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What is Secondary Glaucoma?

Let’s try to understand this a little better. The frontal region of the eye, between the cornea and lens, is filled with a fluid called aqueous humor. This liquid is regularly drained and produced and maintains a constant balance. The aqueous humor constantly drains out through the trabecular meshwork or the uveoscleral outflow. Blockage in either of these can cause eye pressure to increase, which in turn damages the optic nerve can be categorized as secondary glaucoma. Similar to primary glaucoma, secondary glaucoma can affect one or both eyes.

Depending on what pathway is blocked, secondary glaucoma can be categorized into secondary open-angle glaucoma or secondary angle-closure glaucoma. In the former, the trabecular meshwork resists the liquid from flowing freely whereas, in the latter, both the pathways get blocked, mostly caused by a damaged iris blocking the pathways. Both of these are caused by the angle of the iris with the cornea, depending on this either of the pathways could be blocked.

Symptoms of Secondary Glaucoma

  • Patchy blind spots in your peripheral vision
  • Severe headache
  • Pain in the eyes
  • Nausea and vomiting
  • Visible halos around lights
  • Redness of the eyes

Once these symptoms appear, immediate action should be taken as secondary glaucoma causes blindness if left untreated. Now that we know what secondary glaucoma is, let’s look into what causes secondary glaucoma to appear in the first place. 

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Secondary Glaucoma Causes

  • Usage of steroids

  • Diabetes

  • Eye injury – trauma or blow to the eye

  • Eye inflammation

  • Advanced stages of cataract



Prevention of Secondary Glaucoma

The best way to prevent secondary glaucoma is

  • By taking regular eye exams and getting your eyes checked

  • Maintain health by keeping the body active – regular exercise helps keep eye pressure in control

  • Avoid blows to the eyes by wearing protective eye gear during extreme sports

Multiple types of Secondary Glaucoma such as  

  • Exfoliative Glaucoma – caused by flakes of the outer layer of the eye which can clog the drainage system.

  • Neovascular Glaucoma – caused by abnormal growth of blood vessels in the eye, often associated with diabetes

  • Pigmentary Glaucoma – caused by the breaking away of pigments of the iris which break into the clear liquid of the eye.

  • Traumatic Glaucoma – caused due to eye injury

  • Uveitic Glaucoma – caused by the swelling of the uvea

  • Congenital Glaucoma

Diagnosis of secondary glaucoma

The diagnosis of secondary glaucoma generally includes a simple procedure which begins with a dilution of the eyes post which the optometrist will check your optic nerve for signs of glaucoma and most often takes pictures to compare during your next visit.

Other tests for secondary glaucoma include,

  • Tonometry – a test to check the pressure of the eye

  • Visual field test – a test to check your peripheral vision

  • Visual acuity test – to check vision at various distances

  • Gonioscopy – an instrument based test to check the front part of the eye

  • Ophthalmoscopy – a test to check the interior of the eye using a special instrument

Treatment of secondary glaucoma

Secondary glaucoma treatment often includes attempting to bring the eye pressure down through multiple methods. Quite often the underlying issues are also targeted to reduce their impact on the eyes. But the most common treatment options for secondary glaucoma include

  • Eye Drops

  • Oral Medication

  • Laser

  • Surgery

Each of these methods is used to ensure that the eye pressure comes down until the underlying issues such as diabetes or injuries to the eye are dealt with.

While the symptoms of secondary glaucoma appear much later, it is better to take the precaution by taking regular eye exams. Eye care specialists at Dr. Agarwal’s Eye Hospital provide the best care and complete diagnosis for Glaucoma Treatment and other Eye treatment.

Frequently Asked Questions (FAQs)

What is secondary glaucoma, and how does it differ from primary glaucoma?

Secondary glaucoma is a condition characterised by increased intraocular pressure (IOP) due to identifiable underlying causes, whereas primary glaucoma occurs without any identifiable cause. In secondary glaucoma, the elevated pressure within the eye is a result of a pre-existing condition or a complication of another eye disease, distinguishing it from primary glaucoma.

Common causes of secondary glaucoma include eye trauma, certain medications such as corticosteroids, uveitis (inflammation of the middle layer of the eye), neovascularization (abnormal formation of new blood vessels), and conditions like pigment dispersion syndrome or pseudoexfoliation syndrome.

Symptoms of secondary glaucoma may include blurred vision, severe eye pain, headache, nausea, vomiting, and halos around lights. Diagnosis typically involves a comprehensive eye examination, measurement of intraocular pressure, examination of the optic nerve, and imaging tests such as optical coherence tomography (OCT) or visual field testing.

Treatment for secondary glaucoma depends on the underlying cause and severity of the condition. It may include medications such as eye drops to lower intraocular pressure, laser therapy (laser trabeculoplasty) to improve drainage of aqueous humor, conventional surgery (trabeculectomy) to create a new drainage channel, or minimally invasive procedures like trabecular micro-bypass stents. The choice of treatment is determined by the ophthalmologist after careful evaluation of the individual case. Regular follow-up appointments are crucial to monitor the condition and adjust treatment as needed.


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