EYE INJURY AND GLAUCOMA

Ophthalmologist Carolina Valdivia, MD answers a question about eye injury and how it can lead to glaucoma.

A 37 year-old woman from Lagos, Nigeria writes:

Dear Dr. Valdivia:

I had an accident in one of my eyes about 28 years ago. Since then, I have not been able to see clearly out of this eye. I now have been diagnosed with elevated intraocular pressure and glaucoma in the injured eye. Can the glaucoma spread into my other eye too?

Thank you for all of the good work you are doing.

Thank you for your question and for your interest in glaucoma-eye-info.com.

Carolina Valdivia, MD A number of health problems can lead to glaucoma. When the cause is a defect within the eye itself, it is called primary glaucoma. There are two main types: primary open-angle glaucoma and primary angle-closure glaucoma.

It is called secondary glaucoma when there is an identifiable disease process, eye injury, or other problem that is causing the glaucoma, such as diabetes, cataracts, inflammation due to infection or immunological processes, and tumors. Thus, the glaucoma is secondary to another health problem.

In your case, it is likely that you have a secondary glaucoma that is at least in part the result of the eye injury that you suffered 28 years ago. There are a number of reasons why eye trauma experienced several years ago could have developed into glaucoma now. Without examining you myself, I cannot pinpoint exactly which one it might be. But generally speaking, they all relate to an obstruction in outflow of fluid inside your eye called aqueous humor.

Aqueous humor continuously is being produced in an eye structure known as the ciliary body. Eye trauma can interfere with the normal drainage process for aqueous humor, resulting in a buildup of pressure inside the eye. It is this elevated intraocular pressure that causes damage to the fibers of the optic nerve and results in glaucoma.

To answer your specific question, eye trauma experienced in one eye that leads to secondary glaucoma usually has no affect on the other eye. However, it is essential that steps are taken to control intraocular pressure in the injured eye with glaucoma, in order to prevent vision loss in that eye. This is particularly important in your case, since you report that the eye trauma itself caused some degree of vision loss. A number of glaucoma treatments are available that can manage the glaucoma in your affected eye.

Persons 40 years or older are at risk for developing glaucoma, some more than others. Because of this, I recommend that you see an ophthalmologist on a regular basis, not just to manage intraocular pressure in the affected eye, but also to measure it regularly in the other eye.

REFERENCE:

Matelis KH and Congdon N. Glaucoma. In: Kuhn F and Pieramici DJ. Ocular Trauma: Principles and Practice. New York: Thieme, 2002:169-179.

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My goal in answering your questions is to provide you with information, clear up misconceptions, and to explain options so that you can have an informed conversation with your doctor. However, under no circumstances should my response to your question be considered a substitute for ongoing consultation and examination with your doctor. Since I have not examined you, I only can speak in terms of generalities, whereas your doctor has sufficient clinical details to evaluate your case specifically.

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