Glaucoma in seniors develops primarily due to increased pressure inside the eye, which damages the optic nerve responsible for transmitting visual information to the brain. This pressure buildup happens when the fluid inside the eye, called aqueous humor, either drains too slowly or is produced in excess. Over time, this elevated intraocular pressure harms the optic nerve fibers, leading to gradual vision loss that often starts with peripheral vision and can progress to blindness if untreated.
As people age, several changes contribute to the development of glaucoma. The drainage system of the eye, known as the trabecular meshwork, can become less efficient, causing fluid to accumulate and pressure to rise. Additionally, aging may affect the blood flow to the optic nerve and the eye’s ability to clear metabolic waste, further increasing vulnerability to damage. Other factors such as genetics, overall health conditions like diabetes or hypertension, and anatomical changes in the eye also play roles in glaucoma risk among seniors.
There are two main types of glaucoma that affect older adults:
1. **Open-angle glaucoma**: This is the most common form, where the drainage angle formed by the cornea and iris remains open, but the trabecular meshwork is partially blocked, causing a slow increase in eye pressure. It develops gradually and painlessly, often without noticeable symptoms until significant vision loss has occurred.
2. **Angle-closure glaucoma**: Less common but more acute, this occurs when the drainage angle closes suddenly, leading to a rapid rise in eye pressure. It can cause severe eye pain, redness, blurred vision, and requires immediate medical attention.
Treatment options for glaucoma in seniors aim to lower intraocular pressure to prevent or slow optic nerve damage. These include:
– **Medications**: Eye drops are the most common initial treatment. They work by either reducing the production of aqueous humor or improving its outflow. Some common classes include prostaglandin analogs, beta blockers, alpha agonists, and carbonic anhydrase inhibitors. Consistent use is critical to control pressure effectively.
– **Laser therapy**: Procedures like laser trabeculoplasty help improve drainage through the trabecular meshwork by using laser energy to open blocked channels. Laser iridotomy is used in angle-closure glaucoma to create a small hole in the iris, allowing fluid to flow more freely.
– **Surgical interventions**: When medications and laser treatments are insufficient, surgeries such as trabeculectomy or implantation of drainage devices create new pathways for fluid to exit the eye, reducing pressure. These are more invasive but can provide long-term control.
– **Lifestyle and monitoring**: Regular eye exams are essential for early detection and monitoring progression. Seniors are encouraged to manage systemic health issues like blood pressure and diabetes, avoid activities that drastically increase eye pressure, and adhere strictly to treatment regimens.
Emerging research also highlights the importance of maintaining healthy blood flow to the optic nerve and proper metabolic waste clearance in the eye, as impairments in these areas may contribute to glaucoma progression in older adults. This suggests that future treatments might also focus on protecting the optic nerve through vascular and metabolic support.
In summary, glaucoma in seniors develops due to age-related changes that impair fluid drainage and increase eye pressure, damaging the optic nerve over time. Treatments focus on lowering this pressure through medications, laser therapy, or surgery, combined with regular monitoring and management of overall health to preserve vision.