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Glaucoma

Glaucoma is an eye disease that affects the optic nerve permanently and irreversibly (structural damage). The optic nerve is the part of the eye through which all the visual information captured by the eyes is conveyed to the brain.

Glaucoma is a very common disease that affects people of all ages. It has been estimated that up to 10% of the world population might suffer from the disease. In Canada, the number would be 250,000; worldwide, it is close to 65 million.

There are about 60 different types of glaucoma. The most common are the following:

Primary open-angle glaucoma

This form affects mainly persons who present high intraocular pressure (IOP) as a risk factor. Persons with a family history of glaucoma, African-Americans and near-sighted persons are also at risk. Aside from IOP, an eye exam often reveals little more of significance that might help determine the specific cause of glaucoma with accuracy. Consequently, this diagnosis is established after all other forms of glaucoma have been ruled out.

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Primary closed-angle glaucoma (also called “angle-closure glaucoma”)

Though common in industrialized countries, this form of glaucoma is more prevalent than open-angle glaucoma in Asian countries. Persons who suffer from this form experience gradual closure of the irido-corneal angle, which is the part of the eye where the aqueous humour drains away. Closure of this structure leads inevitably to increase IOP. If closure occurs rapidly, what we have is an acute attack of glaucoma. If closure occurs instead over several years, then we refer to it as chronic closed-angle glaucoma.

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Normal-tension glaucoma

This form of glaucoma is characterized by IOP that never exceeds normal values for a population. In general, the upper limit is 21 mm Hg. We believe that persons with this type of glaucoma are more prone to a high blood supply and vascularization of the optic nerve. Risk factors include migraine and Raynaud's phenomenon. This form is also very common in Japan.

Pseudoexfoliative glaucoma

This form of glaucoma is common worldwide and its prevalence increases with age. Patients with pseudoexfoliative glaucoma present tiny deposits on the crystalline lens. Over time, these deposits accumulate and tend to clog the trabecular meshwork. This causes IOP to rise and glaucoma ensues.

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Pigmentary glaucoma

Pigment dispersion syndrome (PDS) is a relatively prevalent condition in white populations, especially men. In this form of glaucoma, an abnormal contact occurs inside the eye between the zonules and the iris; this leads to the progressive and chronic liberation of pigment throughout the anterior segment of the eye. In more sensitive persons, IOP may rise and glaucoma may appear subsequently.

Dr. Sébastien Gagné

Dr. Sébastien Gagné

Dr. Gagné studied medicine at the Université de Sherbrooke from 1997 to 2001 and completed his specialty training in ophthalmology there in 2006.

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