How to Prevent Glaucoma After an Eye Injury

Eye injuries are remarkably common, especially among young people, and they’re a significant cause of preventable vision loss. While most of these injuries may be minor or superficial, not requiring a hospital admission, some ocular trauma is serious — and even potentially fatal. In addition, certain types can develop into secondary glaucoma, also known as traumatic glaucoma.

Retina Specialists has five locations, in Dallas, DeSoto, Plano, Mesquite, and Waxahachie, Texas. Our team of ophthalmologists provides the expert care you need when you’ve sustained eye trauma, helping to save your eyesight and prevent the potential glaucoma that may follow. 

Here’s what you need to know about glaucoma prevention and how we can help.

Glaucoma — the basics

Glaucoma is a group of eye conditions that damage the optic nerve, which is critical for sight. The condition is one of the leading causes of lost vision in those over age 60. Usually the damage is caused by high intraocular pressure (IOP), measured at over 21 mm Hg (normal is around 14-15). 

Many forms of glaucoma produce no warning signs, and vision loss is so gradual you might not notice it until the condition reaches an advanced stage. Whatever vision you lose can’t be recovered with treatment, which is why it’s important to get regular eye exams to detect glaucoma early on.

Traumatic glaucoma is an elevated IOP that results from an injury or damage to the eye. It may result from:

• Impaired drainage, leaving elevated fluid levels
• Hyphema, a pool of blood in the anterior chamber
• Injury to and inflammation of the lens or iris

Adhesions (growths) may also form between the peripheral iris and the structures of the anterior chamber, which reduces the outflow of fluid (aqueous humor) and leads to increased IOP. This condition is called peripheral anterior synechiae (PAS). 

If any of these conditions aren’t treated promptly, the increased pressure damages the optic nerve over time, leading to vision loss.

Symptoms of traumatic glaucoma

In addition to whatever symptoms you may have from the injury itself, such as torn tissues, a broken orbit, bruising, and swelling, if you suffer an eye injury, you need to watch out for signs of traumatic glaucoma:

• Aching pain in the eye which appears soon after the injury
• Sensitivity to light
• Blurred vision (possible retinal detachment)
• Hyphema (blood collecting in the front of the eye) 
• Swelling in the eye
• Elevated eye pressure: eye canals blocked with blood and inflammatory cells

If you experience any of these, get in to see our eye doctors as soon as possible.

Treating and preventing glaucoma after an eye injury

The treatment goal for glaucoma, no matter what the form, is to lower the IOP to less than 21 mm Hg, and to do so without inadvertently damaging the optic nerve further. Treatment for injuries and traumatic glaucoma focuses on repairing any eye damage, decreasing fluid pressure, and preserving what vision remains.

In the case of traumatic glaucoma, treatment and prevention are essentially the same thing. By treating the eye immediately after an injury, you prevent the pressure from building and causing any further damage to the optic nerve. Time = vision, so if there’s any question about whether you should see an ophthalmologist or not, go!

Treatment for traumatic glaucoma involves using medications, either with or without surgery.

Medications

Your doctor may start you on a preventive course of corticosteroids and antibiotics to reduce inflammation and pressure in the eye, especially if your pressure is over 21 mm Hg.

For medications, the first class is the beta-blockers, often used for lowering high blood pressure. These drugs work by reducing the aqueous fluid entering the eye, thereby decreasing IOP.

The next class is composed of the prostaglandin analogues. These medications relax the eye muscles to facilitate fluid outflow, which reduces IOP.

The third and fourth classes are the alpha-adrenergic agonists and carbonic anhydrase inhibitors, both of which decrease the rate of aqueous humor production.

Surgery

At Retina Specialists, we always start with conservative treatments, only recommending surgery when those methods have failed, and the risk of increasing visual loss outweighs the risk of surgery. Some options include argon laser trabeculoplasty, laser procedures, and filtration surgery. 

In addition, we sometimes need to perform surgery to repair badly damaged inner-eye structures after a traumatic event. One example is repairing the retina, the light-sensitive tissue at the back of the eye that allows you to see. It can become detached during a trauma, necessitating repair to preserve your vision.

If you’ve had an eye injury, get it checked out as soon as possible, even if you don’t think there’s any damage. Give Retina Associates a call at any of our offices to schedule a consultation with one of our ophthalmologists, or book online with us today. Detecting glaucoma early may help preserve your sight.