Presentation
We describe a case of a 68-year-old man, referred by his optometrist with suspected low-tension glaucoma, who presented with advanced cupped optic discs and field of vision loss that were subsequently found to be due to a giant prolactinoma. [ncbi.nlm.nih.gov]
“Only half of the patients who present with normal-tension glaucoma will progress over a period of 5 to 7 years. This brings up the question as to whether treatment should always be started on everyone who presents with glaucoma,” he said. Dr. [healio.com]
Eyes
- Blurred Vision
These include: Changes in blood pressure Migraine headaches Blurred vision Stinging or itchy eyes We encourage you to see a specialist right away if you are experiencing the symptoms above. [willseye.org]
If you do notice any symptoms, they might include blurred vision, or seeing rainbow-coloured circles around bright lights. Both eyes are usually affected, although it may be worse in one eye. [nhs.uk]
Side-effects from some eye drops may include a stinging sensation, red eyes, blurred vision, headaches, or changes in pulse, heartbeat or breathing. [umkelloggeye.org]
You should call your doctor immediately if you begin experiencing symptoms, such as severe pain, nausea, and blurred vision. [healthline.com]
Some early symptoms may include blurred vision, halos, mild headaches or eye pain. [arleoeye.com]
Workup
[…] circulation and migraine.10 In addition, studies have suggested an association of immune-related diseases with NTG, including an increased incidence of paraproteinemia and autoantibodies.11 Clinical Evaluation The most important part of the diagnostic workup [reviewofophthalmology.com]
A detailed workup including neuroimaging may be indicated in patients with decreased central visual acuity (< 20/40), patients under 50 years of age, individuals with visual field defects that respect the vertical rather than horizontal midline, and those [glaucomatoday.com]
Workup An evaluation to determine whether a patient has NTG should be done with a thorough history-taking. [aao.org]
Corneal Thickness Measurements in Normal-tension Glaucoma Workups: Is It Worth the Effort?. J Glaucoma. 2009 Apr 15 [Epub ahead of print]. Stewart WC, Reid KK. Incidence of systemic and ocular disease that may mimic low-tension glaucoma. [emedicine.medscape.com]
Treatment
Surgery is an option if medications fail to achieve the target IOP or if the patient is non-adherent to treatment. Deep sclerectomy, laser trabeculoplasty, and filtration surgery are safe and effective options. [news-medical.net]
Nifedipine and acetazolamide treatment seemed to show no advantage over no-treatment in our patients. [ncbi.nlm.nih.gov]
Treatment to lower IOP 30% reduces the risk of disease progression by 66%, but observation without treatment may be warranted in some patients with early-stage glaucomatous optic neuropathy. [scholars.northwestern.edu]
Prognosis
No firm evidence was obtained to indicate that treatment of the low-tension glaucoma improved the prognosis of the ocular course. [ncbi.nlm.nih.gov]
• Prognosis and therapy : • According to Collaborative Normal-Tension Glaucoma Study (CNTGS) • Goal - to achieve an lOP that is as low as possible, without the development of complications. • Aggressive reduction in IOP by 30% to reduce progressive [slideshare.net]
Clinical data about the disease, such as the rate of glaucomatous visual field defect progression and risk factors for disease progression, might be helpful to clinicians to estimate prognosis and devise treatment regimens. [hindawi.com]
Blood pressure variability and cardiovascular prognosis. Many expectations but limited data. Hell J Cardiol. 2017;58:465–7. 6. [nature.com]
Etiology
If vascular disease is important in the etiology of low-tension glaucoma, then it must be localized or vasospastic since this study does not support the concept of a generalized vascular etiology, either of an atheromatous or hyperviscous nature, for [ncbi.nlm.nih.gov]
Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. [icd10coded.com]
Glaucoma Signs: Alternate Possible Explanations Misleading Ocular Conditions Etiologies that can result in visual field loss Etiologies that can predispose to glaucoma progression at normal IOPs • A large physiologic cup. [reviewofophthalmology.com]
The etiology is poorly understood, but whatever it is, the level of IOP seems to determine whether the etiologic factors will lead to glaucomatous damage or not. [ijo.in]
Epidemiology
The epidemiological features of DH were studied in 58 low-tension glaucoma patients by examining them every one to four weeks from 6 to 32 months. [ncbi.nlm.nih.gov]
Although estimates vary widely between studies, taken together, epidemiologic studies suggest that throughout the world, NTG represents perhaps 50% or more of all open-angle glaucoma. The more we look, the more we find, Dr. Park said. [eyeworld.org]
In a large epidemiologic study assessing the prevalence of glaucoma, it was found that an estimated 30 percent of patients diagnosed with OAG had NTG (3)(4), and Asian populations appear to be particularly prone to NTG; the Japanese Tajimi study cited [theophthalmologist.com]
Synthesizes a classical approach to the glaucomas-based on seven earlier editions spanning over 40 years-with the most up-to-date evidence-based and epidemiologically-derived classifications and outcomes.Coherently correlates with authoritative consensus [books.google.com]
Reviewed on 3/9/2018 References Medically reviewed by William Baer, MD; Board Certified Ophthalmology REFERENCES: "Open-angle glaucoma: Epidemiology, clinical presentation, and diagnosis" UpToDate.com "Angle-closure glaucoma" UpToDate.com [emedicinehealth.com]
Pathophysiology
Physiological and pathophysiological aspects of ocular blood flow and of microcirculation and hemorrheology will be considered and the significance of ocular vasospasm in low-tension glaucoma discussed. [ncbi.nlm.nih.gov]
Glaucoma Pathophysiology Glaucoma Causes Last Updated: Feb 4, 2019 Citations Please use one of the following formats to cite this article in your essay, paper or report: APA NM, Ratan. (2019, February 04). What is Normal-Tension Glaucoma?. [news-medical.net]
This video discusses the three main types of glaucoma—open-angle glaucoma, closed-angle glaucoma, and normal-tension glaucoma, as well as the pathophysiology, diagnosis, and treatment. [youtube.com]
Ninth Annual Meeting of the American Glaucoma Society Amelia Island, Florida, on February 18-20, 1999 by: Greg Skuta Symposium Autonomic Innervation and Microcirculation in the Eye - Implication for Glaucoma Pathophysiology, February 26-27, 1999 in Erlangen [e-igr.com]
Prevention
Can You Prevent It? Unfortunately, you can't prevent glaucoma. But blindness from the condition can often be prevented if it's diagnosed and treated early. So keep up with your regular eye exams done by an ophthalmologist. Pagination [webmd.com]
Management follows the same principle of other chronic glaucomas, to lower the IOP by a substantial amount, enough to prevent disabling visual loss. However, many NTG cases are non-progressive. [ncbi.nlm.nih.gov]
This helps lower the eye pressure and prevents further optic nerve damage and visual loss. Your doctor will discuss this possibility with you when other options are not preventing progressive damage. [huroneye.com]
However, if a case seems typical and likely to progress, initiation of treatment would be prudent in order to prevent functional vision loss. [macfarlaneoptometrist.com.au]