glaucoma.

Glaucoma is expected to afflict 60 million people by 1999. It is responsible for 20% of blindness in Pakistan and 14% and 11.6%, of blindness in both eyes in the UK and USA, respectively. In the USA, it afflicts about 3 million Americans, but nearly half are unaware they have the disease.

Glaucoma occurs most commonly in people over the age of 60. It tends to run in families. Anyone over 40, nearsighted people, diabetics, blood relatives of glaucoma patients, steroid users, smokers and people who have previously injured their eyes have the highest risk of contracting glaucoma. The incidence of glaucoma is rising as the population ages. People of African extraction are 3 to 6 times as likely as whites to develop glaucoma and the disease is the leading cause of irreversible blindness in blacks. Blacks tend to develop the disease about 10 years earlier than whites.

1. People are generally not aware of the fairly high risk of glaucoma; in the USA 3 million people have it, but half of them do not yet realize that they have a vision problem. If it is neglected too long, it can blind them. If it is diagnosed early, it can successfully be treated with medicated drops or surgery.

2. The current ophthalmic standard tests for eye pressure are not sufficient to diagnose glaucoma. It is important also to look directly at the optic nerve after pupil dilation, and a test of the person's peripheral vision is needed. It is advisable to check for glaucoma at ages 35 and 40, and then every 2 or 3 years until 60.

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(E) Emanations of other problems