Anatomical & Physiological Influences - Medical Science Assignment Help

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When I was a child I used to wonder why my grandfather had blurry eyes, not being able to see clearly, and having to use eye drops all the time. He used to be a teacher and he likes to read a lot so, I thought maybe that was the problem, but my father explained to me that it was not. His eyes were blue and I used to see something white covering the beauty of his eyes even though he wore glasses and had trouble seeing. Though he always read books and enjoyed doing his activities, as if nothing ever happened to him. Since his conditions were worsening at the time, I did not know what caused him to have these difficulties and he was still able to manage the disease until doctors recommended surgery for him to prevent the disease from progressing further. Since his conditions were worsening at the time, I didn't know what caused him to have these difficulties until I grew up, and I asked my dad, who told me my grandfather was diagnosed with glaucoma due to his father's condition.

Personal story

I remember that after my grandfather had the surgery, he was able to go back to his normal life more quickly. A few years later, I realized it might be a genetic predisposition since my uncle also removed the first layer of the white tissue covering his eyes a few years ago. After studying frequently this year, I started experiencing blurry vision and got annoyed, so I visited my eye doctor. He asked if my family had any history of certain disorders, including glaucoma, and I responded yes, so, he prescribed me an eye drop. I have been using an eye drop for a little while and so far I am fine, but sometimes when I am stressed my vision becomes blurry. I have a higher chance of getting glaucoma if my family has it, so I'm hoping for the best. Until then, I have to keep taking my two eye drops, two during the day and one at night because my eyes dry out easily and irritate me, meaning I have to wear spectacles but I don't like using them and I only do it when I feel I have to.

Anatomical & Physiological Influences:

Glaucoma is an eye disease in which the optic nerve is damaged - usually due to excessively high intraocular pressure that is known as IOP. The damage to the optic nerve results in progressive, permanent vision loss, which begins with unnoticeable blind spots in the field of vision, progressing to tunnel vision, and then to blindness. Irreversible damage to the optic nerve can result from glaucoma. The disease is one of the top causes of irreversible blindness in the United States and around the world, and it is the primary cause of blindness among African Americans and Latinos, and older adults. Diabetes is also a risk factor for glaucoma. Most people with glaucoma do not even realize that they have the disease because there are usually no symptoms early in glaucoma disease. (Cleveland Clinic.)

Cause
Glaucoma occurs when the drainage canals become clogged and the pressure in the eye increases. When this happens, the fluid builds up and damages the optic nerve. In any case, glaucoma can occur for many reasons, such as if your eyes create too much fluid. Infections, inflammatory conditions, and blunt or chemical injuries to the eye may cause glaucoma. If the fluid in the eye does not drain properly, the pressure inside the eye rises, causing damage to the optic nerve. All of these factors can cause damage to the optic nerve. Blind spots may not be noticeable until most of your optic nerve fibers have died. When these nerve fibers die, you develop blind spots in your vision. There are more than a million tiny nerve fibers in the optic nerve. When they all die, you will become blind. ( American Academy of Ophthalmology. 2021)
Symptoms
Open-angle glaucoma and angle-closure glaucoma are the two main types of glaucoma. Having high eye pressure can cause farsightedness and cataracts. In addition to open-angle glaucoma, there are other less common forms. Those with open-angle glaucoma rarely experience symptoms, but those with angle-closure glaucoma usually do. Since open-angle glaucoma is irreversible, early diagnosis is crucial to preventing blindness. The disease causes blind spots in peripheral vision, and most people do not notice any symptoms until the disease is very advanced. Angle-closure glaucoma is a disease of the eye that begins without any symptoms. But the most common symptoms are blurred vision, halos, headaches, and nausea. Patients may see halos surrounding lights and suffer from headaches. Patients may also notice sudden vision loss or halos surrounding lights. (Glaucoma. (2003,. WebMD. 

Diagnosis/Differential Diagnosis Options:

Your doctor will review your medical history and conduct a comprehensive eye examination. He or she may perform several tests, including measuring intraocular pressure (tonometry). Testing for optic nerve damage with a dilated eye examination and imaging tests. Measuring corneal thickness (pachymetry). Inspecting drainage angle (gonioscopy). Performing pachymetry and gonioscopy measurements on the cornea. ( Mayo Clinic, 2020)

Treatment

Treatment for glaucoma often begins with prescription eye drops, which can help decrease eye pressure. The first step in treatment for glaucoma is usually drug therapy that aims to reduce intraocular pressure. Eye drops will not improve the vision of lost vision, but they will prevent further damage from occurring. These eye drops are prescribed to prevent increased intraocular pressure because they contain prostaglandin analogs, Beta-blockers, alpha agonists, carbonic anhydrase inhibitors, and rho kinase inhibitors. Patients may also be prescribed combination drugs if they require more than one type of drug; an older class of drugs, cholinergic agonists (such as pilocarpine), are rarely used today due to their side effects. These drugs bind to receptors in the eye and reduce aqueous humor production by the ciliary bodies. The action of adrenaline also dilates the pupils and increases the flow of fluid through the pupil, causing the amount of fluid in the eye to decrease, thus lowering the IOP. Additionally, carbonic anhydrase inhibitors and rho kinase inhibitors reduce IOP. It does this by directly inhibiting aqueous humor production within the zonules of the ciliary bodies. ( Glaucoma Research Foundation.)When drug therapy is not effective in controlling IOP the next option would be surgical management. There are two common procedures; laser trabeculoplasty and filtering microsurgery. Laser trabeculoplasty will burn the trabecular meshwork, scarring it and causing the meshwork fibers to tighten. This will improve the outflow of aqueous humor and reduce the IOP. Filtering microsurgery will create a drainage hole in the iris between the posterior and anterior chambers. (Mayo Clinic, 2020)Glaucoma is not preventable but early detection and treatment can prevent serious damage to vision. Untreated glaucoma can lead to blindness. People who are at risk should have regular eye exams and avoid medications that are associated with glaucoma. In addition, some over-the-counter and allergy medications may increase IOP, so anyone at risk for glaucoma should closely examine the warning labels on these medications.

Personal impact

After seeing how my grandfather struggled with his vision rapidly deteriorating, I am concerned about having the same problem in the future. If my genetics are involved, I need to take action to maintain my vision early on. When the disease is discovered late, it will not be good for my vision. Because my uncle also has the same problem, he has been using eye drops and wearing glasses, and eventually, he had to have surgery to prevent his vision from worsening completely. Although I know my dad hasn't complained much about his vision, it's good to have our eyes checked every now and then since this disease didn't exhibit any early symptoms, so it can be hard to tell if we have it or not.

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